Bizenjima Takahiro, Osuka Yutaka, Tomita Sachiyo, Saito Atsushi
Tokyo Dental College Chiba Dental Center.
Osuka Dental Clinic.
Bull Tokyo Dent Coll. 2019 Jun 21;60(2):131-138. doi: 10.2209/tdcpublication.2018-0048. Epub 2019 Mar 15.
Here, we report periodontal treatment including regenerative therapy in a patient with generalized chronic periodontitis. The patient was a 53-year-old woman who presented with the chief complaint of gingival swelling and tooth mobility in the right maxillary molar region. An initial examination revealed 36% of sites with a probing depth of ≥4 mm and 15.5% with bleeding on probing. Radiographic examination revealed vertical bone resorption in #15, 24, 27, 34, 37, 45, and 47. Horizontal resorption was noted in other regions. The clinical diagnosis was moderate chronic periodontitis. Initial periodontal therapy consisted of plaque control, scaling, and root planing together with treatment for caries. Occlusal adjustment of premature contact sites was performed after suppression of inflammation. Periodontal regenerative therapy using enamel matrix derivative was performed on #15, 24, 34, 45, and 47. Other sites with residual periodontal pockets were treated by open flap debridement. Tooth #27 was extracted due to a bone defect exceeding the root apex; #37 was extracted due to frequent acute symptoms following periodontal surgery. Following re-evaluation, the patient was placed on supportive periodontal therapy. Periodontal regenerative therapy improved vertical bone resorption. This improvement has been adequately maintained over a 3 years 6 months period. Additional care is necessary, however, to further improve the patient's oral health-related quality of life during supportive periodontal therapy.
在此，我们报告了一例接受包括再生治疗在内的牙周治疗的广泛性慢性牙周炎患者的情况。该患者为一名53岁女性，主要诉求是右上颌磨牙区牙龈肿胀和牙齿松动。初步检查发现36%的位点探诊深度≥4 mm，15.5%的位点探诊出血。影像学检查显示15、24、27、34、37、45和47号牙存在垂直骨吸收。其他区域可见水平骨吸收。临床诊断为中度慢性牙周炎。初始牙周治疗包括菌斑控制、龈上洁治和根面平整以及龋齿治疗。炎症得到控制后，对早接触位点进行了咬合调整。对15、24、34、45和47号牙采用釉基质衍生物进行牙周再生治疗。其他有残留牙周袋的位点采用翻瓣清创术治疗。27号牙因骨缺损超过根尖而拔除；37号牙因牙周手术后频繁出现急性症状而拔除。重新评估后，患者接受了支持性牙周治疗。牙周再生治疗改善了垂直骨吸收。这种改善在3年6个月的时间里得到了充分维持。然而，在支持性牙周治疗期间，仍需要进一步护理以进一步改善患者与口腔健康相关的生活质量。
