牙齒自體移植術應用於患有嚴重局部牙周病病患的牙周矯正治療上的病例報告

Translated title of the contribution: Autotransplantation with Combining Periodontal and Orthodontic Therapies in a Severe Localized Periodontitis Case

劉 明榮(Ming-Jung Liu), 林 明輝(Ming-Huei Lin), 陳 慧玲(Hui-Ling Chen), 李 勝揚(Sheng-Yang Lee)

Research output: Contribution to journalArticle

Abstract

It is suite difficult for dentist to treat patients with upper anterior teeth lost due to severe periodontitis with bimaxillary dentoalveolar protrusion. Fixed partial denture (FPD), removable partial denture (RPD), implant, autotransplantation, or orthodontic space closure are selections which can be chosen when such problem is encountered. In situations with reduced bone height or narrowed ridge treatment with denture or implant alone will cause imperfection in the aspect of function and esthetics. If we try to restore these edentulous area with auto-transplantation, the preserved potential of ossteoinduction in transplanted tooth will not only resolve the problem of the reduced bone height resulted from periodontical tooth loss, but will also remodel the alveolar process with orthodontic tooth movement. With such bone remodeling while retracting the anterior teeth, the appearance of patient profile and problem of dentoalveolar protrusion will be resolved simultaneously. This is a case report of a patient with dentoalveolar protrusion and central and lateral incisors loss due to severe periodontitis. The primary treatment objectives were to close these edentulous area and to improve facial appearance with orthodontic retraction of anterior teeth. However, the clinician would face a predicament, because the space of two-tooth missing on the same side would be too large to close with orthodontic tooth movement. Meanwhile, if we moved tooth across the midline, it would still be risky whether tooth movement could be performed safely across the mid-palatal suture. Therefore, after periodontical treatment and follow-up, we decided to extract all first premolar, except upper right quadrant area, then we transplanted the upper left first premolar to upper right edentulous area. After waiting period of periodontal reallachement on transplanted tooth and endodontic treatment, we started orthodontic tooth movement to close these edentuluous area and to accomplish extensive retraction of the anterior teeth. After 2 years of orthodontic treatment, we successfully resolved her problems of edentulous area and dentofacial appearance.
Original languageTraditional Chinese
Pages (from-to)49-63
Number of pages15
Journal中華民國齒顎矯正學雜誌
Volume20
Issue number3
Publication statusPublished - 2008

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Autologous Transplantation
Periodontitis
Orthodontics
Tooth
Tooth Movement Techniques
Bicuspid
Therapeutics
Orthodontic Space Closure
Removable Partial Denture
Fixed Partial Denture
Alveolar Process
Bone and Bones
Tooth Loss
Bone Remodeling
Dentures
Endodontics
Incisor
Dentists
Esthetics
Sutures

Keywords

  • autotransplantation
  • upper incisors missing

Cite this

牙齒自體移植術應用於患有嚴重局部牙周病病患的牙周矯正治療上的病例報告. / 劉明榮(Ming-Jung Liu); 林明輝(Ming-Huei Lin); 陳慧玲(Hui-Ling Chen); 李勝揚(Sheng-Yang Lee).

In: 中華民國齒顎矯正學雜誌, Vol. 20, No. 3, 2008, p. 49-63.

Research output: Contribution to journalArticle

劉明榮(Ming-Jung Liu) ; 林明輝(Ming-Huei Lin) ; 陳慧玲(Hui-Ling Chen) ; 李勝揚(Sheng-Yang Lee). / 牙齒自體移植術應用於患有嚴重局部牙周病病患的牙周矯正治療上的病例報告. In: 中華民國齒顎矯正學雜誌. 2008 ; Vol. 20, No. 3. pp. 49-63.
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abstract = "臨床上患有雙顎齒槽前突合併有嚴重牙周病而喪失上顎若干前牙的病患,欲尋求理想的整合性復健是相當困難的。前牙區缺牙的整治方法包括:固定牙橋、活動假牙、人工植牙、自體移植,或是利用矯正來關閉空間。但針對雙顎前突合併有已降低骨高度和狹窄化牙脊的前牙區域,單獨假牙或人工植牙的贗復治療,可能會導致門齒的過度外展,咬合功能或美觀上不盡理想。若利用自體移植來解決缺牙區問題,因為保留有誘導骨再生能力的牙周膜,不僅能解決因牙周病而拔除牙齒所產生的骨頭缺損,同時也提供了矯正時牙齒移動的可行性,以及齒槽骨的塑形與再塑形。經由矯正移動與後退前牙區的牙齒,將能改善齒槽前突的問題並獲得臉形的大幅改善。本病例報告為一因嚴重牙周病而喪失上顎同側正中門齒與側門齒且合併有雙顎齒槽前突的病例。首先想到的治療計畫為希望能經由矯正的牙齒移動來關閉此處缺牙空間時,同時獲得前牙區大量的後退,進而解決其雙顎齒槽前突的問題,但針對同側的前牙區大範圍缺牙空間實在是相當困難,又若想利用對側的牙齒移動來解決同側缺牙的問題,也會面臨牙齒移動是否能越過上顎正中顎骨縫合的風險。因此,決定先經由牙周治療與追蹤獲致良好口腔衛生習慣後,拔除左上、左下與右下第一小臼齒,並選擇將左上第一小臼齒移植到右上正中門齒區,待牙周膜再生完成及根管治療後,進行齒顎矯正來關閉缺牙空間並獲致大量的前牙後退。經由兩年的矯正治療,同時改善病患的面部外觀與缺牙問題。",
keywords = "自體移植, 前牙區缺牙, autotransplantation, upper incisors missing",
author = "劉, {明榮(Ming-Jung Liu)} and 林, {明輝(Ming-Huei Lin)} and 陳, {慧玲(Hui-Ling Chen)} and 李, {勝揚(Sheng-Yang Lee)}",
year = "2008",
language = "繁體中文",
volume = "20",
pages = "49--63",
journal = "中華民國齒顎矯正學雜誌",
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publisher = "中華民國齒顎矯正學會",
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T1 - 牙齒自體移植術應用於患有嚴重局部牙周病病患的牙周矯正治療上的病例報告

AU - 劉, 明榮(Ming-Jung Liu)

AU - 林, 明輝(Ming-Huei Lin)

AU - 陳, 慧玲(Hui-Ling Chen)

AU - 李, 勝揚(Sheng-Yang Lee)

PY - 2008

Y1 - 2008

N2 - 臨床上患有雙顎齒槽前突合併有嚴重牙周病而喪失上顎若干前牙的病患,欲尋求理想的整合性復健是相當困難的。前牙區缺牙的整治方法包括:固定牙橋、活動假牙、人工植牙、自體移植,或是利用矯正來關閉空間。但針對雙顎前突合併有已降低骨高度和狹窄化牙脊的前牙區域,單獨假牙或人工植牙的贗復治療,可能會導致門齒的過度外展,咬合功能或美觀上不盡理想。若利用自體移植來解決缺牙區問題,因為保留有誘導骨再生能力的牙周膜,不僅能解決因牙周病而拔除牙齒所產生的骨頭缺損,同時也提供了矯正時牙齒移動的可行性,以及齒槽骨的塑形與再塑形。經由矯正移動與後退前牙區的牙齒,將能改善齒槽前突的問題並獲得臉形的大幅改善。本病例報告為一因嚴重牙周病而喪失上顎同側正中門齒與側門齒且合併有雙顎齒槽前突的病例。首先想到的治療計畫為希望能經由矯正的牙齒移動來關閉此處缺牙空間時,同時獲得前牙區大量的後退,進而解決其雙顎齒槽前突的問題,但針對同側的前牙區大範圍缺牙空間實在是相當困難,又若想利用對側的牙齒移動來解決同側缺牙的問題,也會面臨牙齒移動是否能越過上顎正中顎骨縫合的風險。因此,決定先經由牙周治療與追蹤獲致良好口腔衛生習慣後,拔除左上、左下與右下第一小臼齒,並選擇將左上第一小臼齒移植到右上正中門齒區,待牙周膜再生完成及根管治療後,進行齒顎矯正來關閉缺牙空間並獲致大量的前牙後退。經由兩年的矯正治療,同時改善病患的面部外觀與缺牙問題。

AB - 臨床上患有雙顎齒槽前突合併有嚴重牙周病而喪失上顎若干前牙的病患,欲尋求理想的整合性復健是相當困難的。前牙區缺牙的整治方法包括:固定牙橋、活動假牙、人工植牙、自體移植,或是利用矯正來關閉空間。但針對雙顎前突合併有已降低骨高度和狹窄化牙脊的前牙區域,單獨假牙或人工植牙的贗復治療,可能會導致門齒的過度外展,咬合功能或美觀上不盡理想。若利用自體移植來解決缺牙區問題,因為保留有誘導骨再生能力的牙周膜,不僅能解決因牙周病而拔除牙齒所產生的骨頭缺損,同時也提供了矯正時牙齒移動的可行性,以及齒槽骨的塑形與再塑形。經由矯正移動與後退前牙區的牙齒,將能改善齒槽前突的問題並獲得臉形的大幅改善。本病例報告為一因嚴重牙周病而喪失上顎同側正中門齒與側門齒且合併有雙顎齒槽前突的病例。首先想到的治療計畫為希望能經由矯正的牙齒移動來關閉此處缺牙空間時,同時獲得前牙區大量的後退,進而解決其雙顎齒槽前突的問題,但針對同側的前牙區大範圍缺牙空間實在是相當困難,又若想利用對側的牙齒移動來解決同側缺牙的問題,也會面臨牙齒移動是否能越過上顎正中顎骨縫合的風險。因此,決定先經由牙周治療與追蹤獲致良好口腔衛生習慣後,拔除左上、左下與右下第一小臼齒,並選擇將左上第一小臼齒移植到右上正中門齒區,待牙周膜再生完成及根管治療後,進行齒顎矯正來關閉缺牙空間並獲致大量的前牙後退。經由兩年的矯正治療,同時改善病患的面部外觀與缺牙問題。

KW - 自體移植

KW - 前牙區缺牙

KW - autotransplantation

KW - upper incisors missing

M3 - 文章

VL - 20

SP - 49

EP - 63

JO - 中華民國齒顎矯正學雜誌

JF - 中華民國齒顎矯正學雜誌

SN - 1029-8231

IS - 3

ER -