The Treatment of Periodontal Bony Defects in Combination with Sinus Perforation: An Unusual Case Report

牙周骨缺損合併上顎竇穿孔治療：特殊病例報告

鄭辰貞(Chen-Chen Cheng) ； 呂炫堃(Hsein-Kun Lu) ； 張迺旭(Nancy Nie-Shiuh Chang)

《臺灣牙周病醫學會雜誌》 21卷4期 (2016/12) Pp. 406-417

https://doi.org/10.6121/TAP.2016.21.4.10

摘要

Augmentation of the maxillary sinus floor is a well-documented technique and many studies have examined the vertical relationship between the tooth root apex and the inferior wall of the maxillary sinus. However, very few studies have explored the horizontal relationship between the sinus and teeth. Our clinical case report describes a case involving periodontal osseous surgery where an inferior and horizontally expanded sinus was close to an angular infrabony defect of the molar teeth furcation that was covered with bulky lateral bone. After the sinus lift and guided tissue regeneration, we obtained good and stable results over the follow-up period. Osseous surgery of the posterior maxillary area should be conducted with caution and cone-beam computed tomography should be performed before periodontal surgery in order to lower the risk of sinus perforation.

關鍵字

periodontal surgery ； maxillary sinus ； sinus horizontal pneumatization ； sinus lifting

並列摘要

上顎鼻竇增高術已被廣泛且完善的文獻所支持。多數文章研究上顎後牙牙根與鼻竇的垂直相互關係，但極少的文章討論上顎後牙牙根與鼻竇的水平關係。本篇特殊病例報告，敘述對於上顎牙周垂直性骨缺損大臼齒，伴隨水平且垂直氣室化的鼻竇被其頰側膨大的皮質骨所覆蓋，進行骨手術。術中上顎竇黏膜露出，經過鼻竇增高術和牙周再生手術之後，我們得到良好且穩定的追蹤結果。針對此類病人，在上顎後牙區域的骨手術需更加謹慎，術前的斷層掃描照射，可大幅降低鼻竇穿孔的風險。

並列關鍵字

牙周手術 ； 上顎竇 ； 上顎竇水平氣室化 ； 鼻竇增高術