利用自體齒移植於口鼻相通之修補－病例報告

在門診拔牙手術中，口鼻相通的併發症常發生在拔除接近上顎竇底部的牙齒時，其發生率約為0.3~3%，位於此區域的牙齒包含上顎犬齒至第三大臼齒。當口鼻相通發生時，若洞口小於2mm，僅需保持齒槽窩內之血塊完整；若孔徑大於5mm時，則需考慮以皮瓣手術加以修補。傳統的皮瓣修補手術有頰側皮瓣、顎側皮瓣、頰側及顎側合併皮瓣或頰側脂肪皮瓣等，雖然這些皮瓣修補手術廣為口腔外科醫師信賴與採用，但其缺點是會使患處頰側前庭變淺或腭側骨頭探露疼痛。本病例報告是以自體齒移植之術式來修補口鼻相通，此方式與傳統的修補手術截然不同。患者為20歲男性，因左上第二大臼齒殘根需要拔除，拔除後發現在頰側根尖處有約5mm之口鼻相通，因同側有第三大臼齒存在，故以自體第三大臼齒移植來修補口鼻相通。術後追蹤，無感染或鼻竇問題出現，移植齒相當穩定，牙周組織健康，咬合功能良好。此術式不僅效果良好且無傳統皮瓣之缺點，更可以迅速恢復咀嚼功能，如果應用時機恰當，可提供修補口鼻相通治療的另一選擇。

關鍵字

口鼻相通；皮瓣修補手術；自體齒移植

並列摘要

In dental practice, the complications from oro-antral communication (OAC) often occur after the extraction of the maxillary teeth. The incidence is about 0.3~3%. When the diameter of OAC is smaller than 2mm, it will heal spontaneously. Once the size of OAC is larger than 5mm, a surgical intervention maybe considered. There are several conventional methods widely used for repairing OAC, such as buccal advanced flap, palatal flap, buccal and palatal combined flap and buccal fat pad flap etc. However, there are some morbidity of these flaps, e.g. the reduction of the buccal vestibule depth, denuded palatal bone and destruction of alveolar bone height. In this case report, we repaired an OAC by using tooth-autotransplantaion. The patient was a 20 year-old male. His left maxillary second molar was severely decayed and hopeless. An OAC with perforated sinus membrane (about 5mm in size) was noted at the apical area and the donor third molar was transferred to the recipient socket to repair the communication. One year after the operation, the patient's condition can be summarized as following: (1) No sinus complication was found, (2) the periodontium was healthy, and (3) the transplanted tooth functioned well in the dentition. This case shows that objectives of using autotransplanted tooth to repair OAC are to maintain the original anatomic architectures and restore the masticatory function simultaneously. So this surgery provided a good alternative to treat OAC.

並列關鍵字

oro-antral communication ； autotransplantation of the tooth

國際替代計量

利用自體齒移植於口鼻相通之修補－病例報告

全文下載

主題瀏覽