上顎側門牙區域以牙釉基質衍生物合併骨移植及結締組織移植進行牙周之再生手術：1年追蹤

Periodontal Regeneration of the Upper Lateral Incisor Using Enamel Matrix Derivative, a Bone Graft, and a Connective Tissue Graft: One Year Follow-Up

施佑昇(Yo-Seng Shih) ； 倪志偉(Zhi-Wei Ni) ； 邱賢忠(Hsien-Chung Chiu) ； 江正陽(Cheng-Yang Chiang) ； 傅鍔(Earl Fu) ； 沈一慶(E-Chin Shen)

《臺灣牙周病醫學會雜誌》 20卷1期 (2015/03) Pp. 48-57

https://doi.org/10.6121/TAP.2015.20.1.06

摘要

上顎前牙區為美觀區，若因為嚴重牙周病造成之牙齦及齒槽骨喪失，甚至嚴重至需要拔除，勢必會對美觀造成不小的影響。在前牙區牙周嚴重破壞時，如果能做些牙周再生的嘗試，以達到預期中的維持，也許就能避免遭受拔除的命運。本病例之側門牙，在遠心側有牙周嚴重破壞且造成正頰側牙齦萎縮及角化牙齦不足，利用牙釉基質衍生物合併骨移植，以及結締組織移植，以期能達到牙周組織再生和增加頰側角化牙齦寬度的目的。本病例在治療一年後的追蹤，角化牙齦有增加，且臨床附連組織高度、牙周囊袋探測深度和骨缺損程度都有下降。

關鍵字

牙根覆蓋術 ； 牙周再生 ； 牙釉基質衍生物 ； 結締組織移植

並列摘要

The maxillary anterior region, also known as the aesthetic zone, is where the teeth and their supporting structures are readily visible. Therefore, it is a tragedy if any tooth in this area has to be extracted due to severe periodontal breakdown. Rather than the use of tooth extraction, we should treat the periodontal problems and save the teeth using regeneration techniques to maintain the health of the periodontal tissues and allow ease of cleaning. In this case, the periodontal tissues around the upper lateral incisor had undergone severe destruction on the distal side, with buccal gingival recession and insufficient keratinized gingiva. We treated these defects using an enamel matrix derivative mixed with a bone graft and combined them with a connective tissue graft. This was in order to achieve periodontal regeneration and to increase the width of the keratinized gingiva tissue. Our results showed an increase in keratinized gingiva tissue, a decrease in the clinical attachment level, a decrease in the probing depth, and the reduced presence of bony defects at 1 year post-treatment.

並列關鍵字

root coverage ； periodontal regeneration ； enamel matrix derivative ； connective tissue graft