#Repost @drshantiakazemi#牙医IG翻动派[超话]#
这是我职业生涯中迄今为止治疗过的最独特的病例之一。【机翻+简易修改补充】
一位21岁的男性,在开始正畸前被转到我们科室进行牙周病治疗。
在开始正畸治疗之前,他的整个病例做了SRP(20世纪六七十年代的研究表明:牙周炎时,牙骨质表面有内毒素的存在。该理论认为:内毒素的存在将影响牙周治疗的预后效果。即使清除根面的菌斑和牙石,内毒素仍然存在于牙骨质表面,持续地刺激牙周组织,影响牙周治疗的预后效果。这一假说导致“根面平整术”的出现。根面平整术经常与刮治术联合应用,称之为龈下刮治和根面平整术(scalingand root planing,SRP)。
上颌磨牙的GTR,以及上颌磨牙的LLQ。
下颌磨牙的GTR,以及下颌磨牙的LLQ。
我希望很快能在我的故事中回顾整个病例。
被破坏得最严重的部位是30,活动度为I级,齿槽为Il级(吸收?),齿槽中段和远段有8毫米的退缩,30号部位的牙髓是做过根管治疗
考虑到他有侵袭性牙周炎的病史,年轻的年龄(21岁),我倾向于推迟30号部位的扩展和种植。
尽可能地推迟30号部位的种植。我尝试了
我尝试了一些全新的方法,这些方法到目前为止效果很好
到目前为止,效果还不错。
做了什么?
用自体的GTR
颊侧加异种移植代替
我在颊部和舌部使用CTG。
并实现了初级封闭。
诚然,我们不能完全再生一个l2级的牙龈。
但对于年轻的、有高风险的牙周病患者,我们总是可以推迟种植。
特别感谢@navid.stan的杰出贡献。
特别感谢@navid.stan 为其他3个四边形的种植体所做的工作。
19号现场的再生手术以及后续护理
(swipe left to see 4 years follow up) One
of the most unique cases I've treated in my career so far,
a 21 yr old male referred to our department for perio
clearance prior to start of orthodontic treatment, his
entire case took 4 quads of SRP and rounds of perio
maintenance, GTR for maxillary molars, as well as
mandibular molar LLQ, hopefully soon Ill review the
entire case on my stories.
The area that was most severely destructed was site
30- had mobility grade I, furcation grade Il, pockets of 8
mm mesial and distal , recession, #30 was sound
endodontically
Given his history with aggressive periodontitis, young
age (21), I preferred to postpone ext and implant
placement for site 30 for as long as possible. I tried
something completely new which worked pretty well up
to date.
What was done?
GTR with autogenous
shaving plus xenograft instead
of collagen membrane I used CTG on buccal and lingual
and achieved primary closure.
It is true that we can not fully regenerate a furcation
grade lII, but we can always postpone implant placement
in a young patient with high risk of periodontal
breakdown & peri-implantitis
Special thanks to @navid.stan for outstanding
for the other 3 quads.
regenerative surgery on site 19 as well as follow up care
