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使用抗菌光动力疗法维持患有牙周牙髓联合病变的无保留价值牙齿:一例报告

The Use of Antimicrobial Photodynamic Therapy to Maintain a Hopeless Tooth With a PeriodonticEndodontic Lesion: A Case Report.

作者信息

Derikvand Nahid, Hatami Masoud, Chiniforush Nasim, Ghasemi Seyedeh Sara

机构信息

Department of Periodontics, Faculty of Dentistry, Borujerd Branch, Islamic Azad University, Borujerd, Iran.

Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

J Lasers Med Sci. 2020 Summer;11(3):355-360. doi: 10.34172/jlms.2020.57. Epub 2020 Jun 21.

Abstract

In spite of some advances in periodontal generative methods, it is impossible to stop progressive Loss of supporting alveolar bone in some end-stage periodontitis. The aim of this study is to report a kind of treatment modality which was seemed to be successes full in maintaining teeth. In this case-report, a hopeless tooth was saved by combined non-surgical periodontalendodontal treatment and antimicrobial photodynamic therapy (aPDT). A 58-year-old male presented with a chief complaint of pain and mobility of tooth number 38. Clinical examinations revealed a periodontic-endodontic lesion with clinical attachment loss exceeding 10 mm and grade III mobility. To preserve the tooth, we operated nonsurgical periodontal treatment including scaling and root planning (SRP) plus root canal therapy (RCT) combined with intra-root canal non-aPDT laser decontamination. Then we applied laser pocket therapy with and without aPDT. Following 6 months of the aPDT treatment, the mobility and pocket depth of the tooth improved from grade III to I and from 10 to 3 millimeters respectively. aPDT is a novel adjunctive therapy that can be used for various conditions with microbial etiology. This case report demonstrated that aPDT might be effective in the treatment of periodontic-endodontic lesions in a hopeless tooth.

摘要

尽管牙周再生方法取得了一些进展,但在某些晚期牙周炎中,仍无法阻止牙槽骨支持组织的渐进性丧失。本研究的目的是报告一种在保留牙齿方面似乎取得成功的治疗方式。在本病例报告中,一颗无望保留的牙齿通过非手术牙周牙髓联合治疗和抗菌光动力疗法(aPDT)得以保留。一名58岁男性因主诉38号牙疼痛和松动前来就诊。临床检查发现牙周牙髓联合病变,临床附着丧失超过10毫米,牙齿松动为Ⅲ度。为保留该牙,我们进行了非手术牙周治疗,包括龈上洁治和根面平整(SRP)以及根管治疗(RCT),并结合根管内非aPDT激光去污。然后我们进行了有无aPDT的激光牙周袋治疗。经过6个月的aPDT治疗,牙齿的松动度从Ⅲ度改善为Ⅰ度,牙周袋深度从10毫米减小到3毫米。aPDT是一种新型辅助治疗方法,可用于各种由微生物引起的病症。本病例报告表明,aPDT可能对无望保留牙齿的牙周牙髓联合病变有效。

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