病例报告

运用改良牙冠延长术及种植术处理美学区外伤所致残根残冠1例

  • 贾雪婷 ,
  • 甄敏 ,
  • 胡文杰 ,
  • 刘云松
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  • (北京大学口腔医学院·口腔医院牙周科,北京100081)

网络出版日期: 2015-10-18

基金资助

首都临床特色应用研究专项基金(Z131107002213174)资助

Different multidisciplinary approaches of two traumatic teeth fractures in the esthetic zone: a case report

  • JIA Xue-ting ,
  • ZHEN Min ,
  • HU Wen-jie ,
  • LIU Yun-song
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  • (Department of Periodontics, Peking University School & Hospital of Stomatology, Beijing 100081, China)

Online published: 2015-10-18

Supported by

Supported by Grants from Beijing Municipal Science and Technology Commission,China

摘要

涉及到前牙美学区的残冠残根是临床处置的难题,其治疗目的不但要恢复健康、重建功能,还需同时改善美观[1-2]。本文完整展示了1例针对前牙美学区病例的病情分析、多学科参与治疗设计、具体实施步骤和修复后效果的全过程,并分析了面临复杂病情如何拟定个性化的治疗决策和规划简捷的实施流程,对不同牙周手术的治疗效果进行了探讨。

本文引用格式

贾雪婷 , 甄敏 , 胡文杰 , 刘云松 . 运用改良牙冠延长术及种植术处理美学区外伤所致残根残冠1例[J]. 北京大学学报(医学版), 2015 , 47(5) : 878 -882 . DOI: 10.3969/j.issn.1671-167X.2015.05.029

Abstract

In this article, different methods to deal with teeth fractures were discussed by presenting a case of traumatic crown-root fracture in the anterior esthetic zone. The traumatic crown-root fracture is a common problem in clinic. When a fracture line locates in close proximity to or below the alveolar bone crest, the fracture most likely involve the junctional epithelium and the connective tissue attachment. This type of fracture becomes a challenge for restorative dentists because it involves biologic, functional, and esthetic considerations, especially when the fracture occurs in an esthetic area. In this case, a young patient presented with two fractured upper anterior teeth to the Department of Periodontics, Peking University School and Hospital of Stomatology. After the comprehensive clinical evaluation, the right central incisor was decided to extract for implant therapy and the right lateral incisor was decided to retain by one modified crown lengthening surgery. The most common technique applied to save a retained root is a clinical crown lengthening procedure. However, the aggressive alveolar bone resection of both target and adjacent teeth to reestablish the bone width and periodontal health may compromise functional and esthetic outcomes. To reduce loss of excessive osseous tissue during osteotomy procedure, the modified crown lengthening of the right lateral incisor was performed, including minor bone resection and root reshaping. Regarding the right central incisor, the retained root was all located below the alveolar bone crest. The extraction and implant procedure, combined with guided bone graft were performed to avoid the damage to neighbor teeth during traditional restorative therapy and to reshape a preferable buccal contour. At the last visit, the patient was recalled with healthy periodontium, normal tooth function and favorable esthetic results.

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