重度慢性牙周炎患者软硬组织增量术联合即刻种植修复1例报告及文献复习

doi:10.13481/j.1671-587x.20200531

吉林大学学报(医学版) ›› 2020, Vol. 46 ›› Issue (05): 1082-1086.doi: 10.13481/j.1671-587x.20200531

• 临床医学 • 上一篇

重度慢性牙周炎患者软硬组织增量术联合即刻种植修复1例报告及文献复习

黄玉¹, 赵竹兰², 仲杨¹, 许立硕¹, 刘晨光³, 马宁¹, 张莉²

1. 吉林大学口腔医院牙周科, 吉林长春 130021;
2. 吉林大学口腔医院急诊科, 吉林长春 130021;
3. 吉林省人民医院口腔科, 吉林长春 130021

收稿日期:2020-02-20 发布日期:2020-10-23
通讯作者: 马宁,教授,硕士研究生导师(Tel:0431-88796039,E-mail:maningbsh76@sina.com);张莉,副教授,硕士研究生导师(Tel:0431-85579359,E-mail:2239003764@qq.com) E-mail:maningbsh76@sina.com;2239003764@qq.com
作者简介:黄玉(1995-),女,河南省潢川县人,在读医学硕士,主要从事牙周病基础与临床方面的研究。
基金资助:
吉林省卫健委卫生健康适宜技术扶贫项目资助课题（2019FP018）；吉林大学口腔医院新技术、新疗法项目资助课题（100402）

Soft tissue augmentation and bone regeneration combined with immediate implantation of patient with severe chronic periodontitis:A case report and literature review

HUANG Yu¹, ZHAO Zhulan², ZHONG Yang¹, XU Lishuo¹, LIU Chenguang³, MA Ning¹, ZHANG Li²

1. Department of Periodontics, Stomatology Hospital, Jilin University, Changchun 130021, China;
2. Department of Emergency, Stomatology Hospital, Jilin University, Changchun 130021, China;
3. Department of Stomatology, Jilin Provincial People's Hospital, Changchun 130021, China

Received:2020-02-20 Published:2020-10-23

摘要/Abstract

摘要： 目的：观察软硬组织增量术联合即刻种植对重度慢性牙周炎软硬组织缺失患者的修复效果，分析其对口腔疾病的治疗以及功能恢复的意义。方法：患者，男性，50岁。25和26残根，断面高度位于龈缘以下2 mm。锥形束CT（CBCT）测量26颊和腭侧牙槽嵴顶与上颌窦底距离分别为5.9和3.6 mm。全口牙周袋探诊深度（PD）为5~7 mm，附着丧失（AL）为3~4 mm，探诊出血（BOP）（+）。对患者进行牙周基础治疗，稳定后拔除残根，同时行上颌窦外提升术和即刻种植，并行富血小板纤维蛋白（PRF）联合引导骨再生术（GBR），择期行游离牙龈移植术。定期复诊。结果：患者牙周状态稳定，口腔卫生保持良好。移植术后供区恢复良好，受区平均角化黏膜宽度达到8 mm。18个月后复查，种植体稳固，随访X线片示种植体周围骨密度影像与邻牙无明显区别，种植牙牙龈上皮袖口形态良好，龈粉红，角化龈充足。结论：在牙周炎症得到控制的情况下，牙周软硬组织缺失的治疗可采取上颌窦外提升术、PRF和GBR联合游离牙龈移植术，有利于种植体的健康存活。

关键词: 慢性牙周炎, 即刻种植, 引导骨再生, 角化龈, 富血小板纤维蛋白

Abstract: Objective: To observe the therapeutic effect of soft tissue augmentation and bone regeneration combined with immediate implantation on the soft and hard tissue loss in the patient with severe chronic periodontitis, and to analyze its significance for the treatment and functional recovery of oral diseases. Methods: The male patient aged 50 years old. 25 and 26 of the patient were residual roots with a height of about 2 mm below the gingival. The cone beam CT (CBCT)results showed that buccal and palatal alveolar ridge top distance of 26 from maxillary sinus floor was 5.9 and 3.6 mm, respectively. The probing depth (PD) was 5-7 mm, the attachment loss (AL) was 3-4 mm, and the bleeding on probing (BOP) was positive.The patient was treated with basic periodontal therapy, and the residual roots were removed after stabilization and maxillary sinus elevation and immediate implantation combined with the platelet-rich fibrin (PRF) and guided bone regeneration (GBR) were performed; free gingival transplantation was operated alternatively.The patient received regular examination.Results: The periodontal state of the patient was stable and oral hygiene was good. After free gingival transplantation, the donor area recovered well and the average keratinized mucosal width reached 8 mm. After 18 months of re-examination, the implant was stable and the follow-up X-ray examination results showed no significant difference in the bone density images between the peri-plant bone and the adjacent teeth. The epithelium cuff shape of implant teeth gingival was nice, gingival was pink and the keratinized gingival was sufficient. Conclusion: If the periodontal inflammation is controlled, the treatment of periodontal soft and hard tissue loss can be done by maxillary sinus elevation, PRF and GBR combined with free gingival transplantation, which will be very beneficial for the healthy survival of implants.

Key words: chronic periodontitis, immediate implantation, guided bone regeneration, keratinized gingival, platelet-rich fibrin

中图分类号:

R781.45

黄玉, 赵竹兰, 仲杨, 许立硕, 刘晨光, 马宁, 张莉. 重度慢性牙周炎患者软硬组织增量术联合即刻种植修复1例报告及文献复习[J]. 吉林大学学报(医学版), 2020, 46(05): 1082-1086.

HUANG Yu, ZHAO Zhulan, ZHONG Yang, XU Lishuo, LIU Chenguang, MA Ning, ZHANG Li. Soft tissue augmentation and bone regeneration combined with immediate implantation of patient with severe chronic periodontitis:A case report and literature review[J]. Journal of Jilin University(Medicine Edition), 2020, 46(05): 1082-1086.

参考文献

[1] 王稚英, 李瑞飘. 无牙颌即刻负重种植义齿风险因素的研究进展[J]. 口腔医学研究, 2019, 35(9):821-826.
[2] CHENG Q, SU Y Y, WANG X, et al. Clinical outcomes following immediate loading of single-tooth implants in the esthetic zone:a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implant, 2020, 35(1):167-177.
[3] FILHO O N, FERREIRA J P M. Clinical study of the effect of free gingival graft and apically repositioned flap surgery on peri-implant keratinized gingival augmentation[J]. Clin Oral Implant Res, 2019, 30:276.
[4] KHOSROPANAH H, DEHGHANI-NAZHVANI A, ESMAELZADEH S. Comparison of increasing the width and thickness of keratinized gingiva using two methods of connective tissue graft and graft by plasma-enriched collagen in patients who are candidates for gingival grafts:A pilot study[J]. J Isfahan Dent School, 2013:18-27.
[5] ZUIDERVELD E G, MEIJER H J A, DEN HARTOG L, et al. Effect of connective tissue grafting on peri-implant tissue in single immediate implant sites:a RCT[J]. J Clin Periodontol, 2018, 45(2):253-264.
[6] MANJI F, DAHLEN G, FEJERSKOV O. Caries and periodontitis:contesting the conventional wisdom on their aetiology[J]. Caries Res, 2018, 52(6):548-564.
[7] 孟焕新. 牙周病学[M]. 4版.北京:人民卫生出版社, 2013:127-220.
[8] DE SANTIS D, SINIGAGLIA S, PANCERA P, et al. An overview of guided bone regeneration[J]. J Biol Regul Homeost Agents, 2019, 33(Suppl 1[integer]):49-53.
[9] ZIJDERVELD S A, VAN DEN BERGH J P A, SCHULTEN E A J M, et al. Anatomical and surgical findings and complications in 100 consecutive maxillary sinus floor elevation procedures[J]. J Oral Maxillofac Surg, 2008, 66(7):1426-1438.
[10] OSMAN A H, MANSOUR H, ATEF M, et al. Computer guided sinus floor elevation through lateral window approach with simultaneous implant placement[J]. Clin Implant Dent Relat Res, 2018, 20(2):137-143.
[11] SCHROPP L, WENZEL A, KOSTOPOULOS L, et al. Bone healing and soft tissue contour changes following single-tooth extraction:a clinical and radiographic 12-month prospective study[J]. Int J Periodontics Restor Dent, 2003, 23(4):313-323.
[12] CRESPI R, CAPPARÉ P, CRESPI G, et al. Immediate implant placement in sockets with asymptomatic apical periodontitis[J]. Clin Implant Dent Relat Res, 2017, 19(1):20-27.
[13] BOURI A, BISSADA N, AL-ZAHRANI M S, et al. Width of keratinized gingiva and the health status of the supporting tissues around dental implants[J]. Int J Oral Maxillofac Implant, 2008, 23(2):323-326.
[14] 粱珊珊, 周颖, 蒋滔, 等. 牙外伤致残根的多学科联合修复一例[J]. 中华口腔医学杂志, 2016, 51(10):591-593.
[15] STETLER K J, BISSADA N F. Significance of the width of keratinized gingiva on the periodontal status of teeth with submarginal restorations[J]. J Periodontol, 1987, 58(10):696-700.
[16] AGUDIO G, NIERI M, ROTUNDO R, et al. Periodontal conditions of sites treated with gingival-augmentation surgery compared to untreated contralateral homologous sites:A 10-to 27-year long-term study[J]. J Periodontol, 2009, 80(9):1399-1405.
[17] NAIK A R, RAMESH A V, DWARKANATH C D, et al. Use of autologous platelet rich plasma to treat gingival recession in esthetic periodontal surgery[J]. J Indian Soc Periodontol, 2013, 17(3):345-353.
[18] 马宁, 张正, 金明光, 等. GBR联合PRF修复根尖周囊肿骨缺损的临床观察[J]. 吉林大学学报(医学版), 2011, 37(2):295.
[19] 周倩, 王佐林. 引导骨再生术在种植手术中的应用[J]. 口腔颌面外科杂志, 2010, 20(4):279-284.

重度慢性牙周炎患者软硬组织增量术联合即刻种植修复1例报告及文献复习

Soft tissue augmentation and bone regeneration combined with immediate implantation of patient with severe chronic periodontitis:A case report and literature review

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 10

Metrics

本文评价

推荐阅读 0

[1]	蔡如佳, 关宁, 刘乙臻, 高秀秋, 王琳源. M1型巨噬细胞相关因子在重度慢性牙周炎患者牙龈组织中的表达及其意义[J]. 吉林大学学报(医学版), 2020, 46(02): 372-376.
[2]	宋续军, 张倩, 王少磊, 柏娜, 刘杰. 实验性种植体周围炎小鼠模型的建立及TNF-α在模型小鼠牙龈组织中的表达[J]. 吉林大学学报(医学版), 2020, 46(01): 40-44.
[3]	许立硕, 黄玉, 金权, 刘晨光, 陈飞, 张莉, 马宁. 野菊花骨碎补复合中药制剂联合奥硝唑治疗慢性牙周炎的效果评价[J]. 吉林大学学报(医学版), 2019, 45(05): 1128-1133.
[4]	金权, 郑义, 许立硕, 黄玉, 马宁, 张莉. 骨膜蛋白在慢性牙周炎患者牙龈组织中的表达及其临床意义[J]. 吉林大学学报(医学版), 2019, 45(03): 634-638.
[5]	郑苔菁, 白远亮, 郑佳雯, 刘洪宏, 郭子君, 王萍. 克拉霉素和甲硝唑治疗慢性牙周炎疗效的Meta分析[J]. 吉林大学学报(医学版), 2019, 45(01): 130-136.
[6]	陈飞, 史金先, 焦鹏, 金权, 许立硕, 张莉, 马宁. 牙周炎患者血清中内脂素和PGE2水平检测及其与牙周炎活动性的关系[J]. 吉林大学学报(医学版), 2018, 44(03): 563-567.
[7]	焦鹏, 陈飞, 金权, 陈楠楠, 张莉, 马宁. 重度牙周炎致牙齿松动脱落患者前牙美学区综合治疗1例报告及文献复习[J]. 吉林大学学报(医学版), 2018, 44(02): 421-424.
[8]	陈飞, 史金先, 焦鹏, 金权, 许立硕, 张莉, 马宁. 不良修复体致前牙区残根残冠患者的牙周手术治疗1例报告及文献复习[J]. 吉林大学学报(医学版), 2018, 44(01): 170-174.
[9]	于艳, 韩亚琨, 张颖丽. 慢性牙周炎患者A型人格行为特征分布的调查分析[J]. 吉林大学学报(医学版), 2016, 42(02): 395-399.
[10]	平飞云\|苗卓伟\|王新木\|董研. 壳聚糖在引导骨再生膜中的应用[J]. J4, 2012, 38(4): 813-816.