辅助正畸扩弓治疗的上颌后牙区牙周软硬组织增量1例

Periodontal surgery of soft and hard tissue augmentation for assisting maxillary expansion:a case report

目的本病例报道1例牙周软硬组织增量在正畸治疗过程中出现骨开裂及根面暴露的临床应用。诊治经过:一位26岁男性患者在正畸扩弓治疗过程中出现右上后牙牙龈退缩,遂停止正畸加力,要求牙周治疗。临床检查显示7-5牙MillerⅢ类牙龈退缩,CBCT检查显示7-5牙颊侧根中1/3-根颈1/3牙槽骨吸收。一期通过膜龈手术完成根面覆盖及角化龈增量后,二期采用骨皮质切开+骨增量手术治疗牙颊侧骨开裂。结果术后1年随访,正畸治疗顺利结束,7-5牙根面覆盖效果稳定,颊侧骨充盈良好。结论治疗正畸过程中出现骨开裂及根面暴露时,基于上皮下结缔组织移植的根面覆盖术联合骨皮质切开+骨增量技术能够取得满意效果,然而其长期稳定性仍有待进一步探究。

Objective:This case reports the clinical application of periodontal soft and hard tissue augmentation in the treatment of alveolar bone dehiscence and root surface exposure during orthodontic treatment.Diagnosis and treatment:A 26-year-old male patient suffered gingival recession in his right upper posterior tooth during orthodontic arch expansion,therefore the tooth movement was stopped and periodontal treatment was requested.Clinical examination showed that Miller classⅢgingival recession in teeth7-5.CBCT examination showed that alveolar bone resorption was presented in the coronal third to middle of the roots in teeth7-5.After the mucogingival surgery for root coverage and keratinized gingival augmentation,the corticotomy combined with bone graft surgery was completed to treat alveolar bone dehiscence of teeth7-5.Results:After 1 year of follow-up,the orthodontic treatment was successfully completed,and the condition of gingiva and alveolar bone was stable.Conclusion:Subepithelial connective tissue graft-based procedures combined with corticotomy+bone graft surgery could provide satisfactory outcomes in the treatment of alveolar bone dehiscence and root surface exposure during orthodontic treatment,however the long-term stability remains to be further explored.