嚴重牙周炎患齒之齒脊保存手術與癒合帽帳釘法：病例報告

Alveolar Ridge Preservation and Healing Abutment Tenting Technique in Periodontally Compromised Teeth: A Case Report

翁心宇(Hsin-Yu Wung) ； 宋承恩(Cheng-En Sung) ； 鄭琬蒨(Wan-Chien Cheng) ； 江正陽(Cheng-Yang Chiang)

《中華民國家庭牙醫學雜誌》 14卷4期 (2020/03) Pp. 32-40

https://doi.org/10.6566/JFD.202003_14(4).0005

摘要

嚴重牙周病之患牙拔除後常面臨齒脊的嚴重缺失，以致後續進行植牙手術面臨困難。拔牙同時進行齒脊保存手術已被證實能夠有效維持齒脊體積。本案例：患者為62歲男性，拔除右側下顎第一及第二大臼齒後齒槽骨有4毫米垂直缺損，以人工骨粉與不可吸收之再生膜進行齒脊保存手術，並於8週後移除再生膜。6個月後進行植牙手術，同時以2毫米高之癒合帽作帳釘，以人工骨粉與可吸收再生膜再次進行補骨。3個月後施予牙齦移植手術，1個月後進行二階手術，並於2個月後完成植牙贗復治療。本篇病例報告於嚴重牙周炎之患牙拔除後進行齒脊保存手術，並於植牙時以癒合帽作為帳釘進行骨脊增高，取代額外的補骨手術，成功重建嚴重缺損的牙脊，恢復咬合功能。

關鍵字

齒脊保存術 ； 拔牙窩保存術 ； 帳釘

並列摘要

Teeth with severe periodontal disease often turn into horizontal and/or vertical alveolar ridge defect after extraction, so that subsequent dental implant treatment is difficult. At the same time, ridge preservation after tooth extraction has been proven to maintain tissue volume effectively. This was a 62-year-old male patient with 4 mm vertical defect at the time of extraction over first and second molars of right mandible. Ridge preservation was performed with FDBA and dPTFE membrane which was removed 8 weeks later. After 6 months, the implants were placed with 2mm height healing abutments inserted as tenting abutments, and guided bone regeneration was performed with FDBA and collagen membrane. After 3 months, a free gingival graft transplantation was performed, and prosthesis fabrication was completed after healing. This case report showed that an additional bone graft surgery was replaced with ridge preservation surgery and the healing abutment tenting technique to restore the vertical height of the ridge. This technique achieved an ideal outcome of the ridge height after 14 months of treatment.

並列關鍵字

alveolar ridge preservation ； socket preservation ； tenting