治療多區牙齦退縮－病例報告

Treatment of Gingival Recession in Multiple Sites: A Case Report

尹慧君(Huei-Jyun Yin)

《北市醫學雜誌》 18卷4期 (2021/12) Pp. 475-482

https://doi.org/10.6200/TCMJ.202112_18(4).0010

摘要

牙齦退縮是臨床上常見的問題，而裸露的牙根不僅有美觀問題，還會造成敏感，露出的齒頸部會有磨耗或是齲齒的可能。造成牙齦退縮的原因常常是不當的使用牙刷與刷牙方式或是邊緣軟組織偏薄，其他如：牙根較外突，牙齒錯位，繫帶位置干擾，牙周病治療後或是矯正治療後之副作用。臨床上治療的手術方式包括皮下結締組織移植、游離牙齦移植、蒂狀瓣、引導組織再生手術、牙釉基質衍生物、富含血小板血漿與富含血小板纖維素、無細胞皮膚間質等。其中又以皮下結締組織移植術能有較佳的牙根覆蓋成效。本病例報告為一70歲女性，因不當的刷牙方式導致多處牙齦退縮且敏感，因此採取皮下結締組織移植手術修補並調整刷牙方式。術後一年半，牙齦邊緣高度維持穩定，也不再有敏感問題。

關鍵字

牙齦退縮 ； 牙根覆蓋 ； 隧道穿通皮瓣術 ； 皮下結締組織移植術

並列摘要

Gingival recession is a common clinical problem. The exposed roots cause sensitivity and aesthetic problems, and the cervical part of an exposed tooth may be worn or develop caries. The reasons for gingival recession are often the improper use of toothbrushes and brushing methods or because of the thin soft tissues at the gingival margin. Other reasons include protruding roots, mal-position of teeth, interference with frenum position, periodontal disease treatment, and side effects after orthodontic treatment. The surgical treatments for gingival recession include subepithelial connective tissue graft, free gingival graft, pedicle flap, guided tissue regeneration, enamel matrix derivatives, platelet-rich plasma and fibrin, acellular dermal matrix, etc. Among them, subepithelial connective tissue graft can achieve better root coverage. This case is a 70-year-old woman. Multiple gingival recession sites emerged and were sensitive due to improper brushing. Therefore, a subepithelial connective tissue graft was used, and her brushing method was adjusted. One and a half years after the treatment, the height of the gingival margin remained stable, and there was no longer any sensitivity problem.

並列關鍵字

gingival recession ； root coverage ； tunneling technique ； subepithelial connective tissue graft