傳統牙周治療合併全身性抗生素於廣泛型侵犯性牙周炎：病例報告

Adjunctive Use of Systemic Antibiotics and Conventional Periodontal Therapy on Generalized Aggressive Periodontitis: A Case Report

林卓瑩(Cho-Ying Lin) ； 潘惠玲(Whei-Lin Pan) ； 呂佳芳(Chia-Fang Lu) ； 朱毓仁(Yuh-Ren Ju) ； 陳朝寶(Chiu-Po Chan)

《臺灣牙周病醫學會雜誌》 20卷3期 (2015/09) Pp. 227-244

https://doi.org/10.6121/TAP.2015.20.3.08

摘要

侵犯性牙周炎為一快速牙周附連和骨喪失的牙周病變，而其嚴重破壞程度與牙菌斑分布的情形並不相符，病患臨床上通常無系統性疾病，有明顯家族群集性（familial aggregation），此外也和特定菌種的存在有顯著相關性。目前合併物理性清創和全身性抗生素的治療原則已證實可顯著改善臨床數值，且對特定菌種有較長期穩定的抑制效果。廣泛型侵犯性牙周炎病患於病理性移位和植牙評估等，均為臨床治療上的重要考量。本病例為一位24歲的廣泛型侵犯性牙周炎病患，經過牙周基礎治療合併全身性抗生素給予、牙周翻瓣手術合併充填移植骨及引導組織再生手術，於牙周治療穩定後進行26 牙位的二階段植牙手術及鼻竇增高術，而術後一年假牙製作亦已完成，追蹤顯示牙周狀況及咬合功能均有顯著改善。（臺灣牙周醫誌，20(3):227-244, 2015）

關鍵字

廣泛型侵犯性牙周炎 ； 病理性移位 ； 全身性抗生素 ； 人工植牙

並列摘要

Aggressive periodontitis (AgP) was regarded as a periodontal disease with rapid periodontal attachment loss and bony destruction, yet the severity of the tissue breakdown was not consistent with the distribution of plaque. Generalized AgP (GAgP) often presents with generalized involvement affecting at least 3 permanent teeth other than first molars and incisors. Besides rapid and severe periodontal destruction, AgP also has a significant relationship with specific microbial pathogens. The treatment protocol of mechanical debridement with combined systemic antibiotics has been shown to improve the clinical parameters as well as better efficacy in inhibition to specific pathogens. Additionally, pathologic tooth migration and implant evaluation in GAgP patients are important issues of clinical treatment. A 24 year-old female with GagP received phase I periodontal treatment combined with adjunctive systemic antibiotics, guided- tissue regenerative surgery and bone grafting. Implant surgery and sinus lifting were subsequently performed when periodontal condition was stable. In oneyear follow-up, crown restoration was completed, periodontal condition and occlusal function both showed significant improvements. (J Taiwan Periodtontol, 20(3):227-244, 2015)

並列關鍵字

generalized aggressive periodontitis ； pathologic tooth migration ； systemic antibiotics ； dental implant