摘要
目的:探讨侵袭性牙周炎患者经口腔多学科联合治疗后的临床修复效果,阐述多学科联合治疗对口腔功能恢复的重要意义。方法:收集1例重度侵袭性牙周炎导致牙松动和脱落患者的临床资料,经过牙周科、正畸科、种植科和修复科多学科联合治疗,观察患者探诊出血(BOP)、探诊深度(PD)、附着丧失(AL)和种植体骨结合指标,以确定其临床修复效果;同时进行文献复习。结果:患者,女性,于2016年1月自觉下颌前后牙开始松动不适,近期松动加重,不敢咬硬物。临床检查患者口腔卫生状况差,31、35、36、37和41牙龈暗红,BOP(+),PD为5~7 mm,AL为3~5 mm,且达到松动Ⅲ°。临床诊断为重度侵袭性牙周炎。首先进行牙周治疗,消除炎症,炎症明显消除后,对Ⅲ°松动的患牙进行拔除。为了关闭上前牙间隙,开拓下前牙,预留出种植空间,对患者进行正畸治疗,最后采用引导骨再生(GBR)技术修复骨缺损,待牙周软硬组织生长良好,牙槽嵴丰满,行种植修复;治疗过程中,严格控制菌斑,恢复患者的咀嚼功能,达到患者预期的美学效果。种植修复治疗完成1年后复诊,患者口腔卫生状况良好,种植体位置稳固,影像学检查显示种植体周围骨无丧失,牙龈粉红,无明显炎症。结论:侵袭性牙周炎患者经过牙周科、正畸科、种植科和修复科多学科联合治疗,不仅能恢复患者咀嚼功能,还可以达到美学修复效果。
Objective:To discuss the clinical restoration effect of multi-disciplinary combined treatment for invasive periodontitis,and to explain the significance of multi-disciplinary combined treatment on the restoration of oral function.Methods:The clinical data of one patient with severe invasive periodontitis resulted in loosening and disengagement of teeth were collected.After periodontium-orthodontium-implant-prosthesis multidisciplinary combined treatment,the bleeding on probing(BOP),probing depth(PD),attachment loss(AL)and implant osseointegration indexes of the patient were observed to determine the clinical repair effect;at the same time,literature review was conducted.Results:The patient,female,was conscious of the loosening and discomfort of the front and rear mandibular teeth in Jan.2016;recently,the loosening became worse and she dared not bite on the hard objects.The clinical examination found that the patient’s oral hygiene was poor;the gingival of 31,35,36,37,41 were dark red;BOP(+);PD 5-7 mm;AL 3-5 mm;teeth mobility:Ⅲ°.The clinical diagnosis was severe invasive periodontitis.First,periodontal treatment was performed to eliminate inflammation.After the inflammation was obviously eliminated,the affected teeth loosened byⅢ°were removed.In order to close the anterior teeth space,develop the lower anterior teeth and leave space for implantation,the patient was treated with orthodontic treatment.Finally,the bone defect was repaired by guided bone regeneration(GBR).When the periodontal soft and hard tissues grew well and the alveolar ridge was plump,implant restoration was performed.During the whole treatment process,the plaque was strictly controlled,the chewing function of the patient was restored,and the anticipated aesthetic effect was achieved.One year later,the patient’s oral hygiene was good,the implant position was stable,and the radiographic examination showed no loss of bone around the implant.The gingival was pink and had not obvious inflammation.Conclusion:Multidisciplinary combined treatm
作者
赵竹兰
张庆宇
夏德庚
仲杨
张天翼
黄玉
张莉
马宁
ZHAO Zhulan;ZHANG Qingyu;XIA Degeng;ZHONG Yang;ZHANG Tianyi;HUANG Yu;ZHANG Li;MA Ning(Department of Emergency,Stomatology Hospital,Jilin University,Changchun 130021,China;Department of Periodontics,Stomatology Hospital,Jilin University,Changchun 130021,China)
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2021年第5期1292-1297,共6页
Journal of Jilin University：Medicine Edition
基金
吉林省卫健委卫生健康适宜技术扶贫项目(2019FP018)。
关键词
侵袭性牙周炎
牙松动
正畸治疗
引导骨再生
invasive periodontitis
teeth loosening
orthodontics treatment
guided bone regeneration
