Kudo Motomu, Shirakata Yoshinori
Prismtower Kudo Dental Office, Tokyo, Japan.
Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Esthet Restor Dent. 2023 Dec;35(8):1171-1185. doi: 10.1111/jerd.13075. Epub 2023 Jun 23.
The aim of this case report was to demonstrate the long-term effects of a multidisciplinary approach involving periodontal reconstructive surgery and strategic implant placement before orthodontic (SIMBO) treatment in a patient with severe periodontitis (e.g., stage IV/grade C).
The patient presented with severe periodontitis and pathologic tooth migration (PTM) without stable occlusion or occlusal support. After performing cause-related therapy, periodontal regenerative surgery, pre-orthodontic posterior implant placement, and orthodontic treatment involving anterior implant placement with papilla reconstruction, the patient achieved full-mouth rehabilitation and improvement of dental and smile esthetics. The clinical and radiographic results obtained were maintained over a 10-year period.
Within the limits of this as a single case, multidisciplinary treatment involving the SIMBO approach appeared to allow long-term improvement of periodontal condition, stability of the dental arches and occlusion, and esthetics in a patient with severe periodontitis, PTM and posterior bite collapse. Future studies with more subjects are needed to evaluate and validate this approach.
When addressing periodontal disease, SIMBO approach-based multidisciplinary treatment appears safe and effective as a clinical protocol for establishing esthetic and functional rehabilitation in generalized stage IV/grade C periodontitis.
本病例报告旨在展示多学科方法的长期效果,该方法包括对一名重度牙周炎患者(如IV期/C级)在正畸治疗前进行牙周重建手术和策略性种植体植入(SIMBO)。
该患者患有重度牙周炎和病理性牙齿移位(PTM),无稳定的咬合或咬合支持。在进行病因相关治疗、牙周再生手术、正畸前的后牙种植体植入以及涉及前牙种植体植入和乳头重建的正畸治疗后,患者实现了全口修复,并改善了牙齿和微笑美观度。所获得的临床和影像学结果在10年期间得以维持。
在本单病例的限制范围内,涉及SIMBO方法的多学科治疗似乎能使重度牙周炎、PTM和后牙咬合塌陷患者的牙周状况得到长期改善,牙弓和咬合稳定,美观度提高。需要更多受试者的进一步研究来评估和验证这种方法。
在治疗牙周疾病时,基于SIMBO方法的多学科治疗作为一种临床方案,在建立广泛性IV期/C级牙周炎的美观和功能修复方面似乎是安全有效的。