Tokyo Dental College Chiba Dental Center.
Department of Periodontology, Tokyo Dental College.
Bull Tokyo Dent Coll. 2021 Jun 4;62(2):107-117. doi: 10.2209/tdcpublication.2020-0034. Epub 2021 May 14.
This report describes a case of generalized chronic periodontitis requiring periodontal regenerative therapy. The patient was a 62-year-old man who presented with the chief complaint of gingival swelling in the molar region. An initial examination revealed that 31.6% of sites had a probing depth of ≥4 mm and 18.5% bleeding on probing. Radiographic examination revealed vertical bone resorption in #14, 25, 26, 27, 32, 37, 45, and 47, and horizontal resorption in other regions. Based on a clinical diagnosis of moderate chronic periodontitis, initial periodontal therapy consisting of plaque control and scaling and root planing was performed. Occlusal adjustment of premature contact sites was performed after inflammation was suppressed. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 was performed on #14, 25, 26, 32, and 37. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #45 and 47. Other sites with residual periodontal pockets were treated by open flap debridement, and #27 was extracted due to a bone defect exceeding the root apex. Progress was then reevaluated and the patient placed on supportive periodontal therapy. Periodontal regenerative therapy using rhFGF-2 in combination with DBBM resulted in an improvement in clinical parameters and vertical bone resorption. This improvement has been adequately maintained over an 18-month period. The periodontal treatment provided resulted in a marked improvement in the patient's oral health-related quality of life.
本报告描述了一例需要牙周再生治疗的广泛性慢性牙周炎病例。患者为 62 岁男性,主要诉求为磨牙区牙龈肿胀。初始检查发现,4mm 深牙周袋探针探诊深度≥%的位点为 31.6%,探诊出血的位点为 18.5%。放射影像学检查显示,#14、25、26、27、32、37、45 和 47 存在垂直骨吸收,其他区域存在水平骨吸收。基于中度慢性牙周炎的临床诊断,对患者进行了初始牙周治疗,包括菌斑控制、洁治和根面平整。在炎症得到抑制后,对早接触点进行了咬合调整。随后在选定的部位进行了手术性牙周治疗。在#14、25、26、32 和 37 部位进行了使用重组人成纤维细胞生长因子(rhFGF-2)的牙周再生治疗。在#45 和 47 部位进行了 rhFGF-2 与脱蛋白牛骨矿物质(DBBM)的联合治疗。对其他仍有牙周袋的部位进行了翻瓣清创术,由于根尖骨缺损超过根长,#27 被拔除。随后对进展情况进行了重新评估,并为患者安排了辅助性牙周治疗。rhFGF-2 与 DBBM 联合使用的牙周再生治疗改善了临床参数和垂直骨吸收。在 18 个月的时间里,这种改善得到了充分的维持。牙周治疗显著改善了患者的口腔健康相关生活质量。