嚴重牙周牙髓合併病灶之牙周再生治療：完整治療病例報告

本文提出一位53歲女性廣泛性中度和局部性重度之慢性牙周炎女性患者接受牙周整體治療的病例報告，尤其患者在#37、#46區域伴有嚴重牙周牙髓合併病灶，經由非手術的根管治療、牙周第一階段的初期治療以及第二階段於病灶處施行引導組織再生手術合併骨移植手術。治療後一年追蹤全口的牙周囊袋深度皆在4毫米以內，96.4%的區域囊袋深度在3毫米以內；牙周探測出血指數由原始的42.2%降至3%，55%的牙周部位有附連獲得，放射線檢查多處手術部位骨內缺損皆有放射線骨密度增加。病患口腔衛生保持良好，整體牙周健康狀況恢復良好。本報告除了詳細介紹患者的治療過程，並進一步針對自體移植骨、DFDBA以及再生膜運用於骨內缺損及根叉侵犯之臨床效果做文獻回顧。

關鍵字

慢性牙周炎；牙周再生手術；牙周牙髓合併病灶

並列摘要

This article is a case report of a 53 year-old woman who suffered from generalized chronic periodontitis and received comprehensive periodontal treatment. In particular, the sites of teeth #37 and #46 were found to have periodontitis associated with pulpal disease and severe bony destruction. The patient received non-surgical endodontic treatment together with periodontal initial therapy. After phase I therapy, guided tissue regeneration together with bone graft therapy was performed on the severe lesions. One year after treatment, the full mouth probing depth overall had been reduced to below 4mm and 96.4% of sites had been reduced to below 3 mm. An initial 42.2% bleeding on probing had improved to 3% and 55% of the sites showed attachment level gains. Radiography was also carried out and this showed apparent bone fill affecting multiple intrabony defect and furcation involvement sites. Overall, the patient now has good oral hygiene and carries out regular maintenance. The periodontal health of the patient has improved significantly and is stable. This report also presents the treatment courses used and further reviews the current literature on the clinical efficacy of different regenerative materials including autogenous bone grafts, DFDBA and barrier membranes when they are used to treat periodontal intrabony defects and furcation involvement.

並列關鍵字

chronic periodontitis ； periodontal regenerative surgery ； perio-endo combined lesion

國際替代計量

嚴重牙周牙髓合併病灶之牙周再生治療：完整治療病例報告

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