引導骨再生在巨大根尖病灶的應用─十五年病例報告

再生膜可以阻隔皮上或結締組織快速向病灶區生長，有助於骨的癒合與生成。一位31歲女性患者，於85年因牙齒#11與#12頰側腫痛至本院求診。詢問過去病史得知#11、#12與#21在78年因外傷撞擊，導致.#21牙髓壞死接受根管治療。臨床檢查， #11與#12頰側有一瘺管並於觸診時有波動感，且從顎側施壓觸診時，有膿液從頰側瘺管流出，牙髓活性測試均無反應。X光片檢查，#11與#12根尖處有一約15x9毫米平方的巨大根尖病灶，判斷此病灶為一頰顎側穿通的漏斗狀骨缺損。經根管治療後無法改善症狀，進而安排根尖手術合併利用不可吸收再生膜(GTAM)與骨粉(Osteogen) 來引導骨再生。術後半年再進行翻瓣手術取出先前放置頰顎側的再生膜，病灶區已順利癒合。13年後患者牙齒再因外傷撞擊而出現根尖病灶，#11再次接受根尖手術，手術時仍可見13年前當初病灶區的引導骨存在。此病例應用引導骨再生方式，經15年追蹤也得到相同的結果。(台灣牙周醫誌16: 185- 191, 2011)

關鍵字

引導骨再生；根尖病灶；再生膜

並列摘要

Barrier membrane can prevent epithelium cells or connective tissue from ingrowth into the bony lesion. This condition will improve the healing and formation of the bone. A 31-year-old woman visited our dental department due to the pain and swelling of the teeth #11 and #12 in 1996. According to her dental history, she had dental trauma in the past, leading to the pulpal necrosis of #21, which was then treated with root canal therapy. Her teeth #11、#12 were also affected by the trauma. A tistula was noted at buccal side of the teeth #11 . #12 and discharged exudate from the fistula while palpating on palatal side. Electric pulp testing was negative and x ray showed a 15x15mm2 through and through apical lesion. Since there were no of improvement after endodontic therapy, apical surgery combined barrier membrane(GTAM) and bone graft(Osteogen) were performed. We found the complete healing of the large bony defect following reentry for removal of the nonresorbable barrier membrane after half year. Unfortunately, she had another trauma to the same area and resulted in appearance of apical lesion of the tooth #11. Apical surgery was performed again and simultaneously we saw the guided bone of 13 years ago. We used the tchnique of guided bone regeneration 15 years ago and gained the same result now. (J Taiwan Periodontol 16: 185-191，2011)

並列關鍵字

guided bone regeneration ； apical lesion ； barrier membrane

國際替代計量

引導骨再生在巨大根尖病灶的應用─十五年病例報告

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