牙周病整體治療病例報告

Periodontal Full Treatment Case Report

王研力(Yen-Li Wang) ； 潘惠玲(Whei-Lin Pan) ； 朱毓仁(Yuh-Ren Ju) ； 陳朝寶(Chiu-Po Chan)

《臺灣牙周病醫學會雜誌》 15卷2期 (2010/06) Pp. 123-141

摘要

本文提出一位54歲，廣泛性中重度及局部性輕度慢性牙周炎男性患者的牙周整體治療的病例報告。患者治療前多顆牙有5到8毫米之探測深度，並有嚴重骨內缺損，此外部分牙齒具有一些特別的解剖構造是局部牙周破壞的輔助因子，例如牙釉質突起，顎齦溝等。在牙周基本治療再評估後，在後牙區施行手術治療。手術區域利用可吸收再生膜合併移植骨進行牙周再生手術，或是利用牙釉基質衍生物合併移植骨輔助再生。術後一年的觀察發現：全口牙周探測深度皆在4毫米以內，牙菌斑指數由26%降至4%，探測出血指數由原先25%降至5%，牙齦民指數由1.7降至0.4，並有25%區域得到3~6毫米之附連獲得。放射線檢查可見再生手術區之骨缺損處有骨充填。患者之術後口腔衛生良好，預後也十分穩定。

關鍵字

慢性牙周炎 ； 牙周治療 ； 骨內缺損 ； 牙周再生手術 ； 牙釉基質衍生物

並列摘要

This article is a case report of a 54-year-old man who suffered from generalized moderate to severe periodontitis. The patient had generalized periodontal pocket depths ranging from 5 to 8 mm with severe intrabony defects. The presence of special anatomic structures, such as cervical enamel projections, and palatogingival grooves, were considered the secondary etiologic factors of periodontal disease. After evaluation of phase I treatment, the posterior areas were treated surgically. The surgical treatment included guided tissue regeneration using bioabsorbable membrane combined with bone grafts, or enamel matrix derivatives combined with bone grafts to enhance periodontal regeneration. Periodontal recall one year after surgery showed full mouth probing depths within 4 mm, bleeding on probing score decreased from 25% to 5%, gingival index score decreased from 1.7 to 0.4, and clinical attachment gain of 3 to 6mm in 25% of the sites. The radiographic analysis after surgery showed bone fill over surgical sites. The patient showed very good oral hygiene and had a stable prognosis.

並列關鍵字

chronic periodontitis ； periodontal treatment ； intrabony defects ； guided tissue regeneration ； enamel matrix derivatives