牙周病整體治療病例報告及文獻回顧

Periodontal Full Treatment Case Report & Literature Reviews

何鳳娟(Feng-Chuan Ho) ； 林怡君(Yi-Chun Lin) ； 陳恆理(Hen-Li Chen) ； 陳柏堅(Bor-Jian Chen) ； 賴玉玲(Yu-Lin Lai)

《中華民國牙周病醫學會雜誌》 12卷1期 (2007/03) Pp. 13-33

摘要

本文是一位合併有贗復體重建問題的慢性牙周炎患者之病例報告，患者口內多顆牙皆有臨時贗復體，其中部分牙齒臨床牙冠不足，上顎前牙臨時贗復體顯現美觀條件不佳，下顎缺失多顆後牙導致咀嚼功能不良。在牙周檢查方面，上顎兩側後牙區有5~8毫米之牙周探測深度。本病例整體牙科治療包括牙周、根管、矯正、植牙、贗復治療。首先進行牙周治療，並安排有牙髓問題的牙齒接受根管治療，接著進行上顎矯正治療，於嬌正期間著手下顎植牙手術，矯正完成後藉由牙周整形手術改善不協調之牙齦緣，最復製作永久假牙並安排定期牙周維持治療。結果評估顯示牙周探測深度皆峰至4毫米以內，32%的區域有1~5毫米之附連獲得，同時改善病息咀嚼功能，並達成前牙美觀的治療結果。

關鍵字

慢性牙周炎 ； 牙周治療 ； 強逼萌出 ； 牙冠增長術 ； 牙嵴增進術 ； 種植體

並列摘要

This article is a case report of a patient with chronic periodontitis and existing restoration problems. Patient came with multiple teeth with temporary restoration. The upper temporary prosthesis demonstrated the compromised esthetics. The periodontal examination revealed that there was 5~8 mm probing depth over the maxillary molar area. A compressive therapy with multidisciplinary approach consisting periodontic, endodontic, orthodontic, implant and prosthetic therapy was delivered for this patient. The treatment sequences included periodontal and endodontic treatment initially. Then, the patient received orthodontic treatment of maxillary teeth for the space redistribution and tooth alignment. In the meantime, the implant placement over mandibular posterior area was scheduled, The periodontal plastic surgery for correction of uneven gingival contour of maxillary esthetic regions was performed following tooth leveling. A final prosthesis was completed with periodical periodontal maintenance. One-year postoperative follow up revealed that the overall probing depth was within 4mm and 32% of periodontally involved teeth had 1~5mm attachment gain. The patient's chewing function was improved and an esthetic result was achieved.

並列關鍵字

chronic periodontitis ； periodontal treatment ； forced eruption ； crown lengthening procedure ； soft tissue augmentation ； dental implants