骨內缺損之牙周與矯正協同治療：文獻回顧與病例報告

Interdisciplinary Treatment of Periodontal and Orthodontic Therapy in Intrabony Defect: Literature Review and Case Report

林妍華(Yen-Hua Lin) ； 呂炫堃(Hsein-Kun Lu) ； 楊瑞賢(Ruei-Sian Yang) ； 楊岳炤(Yueh-Chao Yang)

《臺灣牙周病醫學會雜誌》 19卷4期 (2014/12) Pp. 317-333

https://doi.org/10.6121/TAP.2014.19.4.05

摘要

臨床上常見有需要牙周合併矯正治療的患者，但是關於矯正介入的時間點，目前沒有一致性的看法，本文回顧了牙周和矯正協同治療的臨床研究，歸納了包括牙周病患接受矯正治療時的注意事項、矯正對於牙周組織的影響、骨充填材料和矯正時牙齒移動速度的關係等，並提出一實際病例作參考。整體而言，建議先在牙周骨內缺損區進行牙周再生手術，恢復附連組織，讓牙周狀況更適於後續的矯正治療。本病例在牙周再生手術後3個月進行矯正介入，於術後14個月的追蹤中獲得3.25mm的牙周附連，顯示矯正對於新生的牙周組織沒有負面影響，這結果可提供臨床治療的參考。

關鍵字

骨內缺損 ； 移植骨 ； 牙周再生手術 ； 矯正治療

並列摘要

Patients with periodontitis often need combined treatment with orthodontic therapy. However, the time for carrying out orthodontic intervention is still not well defined. This article reviews the key points related to the interdisciplinary treatment of periodontal and orthodontic therapy, including the characteristics of the periodontitis patients receiving orthodontic tooth movement, the influence of orthodontic force upon periodontal tissue, whether orthodontic treatment can be performed immediately after regeneration therapy, the impact of bone graft material on the rate of tooth movement, and other factors. In addition, a clinical case is outlined for discussion. The results of the literature review show that periodontal regeneration should be performed before orthodontic therapy, especially when the site has a intrabony defect. After periodontal attachment has been reconstructed, the periodontal status is more favorable for orthodontic therapy. In our case, orthodontic treatment took place after 3 months of regeneration surgery. An attachment level gain of 3.25 mm was found at 14 months post-surgical follow up. This review shows that orthodontic treatment has no detrimental effect on the newly regenerated tissue. Our clinical results offer a treatment option for multidiscipline decision making.

並列關鍵字

intrabony defect ； bone graft ； periodontal regeneration ； orthodontic treatment