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  • 學位論文

牙周補綴病例報告集-拔牙後,立即置入人工牙根,以獲得齒槽骨的垂直高度,並且上下全口重建為代表

Periodontal-Prosthetic Case Reports-Represented by a case of immediate implant placement to gain the height of the alveolar bone after the extraction of the teeth and the rehabilitation of full mouth

指導教授 : 洪純正
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摘要


齒槽脊破壞嚴重的慢性牙周炎患齒,牙齒被拔除後,齒槽脊萎縮的很快,常造成以後贗復的困難,即使在這個位置作多次的骨移植和結締組織移植,要增加到原來齒槽脊高度的一半也很難,病人多次挨刀受苦,效果卻不理想,所以拔完牙,立即植入人工牙根,以獲得齒槽骨的高度,就顯得相當重要。 本病例報告的主要目的是對嚴重牙周病患者,拔完牙,立即置入人工牙根,齒槽骨高度獲得保留的評估。其結果支持如Novaes Jr和Novaes研究團隊所述,牙周發炎地區如果有適當的臨床術前術後追蹤如抗生素的使用,發炎地區有精緻的清除乾淨,植牙前齒槽脊清創徹底,初期的翻瓣手術能完全縫合,以及植體沒有暴露出來,則立即植牙並不是禁忌症,即使是對嚴重牙周病患者亦是如此。

並列摘要


The severely destroyed alveolar bone of the chronic severe periodontal teeth will atrophy even more quickly after the extraction of the teeth.This phenomenon often causes the difficulty of later prosthetics.Even if bone grafting and tissue grafting have been conducted many times at the same area,it is also hard to increase even half of the original height of alveolar bone .In order not to let patients suffer the pain from the operations and to improve the effectiveness of the operation,immediate implant placement into the socket after the extraction of the teeth to gain the height of alveolar bone is very important. The objective of the case report was to evaluate the preservation of the height of the alveolar bone after the extraction of the teeth with the chronic severe periodontal disease.The results of this report support the conclusion that periodontal infected site may be not a contraindication for immediate implant and even for severe peridontal teeth if appropriate administration of periodontal infection has performed before implant placement,as describe by Novaes Jr. and Novaes coworkers,such as antibiotic administration,meticulous cleaning,and alveolar debridement before surgery.In addition,primary flap closure is also desirable when placing immediate implants,and avoid exposure of the implant must be considered.

參考文獻


1. Nevins M. Periodontal prosthesis reconsidered. Int J Periodont Rest Dent, 6 (2): 209-217, 1993.
2. Rose LF, Rosenbrg ES, Abrams L. Periodontal and restorative considerations  in implant density: the compromised dentition. Compend Contion Educ Dent, 12 (12): 88-92, 1991.
3. Amsterdam Morton. Periodontal prosthesis: twenty-five years in retrospect.  Alpha Omegan Scientific issue, Dec 1974.
4. Glickman I, Sm,ulow JB. Alterations in the pathway of gingical inflammation  into the under lying tissues induced by excessive occlusal forces. J      Periodontol, 52: 511-517, 1981.
5. Becker W, Becker BE, Berg LE. Periodontal treatment without maintenance. A  retrospective study in 44 patients. J Periodontol, 55: 505-509, 1984.

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