持久齒源性牙齦或皮下瘻管的治療與預後

牙齒因為牙周或牙髓組織發炎病灶，有時會造成牙齦或皮下呈現瘻管，不但不易痊癒，且易被誤診。本院牙科自民國85年至93年間收集60個疑似牙齒起源性之持久性牙齦或皮下瘻管病例，經臨床及牙科x光片診斷，再予分類及治療。第一類源自牙髓病因，有49例予以齒內治療即治癒，其中有6例屬皮下瘻管。第二類有6例，雖源自牙髓病因，但除齒內治療外，還須牙根尖切除或牙根截斷手術才痊癒。第三類為由牙髓病灶蔓延至牙周組織者，有5例，屬長期感染，除先予以牙髓治療後，還須牙周膜翻瓣手術才治癒。本研究發現，病因起源於牙髓病灶者，共有55例，占全部病例之91.2%。所有病例經一年以上追蹤，均無任何臨床不適，且不再復發。

關鍵字

皮下和牙齦瘻管；治療；預後

並列摘要

Bacterial infection may induce periodontitis or periodontal abscess, so fistulas are occasionally found in those teeth located on gingival or subcutaneous tissue. It results in treatment difficulties and misdiagnosis. Therefore, from 1985 to 1993, our hospital has collected sixty teeth with possible persisted gingival or skin sinus tract, and divided them into three categories after clinical and radiographic examination for different treatment. Forty-nine teeth were classified as class Ⅰ. These teeth originally had pulpal disease, and were cured by endodontic therapy, including 6 skin fistula cases. Six teeth were categorized as class Ⅱ. Although also had pulpal disease, the class Ⅱ teeth required root amputation or apicoectomy besides endodontic therapy to be cured. Five teeth were categorized as class Ⅲ. These teeth had pulpal lesion that gradually caused periodontal destruction after long-term infection. They required endodontic therapy plus periodontal flap surgery to be cured. Among the 60 teeth in this study, 55 originally had pulpal disease, 91.2% of total cases. Follow-up evaluation after one year revealed no recurrence of clinical symptoms in any of the patients.

並列關鍵字

skin and gingival fistula ； treatment ； prognosis

國際替代計量

持久齒源性牙齦或皮下瘻管的治療與預後

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