十号牙医丶10
22-08-25 07:03 微博认证:体育博主 超话主持人(牙医IG翻动派超话)

#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⁣

发布于 江苏