The Use of a Customized Acrylic Resin Stent to Stabilize a Free Gingival Autograft within the Distobuccal Area of a Mandibular Second Molar with High Degree of Muscle Attachment

使用客製化的壓克力樹脂導板固定高位肌肉附著之下顎第二大臼齒遠心頰側區的游離牙齦自體移植體－病例報告

王淵民(Yuan-Min Wang) ； 朱毓仁(Yuh-Ren Ju) ； 吳佩儒(Tina Wu) ； 潘惠玲(Whei-Lin Pan) ； 陳朝寶(Chiu-Po Chan)

《臺灣牙周病醫學會雜誌》 20卷2期 (2015/06) Pp. 140-146

https://doi.org/10.6121/TAP.2015.20.2.07

摘要

不適當的高位肌肉附著之下顎第二大臼齒遠心頰側區，往往是因為第三大臼齒拔除後使用不當縫合方式所導致的結果，這可能會增加之後牙周手術的困難度，例如牙周再生術、牙冠增長術等。如何去修正高位肌肉附著並同時舒展肌肉纖維一直是大多數臨床牙醫師面臨的挑戰。即使以往有很多術式被提出於改善這類軟組織的問題，然而並沒有任何一個術式可以滿足臨床各種狀況。在這個病例報告中，我們提出了一個設計簡單、低成本、有效的裝置來固定下顎後臼齒區的游離牙齦自體移植體，以維持適當空間來增加前庭深度。在術後一年的追蹤，仍有令人滿意的結果。下顎第二大臼齒遠心頰側區的前庭不僅加深了7毫米，同時也增加了角化牙齦。這項新技術應能幫助解決臨床角化牙齦不足和前庭深度過淺等問題。

關鍵字

壓克力樹脂導板 ； 游離牙齦自體移植體 ； 高位肌肉附著 ； 前庭深度過淺

並列摘要

An unfavorably high degree of muscle attachment in the distobuccal area of a mandibular second molar usually results from an inappropriate suture method after third molar extraction. This may lead to interference during subsequent periodontal surgery, such as guided tissue regeneration and crown lengthening procedures. How to correct such muscle attachment and bring about the release muscle fibers simultaneously is always a challenge for dentists. A number of methods have been proposed to improve such soft tissue morphology, but no method satisfies all clinical conditions. In this case report, a simple, low-cost and effective device to stabilize a free gingival autograft and bring about space maintenance by increasing vestibular depth was introduced. A clinical case is presented in which a satisfactory treatment outcome was achieved based on one year of follow-up. The vestibule on the distobuccal area of a mandibular second molar was increased by 7 mm in width and the keratinized gingiva was also increased. This new innovation may help to solve problems that are associated with inadequate keratinized gingiva and vestibular depth.

並列關鍵字

acrylic resin stent ； free gingival graft ； high muscle attachment ； shallow vestibular depth