牙根切除術：保存上顎臼齒的另類選擇

根叉病變是臨床牙周治療的一大挑戰。罹患根叉病變的牙齒通常治療難度較高，且預後較差。國人牙根解剖結構上，齒頸牙釉質突起（cervical enamel projection）的情形比白種人更常見。與齒頸牙釉質突起有關的牙周根叉病變，在臨床治療上更為棘手。根叉病變的治療方式包括非手術性治療、根叉封填，或手術治療。根叉病變的主要治療目標是在徹底去除病因，或利用再生技術以恢復牙齒的健康、舒適、功能，並防止疾病復發。各種術式中，最難處理的是如何將病因完全去除並重建良好的牙根形態，以利菌斑控制。牙根切除術在牙科治療的應用已有上百年的歷史，只要病例選擇得當，特殊情況下不失為促進病因去除，保存牙齒重要的方法。本文將針對上顎牙根切除術的定義、適應症與禁忌症、長期療效評估、與其他療法的比較做文獻回顧，並附上病例報告說明治療方式及臨床應注意事項。

關鍵字

牙根切除術；上顎臼齒；根叉病變

並列摘要

Management of furcation invasion is a great challenge in periodontics. Teeth with furcation invasion are more difficult to treat and have less favorable prognosis. The prevalence of cervical enamel projection on molar root is more common in Chinese than in Caucasian population. Cervical enamel projection in teeth with furcation involvement makes the thorough debridement of this area more difficult. Non-surgical therapy, furcation restoration, and surgical therapy have been utilized to treat molars with furcation invasions. The goals of treatment are to eliminate etiological factors, to regenerate the lost periodontal tissues in the furcation areas, to provide patients with health, comfort, and function, and to prevent disease recurrence. For most treatment modalities, complete removing and controlling etiological factors appeared to be an impossible mission. Root resection technique had been controlling etiological factors appeared to be an impossible mission. Root resection technique had been applied in dentistry for over a century. With appropriate case selection, root resection may promote elimination of local factors and preservation of molars with furcation involvements under good indications. The purpose of this paper was to review the definition of root resection therapy, and long-term results achieved with other treatment modalities. Three case reports were presented to elaborate the clinical procedures and considerations in performing upper molar root resection.

並列關鍵字

root resection ； maxillary molars ； furcation invasion

國際替代計量

牙根切除術：保存上顎臼齒的另類選擇

未授權

主題瀏覽