Kitamura Yurie, Okuyama Keiko, Saito Atsushi
Department of Periodontology, Tokyo Dental College.
Bull Tokyo Dent Coll. 2025 Mar 11;66(1):31-40. doi: 10.2209/tdcpublication.2024-0029. Epub 2025 Feb 15.
This report describes a case of generalized aggressive periodontitis requiring periodontal treatment including regenerative therapy. The patient was a 34-year-old woman who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of pain in tooth #14. An initial examination revealed that 35.8% of sites had a probing depth of ≥4 mm, while 19.1% showed bleeding on probing. Radiographic examination revealed angular bone resorption in #14, 33, 36, and 46, with horizontal resorption in other areas. Based on a clinical diagnosis of Stage III Grade C periodontitis, initial periodontal therapy consisting of plaque control, and scaling and root planing was performed. After reevaluation, periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) in combination with carbonate apatite (COAp) granules was performed for #14 and 33, while regenerative therapy using rhFGF-2 alone was performed for #46. Following reevaluation, the patient was placed on supportive periodontal therapy (SPT). During SPT, CAD/CAM crowns were placed on #26 and 46. Periodontal regenerative therapy using rhFGF-2 with COAp granules yielded a resolution of angular bone defects in #14 and 33. This improvement has been adequately maintained over a 30-month period.
本报告描述了一例需要包括再生治疗在内的牙周治疗的广泛性侵袭性牙周炎病例。患者为一名34岁女性,因14号牙疼痛为主诉前来东京齿科大学水道桥医院就诊。初步检查发现,35.8%的位点探诊深度≥4mm,而19.1%的位点探诊出血。影像学检查显示14、33、36和46号牙有角形骨吸收,其他区域有水平骨吸收。基于III期C级牙周炎的临床诊断,进行了包括菌斑控制、龈下刮治和根面平整在内的初始牙周治疗。重新评估后,对14和33号牙采用重组人成纤维细胞生长因子-2(rhFGF-2)联合碳酸磷灰石(COAp)颗粒进行牙周再生治疗,对46号牙单独使用rhFGF-2进行再生治疗。重新评估后,患者接受了支持性牙周治疗(SPT)。在SPT期间,为26和46号牙制作了CAD/CAM全冠。使用rhFGF-2与COAp颗粒进行的牙周再生治疗使14和33号牙的角形骨缺损得到修复。这一改善在30个月的时间里得到了充分维持。