Tseng C C, Harn W M, Chen Y H, Huang C C, Yuan K, Huang P H
Dental Department, National Cheng Kung University Medical Center, Taiwan Republic of China.
J Endod. 1996 Dec;22(12):693-6. doi: 10.1016/S0099-2399(96)80067-7.
Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endo-perio true-combined lesion on a maxillary premolar was first treated with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curettage on the tooth. The facial bony defect was then filled with a decalcified freeze-dried bone allograft mixed with tetracycline powder. A non-resorbable Teflon membrane was then used to cover the bone material and the periodontal flap sutured over this. This combined treatment resulted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion.
临床医生在诊断和治疗牙髓-牙周联合病变时常常遇到困难。一例上颌前磨牙的牙髓-牙周真性联合病变病例，首先接受了传统的牙髓治疗。随后进行了牙周手术，包括对该牙进行刮治和根面平整以及根尖刮治。然后用与四环素粉末混合的脱钙冻干异体骨填充面部骨缺损。接着使用不可吸收的聚四氟乙烯膜覆盖骨材料，并在其上缝合牙周瓣。这种联合治疗使探诊深度最小化（2毫米），临床附着获得最大化（8毫米），同时有牙槽骨生长的影像学证据。本病例报告表明，正确诊断，随后去除病因，并采用引导组织再生技术结合骨移植，将使因牙髓-牙周病变导致严重附着丧失的牙齿恢复健康和功能。
