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. 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. 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: 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