摘要
病例為一個11歲男孩沒有系統性疾病及長期服用任何藥物，病人於五歲就診主述前牙區及臼齒區有明顯牙齦增生。切片報告顯示有牙齦增生包含增厚且粗的結締組織纖維病變，包含了纖維母細胞及巨細胞，其上表皮有角質增生、棘層增厚及網脊增長。其母親及遠房舅舅同樣有牙齦增生的狀況。追蹤過程發現病人同時有多生牙及齒源性囊腫，並於全身麻醉下進行齒切除術及造袋術。因多處牙齒異位性萌發及骨性第二類咬合合併深咬，建議早期使用功能性咬合誘導裝置治療。待生長發育穩定後，全口矯正治療配合全口牙齦修整術將列為治療考量。遺傳性牙齦增生容易復發且與口腔衛生有關係，現今介入全口牙周處理的時間點仍是一個爭議。但病人需於全口矯正之前進行第一次全口牙周整形，其終身都有可能需要牙周手術的整形。發現病人同時有多生牙及齒源性囊腫，並於全身麻醉下進行齒切除術及造袋術。因多處牙齒異位性萌發及骨性第二類咬合合併深咬，建議早期使用功能性咬合誘導裝置治療。待生長發育穩定後，全口矯正治療配合全口牙齦修整術將列為治療考量。遺傳性牙齦增生容易復發且與口腔衛生有關係，現今介入全口牙周處理的時間點仍是一個爭議。但病人需於全口矯正之前進行第一次全口牙周整形，其終身都有可能需要牙周手術的整形。
並列摘要
This case report is an 11 years old boy with slowly progressive gingival enlargement, supernumerary tooth and dentigerous cyst. The case report addresses oral diagnosis of hereditary gingival hyperplasia (HGF) and management of supernumerary tooth and dentigerous cyst. Gingival tissues surrounding both the maxillary and the mandibular dentition are affected. His mother and distant uncle of his mother also reveal gingival overgrowth. Microscopically, biopsy shows gingival hyperplasia composed of dense proliferative fibrous connective tissue and reactive fibroblasts and giant cells. The overlying epithelium reveals hyperplasia with hyperkeratosis, acanthosis and elongated rete ridges. Surgical removal supernumerary tooth was performed. Marsupialization was done and the size of lesion was. It is recommended that the patients with this condition should be on closely follow up due to the difficulty of oral hygiene maintenance. Due to several ectopic erupting teeth, deep bite and skeletal class II malocclusion with high mandibular angle, the orthopedic treatment proceeded for occlusion guidance. The fall mouth periodontal treatment is also needed. While clinicians disagree on the modalities and timing of treatment for HGF, the clinical condition generally requires repeated periodontal surgical procedures of resection over the patient's lifetime.
延伸閱讀
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