- 期刊
Deformed Ridge Reconstruction Combining Tenting Screws and Guided Bone Regeneration before Implant Surgery-A Case Report
利用骨釘合併骨引導再生於植牙前重建嚴重骨缺失－病例報告
摘要
此病例報告的目的為提供一種利用骨釘及引導骨再生於植牙前重建因牙周病造成的嚴重骨缺失，相較於自體骨移植為簡易且更具效率。四十五歲男性其右上第二大臼齒，右下第一及第二大臼齒因嚴重牙周病而拔除。經評估後，建議病人於植牙前利用骨釘，人工合成骨粉及可吸收再生膜於缺牙區進行缺失骨嵴的保留及重建。術後七個月，於重建之齒槽骨植入植體。追蹤八個月後進行二階段手術及進一步的植牙贋復。此病例報告之術式之原理為將骨釘延伸至高於骨嵴幾個毫米的位置可提供再生膜實質上的結構支持避免塌陷。藉此方式，於右上第二大臼齒缺牙區獲得4毫米垂直骨嵴增加，於右下第一及第二大臼齒缺牙區獲得4至8毫米垂直骨嵴增加。根據此病例報告骨釘及引導骨再生能有效地重建嚴重缺失之齒槽骨，以利植體之植入。
並列摘要
The purpose of this case report is to demonstrate a more effective and easier method, which combines tenting screws and guided bone regeneration (GBR), for the reconstruction of severely deformed bone before implant placement. A forty-five-year-old male lost his right maxillary 2nd molar, right mandibular 1st and 2nd molars due to advanced periodontitis. After extracting the hopeless teeth, the patient was suggested to receive GBR surgery by using screws, particulate alloplast bone graft and resorbable membranes to reconstruct the deformed ridge. Seven months after the surgery, implants were placed in the reconstructed edentulous areas. Second stage surgery and further prostheses reconstructions were finished after eight months. In this case, we used screws extending beyond the ridge for a few millimeters to provide an actual support to the membrane and avoid its collapse. By using this technique, a 4 mm of bone gain in height was noted over the right maxillary 2nd molar area, and a 4 to 8 mm of bone gain in height was noted over the right mandibular 1st and 2nd molars area. In conclusion, a combination of tenting screws and guided bone regeneration is a promising stratsgy to reconstruct severely deformed alveolar ridge before implant placement.
延伸閱讀
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- 胡愷芳、周郁翔、何坤炎、吳逸民、蔡吉政、何雅萍（2010）。應用引導組織再生術於骨內缺損治療－病例報告。臺灣牙周病醫學會雜誌，15(4)，269-283。https://www.airitilibrary.com/Article/Detail?DocID=10279962-201012-201103110028-201103110028-269-283