摘要
牙周破壞不只會造成牙周和骨喪失，進而造成牙齒位移、搖動，患者往往有咀嚼酸軟無力的困擾。本文提出一慢性牙周炎合併下顎左側後牙區病理性牙齒位移的牙周整體治療病例，治療前有廣泛性牙齦發炎，口內有5 到7毫米之牙周囊袋探測深度，經過牙周基本治療及牙周手術治療包括在後牙區骨內缺損中，分別使用去礦化冷凍異體移植骨、去礦化冷凍異體移植骨合併使用膠原蛋白可吸收再生膜及隧道穿通術。治療後一年的臨床結果顯示下顎左側後牙區經牙周手術治療後，原先1毫米的牙齒間隙已自動閉合，後牙區骨缺損中均有放射線骨充填，99% 以上的全口牙周探測深度改善至3毫米以內。本報告除了詳細介紹患者的治療過程，並進一步針對病理性牙齒位移、去礦化冷凍異體移植骨應用於骨內缺損及根叉侵犯的缺損的臨床效果及隧道穿通術的存活率做文獻回顧。（台灣牙周醫誌17: 45-63, 2012）
並列摘要
Periodontal destruction not only causes the periodontal and bone loss, but also may result in tooth displacement and tooth mobility. It usually affected patient's chewing function. This article presents a chronic periodontitis patient who was bothered about pathological tooth migration over mandibular posterior region. Before periodontal treatment, she had generalized gingival inflammation, and periodontal pocket probing depth ranged from 5 to 7 mm at multiple sites of dentition. The intrabony defects with demineralized freeze-dried bone allografts, combination therapy with demineralized freeze-dried bone allografts and collagen membrane as well as tunneling procedure. Space of mandibular pathologically tooth migration was spontaneous closed completely after surgical periodontal treatment. Clinical improvement with bone fill over bony defect areas and probing depth of 99% tooth sites reduced below 3 mm was demonstrated one year following periodontal therapy. This paper will present the treatment courses and review the current literatures to introduce treatment of pathological tooth migration, comparing the clinical efficacy of different material s including demineralized freeze-dried bone allografts or barrier membranes and survival rate of tunneling procedure. (J Taiwan Periodontol 17: 45-63, 2012)
延伸閱讀
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- 王華寧、賴玉玲、凌莉珍（2003）。牙周病整體治療病例報告。中華民國牙周病醫學會雜誌，8(2)，91-104。https://www.airitilibrary.com/Article/Detail?DocID=10279962-200306-8-2-91-104-a
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- 程季芳、賴玉玲（2005）。牙周病整體治療病例報告。中華民國牙周病醫學會雜誌，10(2)，95-110。https://www.airitilibrary.com/Article/Detail?DocID=10279962-200506-10-2-95-110-a
- 周宏安、賴玉玲、陳恆理、謝依蓁、林怡君（2007）。Periodontal Full Treatment Case Report and Literature Review。中華民國牙周病醫學會雜誌，12(1)，35-51。https://www.airitilibrary.com/Article/Detail?DocID=10279962-200703-12-1-35-51-a