Tizzoni Riccardo, Tizzoni Marta
Private practice in Milan, Italy, Via San Barnaba 30, Milan, Italy, Phone: +39-025453560, e-mail:
Private practice in Milan, Italy.
J Contemp Dent Pract. 2019 May 1;20(5):639-644.
The present case illustrates how a tooth, which had a highly questionable prognosis, was preserved by carrying out a periodontal regeneration surgery.
Treatment of periodontitis involves a careful consideration of all the factors that may allow the achievement of a favorable outcome; among those, the skillful use of guided tissue regeneration (GTR) membranes is of paramount importance.
A 39-year-old patient presented with a mobile central upper incisor due to severe periodontitis and was treated according to GTR principles using a collagen membrane. A collagen-preserving bone graft was also used, as a scaffold for clot formation and cellular infiltration, which was covered with a second collagen membrane. The patient was contacted for follow-up assessment at 3, 6, 12, and 18 months after surgery. Follow-up radiographs showed that bone regeneration occurred around the involved tooth and very little tooth mobility was observed. The patient's masticatory function, appearance, and comfort were favorable.
The use of two equine collagen membranes with the purpose of creating the best conditions to carry out periodontal regeneration according to GTR principles, in association with an equine, collagen-preserving, enzyme-deantigenic bone graft, allowed sufficient bone regeneration to salvage a tooth that was deemed otherwise lost because of periodontitis.
In cases of teeth that are severely compromised by periodontitis, the use of collagen membranes according to GTR principles can allow the regeneration of the periodontal tissues; the association with a bone substitute having well-known performance rates, covered with a collagen membrane (guided bone regeneration, GBR) can, in some cases, improve bone regeneration at the defect site.
本病例展示了如何通过进行牙周再生手术来保留一颗预后极不确定的牙齿。
牙周炎的治疗需要仔细考虑所有可能有助于取得良好治疗效果的因素；其中，熟练使用引导组织再生（GTR）膜至关重要。
一名39岁患者因严重牙周炎导致上颌中切牙松动，按照GTR原则使用胶原膜进行治疗。还使用了一种保留胶原的骨移植材料，作为血凝块形成和细胞浸润的支架，并覆盖了第二层胶原膜。在术后3、6、12和18个月对患者进行随访评估。随访X光片显示，患牙周围发生了骨再生，且观察到牙齿松动极小。患者的咀嚼功能、外观和舒适度良好。
根据GTR原则使用两层马源胶原膜，以创造进行牙周再生的最佳条件，并联合使用马源的、保留胶原的、酶脱抗原骨移植材料，可实现充分的骨再生，从而挽救一颗因牙周炎原本会失去的牙齿。
在因牙周炎而严重受损的牙齿病例中，根据GTR原则使用胶原膜可实现牙周组织再生；联合使用性能已知的骨替代材料并覆盖胶原膜（引导骨再生，GBR），在某些情况下可改善缺损部位的骨再生。
