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Three-dimensional Maxillofacial Morphology Measurements in Japanese Adults with Normal Occlusion. 日本成人正常咬合的三维颌面形态学测量。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2023-12-28 Epub Date: 2023-11-15 DOI: 10.2209/tdcpublication.2023-0012
Mai Takusagawa, Yasushi Nishii, Kunihiko Nojima, Shinichi Abe, Takashi Takaki, Kenji Sueishi

Accurate orthodontic analysis and diagnosis based on anatomical landmarks is essential to the success of orthodontic treatment. Helical computed tomography (CT) has evolved markedly, and dentists can now quickly obtain 3-dimensional (3D) reconstruction data using this imaging modality. The planning of orthodontic treatment had traditionally been based on cephalometric analysis using 2D landmarks. This study aimed to collect 3D morphological data using CT images to establish new landmarks for analysis and diagnosis in orthodontic treatment. Twenty male and 20 female adult Japanese dry skulls with of normal occlusion were selected. The skulls were scanned using a multidetector helical CT system (SIEMENS, Volume Zoom Plus 4, Germany). Models were reconstructed using 3D measurement software (Simplant, Dentsply Sirona, Tokyo, Japan) and 45 landmarks determined. Three-dimensional measurement for a total of 30 items representing these landmarks was then performed. The results provided 3D standard values for maxillofacial morphology in adult Japanese individuals with normal occlusion. These measurement items should allow the disadvantages of 2D cephalometric analysis to be overcome.

准确的基于解剖标志的正畸分析和诊断对正畸治疗的成功至关重要。螺旋计算机断层扫描(CT)已经有了显著的发展,牙医现在可以使用这种成像方式快速获得三维(3D)重建数据。正畸治疗的计划传统上是基于使用二维地标的头颅测量分析。本研究旨在利用CT图像收集三维形态学数据,为正畸治疗的分析和诊断建立新的标志。选取正常闭塞的日本成年干颅骨各20个,男性和女性各20个。颅骨扫描采用多探测器螺旋CT系统(SIEMENS, Volume Zoom Plus 4, Germany)。使用三维测量软件(Simplant, Dentsply Sirona, Tokyo, Japan)重建模型并确定45个地标。然后对代表这些地标的总共30个项目进行三维测量。结果为正常咬合的成年日本人的颌面形态提供了三维标准值。这些测量项目应该能够克服二维头颅测量分析的缺点。
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引用次数: 0
Direct Mechanical Stimulation Mediates Cell-to-Cell Interactions in Cultured Trigeminal Ganglion Cells. 直接机械刺激介导三叉神经节细胞间相互作用。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-09-05 Epub Date: 2022-08-15 DOI: 10.2209/tdcpublication.2021-0034
Tatsuhiko Yazaki, Hidetaka Kuroda, Maki Kimura, Sadao Ohyama, Tatsuya Ichinohe, Yoshiyuki Shibukawa

Trigeminal neuralgia occurs in the orofacial region, characteristically causing pain that feels like a transient electric shock. Some histopathological studies have reported that trigeminal neuralgia is caused by mechanical compression of the demyelinated trigeminal nerve; the pathophysiological mechanism behind this phenomenon remains to be clarified, however. Cell-cell interactions have also been reported to be involved in the development and modulation of some types of neuropathic pain. The purpose of this study was to investigate the potential contribution of cell-cell interactions to trigeminal neuralgia by measuring intracellular free Ca2+ concentrations ([Ca2+]i) in primary cultured trigeminal ganglion (TG) cells. Direct mechanical stimulation of TG cells induced an increase in [Ca2+]i in both neuronal and non-neuronal cells, such as glial cells. Moreover, this increase was stimulus intensity-dependent and non-desensitizing. Direct mechanical stimulation increased [Ca2+]i in neighboring cells as well, and this increase was inhibited by application of carbamazepine. These results indicate that direct mechanical stimulation affects Ca2+ signaling. Trigeminal ganglion cells establish intercellular networks between themselves, suggesting that this is involved in the development and generation of trigeminal neuralgia.

三叉神经痛发生在口面部区域,典型的疼痛感觉就像短暂的电击。一些组织病理学研究报道三叉神经痛是由机械压迫脱髓鞘的三叉神经引起的;然而,这一现象背后的病理生理机制仍有待阐明。细胞间的相互作用也被报道参与了某些类型神经性疼痛的发展和调节。本研究的目的是通过测量原代培养的三叉神经节(TG)细胞内游离Ca2+浓度([Ca2+]i)来研究细胞-细胞相互作用对三叉神经痛的潜在贡献。TG细胞的直接机械刺激诱导神经细胞和非神经细胞(如胶质细胞)中[Ca2+]i的增加。此外,这种增加是刺激强度依赖性和非脱敏性的。直接的机械刺激也增加了邻近细胞的[Ca2+]i,卡马西平的应用抑制了这种增加。这些结果表明,直接机械刺激影响Ca2+信号。三叉神经节细胞之间建立细胞间网络,提示这参与了三叉神经痛的发生和发展。
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引用次数: 0
Neuropathic Pain in Lower Lip after Guided Tissue Regeneration: A Case Report. 引导组织再生后下唇的神经性疼痛:一例报告。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-09-05 Epub Date: 2022-08-15 DOI: 10.2209/tdcpublication.2022-0007
Toshiyuki Handa, Tatsuya Ichinohe
Post-traumatic trigeminal neuropathic pain is mainly caused by the extraction of third molars or the placement of dental implants. This report describes the treatment of neuropathic pain arising after guided tissue regeneration (GTR). The patient was a 55-year-old woman who had to undergo GTR due to severe periodontitis in the distal aspect of the right mandibular second molar. Postoperatively, the patient had been prescribed mecobalamin for hypesthesia and allodynia in the right lower lip. No improvement was observed in these symptoms after 4 months, however, so she was referred to our Orofacial Pain Center. Preoperative and postoperative cone-beam computed tomography revealed a cyst-like lesion (radiolucent area) close to the right mandibular second molar and canal. Although the results of quantitative sensory examination were normal, rubbing the right lower lip with a cotton swab elicited mechanical allodynia. The diagnosis was post-traumatic trigeminal neuropathic pain for which the patient was given pregabalin and Neurotropin®. The symptoms improved within approximately 32 weeks, with the medication being terminated at 64 weeks. Although hypoesthesia due to nerve injury may suddenly go into remission, allodynia is often intractable. If symptoms show no improvement after 3 months, possible nerve injury should be investigated. Additionally, the distal root of the mandibular molar may be close to the inferior alveolar nerve, necessitating appropriate diagnostic imaging of the operative field. If the lesion or distal root is close to the inferior alveolar nerve, postoperative hypesthesia or neuropathic pain may occur, even without direct trauma.
创伤后三叉神经性疼痛主要由拔除第三磨牙或植入种植牙引起。本报告描述了引导组织再生(GTR)后引起的神经性疼痛的治疗。患者是一名55岁的女性,由于右下颌第二磨牙远端严重牙周炎,不得不接受GTR。术后,患者服用甲钴胺治疗右下唇的感觉减退和异常性疼痛。然而,4个月后,这些症状没有改善,因此她被转介到我们的口腔面部疼痛中心。术前和术后锥形束计算机断层扫描显示右侧下颌第二磨牙和根管附近有一个囊肿样病变(放射透明区域)。虽然定量感觉检查结果正常,但用棉签摩擦右下唇引起机械异常性疼痛。诊断为创伤后三叉神经性疼痛,患者给予普瑞巴林和Neurotropin®。症状在大约32周内得到改善,在64周时停止用药。虽然由神经损伤引起的感觉减退可能会突然缓解,但异常性痛觉通常是难以治疗的。如果3个月后症状没有改善,应检查是否有神经损伤。此外,下颌磨牙的远端根可能靠近下牙槽神经,需要对手术野进行适当的诊断成像。如果病变或远端根靠近下牙槽神经,即使没有直接创伤,术后也可能发生感觉减退或神经性疼痛。
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引用次数: 1
Surgical Periodontal Therapy Using Recombinant Human Fibroblast Growth Factor-2 in Combination with Carbonate Apatite Granules for Stage III Grade B Periodontitis: A Case Report with 1-year Follow-up. 重组人成纤维细胞生长因子-2联合碳酸钙磷灰石颗粒治疗III期B级牙周炎:1例1年随访报告。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-09-05 Epub Date: 2022-08-15 DOI: 10.2209/tdcpublication.2022-0008
Tasuku Murakami, Kentaro Imamura, Naoko Watanabe-Egawa, Sachiyo Tomita, Atsushi Saito

This report describes a case of generalized chronic periodontitis requiring periodontal treatment including regenerative therapy. The patient was a 60-year-old woman who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of tooth mobility and pain in tooth #26. Periodontal examination at the first visit revealed that 32.0% of sites had a probing depth of ≥4 mm and 43.8% bleeding on probing. Radiographic examination revealed vertical bone resorption in #17. Horizontal resorption was noted in other areas. Initial periodontal therapy consisting of plaque control, scaling and root planing, and caries treatment was performed based on a clinical diagnosis of Stage III Grade B periodontitis. Tooth #26 was extracted due to bone resorption extending as far as the root apex. After reevaluation, periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) in combination with carbonate apatite (CO3Ap) granules was performed for #17. Following reevaluation, a zirconia crown (#16) and zirconia bridge (#24-27) were placed. Following further reevaluation, the patient was placed on supportive periodontal therapy (SPT). The periodontal regenerative therapy using rhFGF-2 with CO3Ap granules yielded an improvement in the vertical bone resorption observed in #17. This improvement has been adequately maintained over a 1-year period postoperatively. Continued SPT is needed to maintain stable periodontal conditions.

本报告描述一例广泛性慢性牙周炎需要牙周治疗包括再生疗法。患者是一名60岁妇女,她到东京牙科学院水桥医院就诊,主诉为牙齿活动和26号牙齿疼痛。首次就诊时牙周检查发现32.0%的牙周探诊深度≥4mm, 43.8%的牙周探诊出血。x线检查显示17号骨垂直吸收。在其他区域也发现了水平吸收。根据临床诊断为III期B级牙周炎,进行初步牙周治疗,包括菌斑控制,刮除和牙根刨除,以及龋齿治疗。由于骨吸收延伸到牙根尖,26号牙被拔除。重新评估后,采用重组人成纤维细胞生长因子-2 (rhFGF-2)联合碳酸钙磷灰石(CO3Ap)颗粒进行牙周再生治疗。重新评估后,放置氧化锆冠(#16)和氧化锆桥(#24-27)。在进一步评估后,患者接受支持性牙周治疗(SPT)。使用rhFGF-2和CO3Ap颗粒进行牙周再生治疗可以改善#17中观察到的垂直骨吸收。这种改善在术后1年的时间里得到了充分的维持。需要持续的SPT来维持稳定的牙周状况。
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引用次数: 0
Identification of Novel Regulator Involved in Differentiation of Mouse iPS Cells into Odontoblast-like Cells. 小鼠iPS细胞向成牙细胞样细胞分化的新调控因子的鉴定。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-09-05 Epub Date: 2022-08-15 DOI: 10.2209/tdcpublication.2021-0045
Kenji Inoue, Kenichi Matsuzaka, Takashi Inoue

Odontoblasts differentiate from dental papilla stem cells, but the genetic changes that occur during this process remain unclear. The aim of this study was to investigate gene expression patterns during differentiation of mouse iPS cells into odontoblast-like cells. Mouse iPS cells were cultured on a collagen type-1 scaffold with bone morphogenetic protein 4 (BMP4) and retinoic acid (RA). The results of immunofluorescence studies for dentin sialoprotein, dentin matrix protein 1 (DMP1), and nestin were positive. A qRT-PCR analysis revealed that mRNA expression levels of neural crest marker sex determining region Y box (Sox)-10, dentin sialophosphoprotein (Dspp), and Dmp1 were up-regulated, but that mRNA expression levels of the mineralization markers bone sialoprotein and osteocalcin were down-regulated. Microarray analysis showed that 2,597 entities were up-regulated and 1,327 down-regulated among a total of 15,330 investigated. Sox11 was among the up-regulated genes identified. The Sox11 mRNA expression level with odontoblast induction after day 11 was higher than that after day 2 (p<0.05). Gene knockdown using small interference RNA (siRNA) silencing was used to characterize the function of Sox11. The Dspp mRNA expression level in Sox11 siRNA-treated cells was significantly lower than that in the control (p<0.05). These results suggest that BMP4 and RA induce mouse iPS cells to differentiate into odontoblast-like cells. The differentiation efficiency is not high, however, and many stem cells remain. The results also suggest that Sox11 is an important factor in odontoblastic differentiation.

成牙细胞从牙乳头干细胞分化而来,但在此过程中发生的遗传变化尚不清楚。本研究的目的是研究小鼠iPS细胞向成牙细胞样细胞分化过程中的基因表达模式。采用骨形态发生蛋白4 (bone morphogenetic protein 4, BMP4)和维甲酸(retinoic acid, RA)的1型胶原支架培养小鼠iPS细胞。牙本质唾液蛋白、牙本质基质蛋白1 (DMP1)和巢蛋白免疫荧光检测结果均为阳性。qRT-PCR分析显示,神经嵴标记性别决定区Y盒(Sox)-10、牙本质唾液磷酸蛋白(Dspp)和Dmp1 mRNA表达水平上调,而矿化标记骨唾液蛋白和骨钙素mRNA表达水平下调。微阵列分析显示,在所调查的15,330个实体中,有2,597个实体上调,1,327个实体下调。Sox11是被鉴定的上调基因之一。诱导成牙细胞后第11天Sox11 mRNA表达量高于第2天(p
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引用次数: 1
External Root Resorption of Second Molars Due to Impacted Mandibular Third Molars during Orthodontic Retention. 正畸固位时下颌第三磨牙阻生对第二磨牙外牙根吸收的影响。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-09-05 Epub Date: 2022-08-15 DOI: 10.2209/tdcpublication.2021-0044
Dai Ariizumi, Teruo Sakamoto, Masae Yamamoto, Yasushi Nishii

Whether there is a relationship between impaction of the third molars and the onset of crowding remains to be determined, and extraction of third molars after orthodontic treatment is left to the judgement of the practitioner. This report describes a case where a third molar caused external root resorption (ERR) of the mandibular second molar after orthodontic treatment. As ERR of the mandibular second molar was detected after non-extraction orthodontic treatment, the affected tooth was extracted and substituted with the third molar. External root resorption of the second molar occurred despite being determined as low risk given the state of the impacted third molar as observed on a panoramic radiograph obtained at the end of active treatment. The present results indicate that in cases where the mandibular third molar is present, the corpus length is short, and non-extraction treatment has been performed, it is necessary to obtain X-ray images on a regular basis or preventively extract the third molar to avoid ERR of the second molars.

第三磨牙的嵌塞与拥挤的发生是否有关系还有待确定,正畸治疗后第三磨牙的拔除还有待医生判断。本报告描述了一个病例的第三磨牙引起下颌第二磨牙外根吸收(ERR)后正畸治疗。由于非拔牙正畸治疗后检测到下颌第二磨牙ERR,因此将患牙拔出并替换为第三磨牙。尽管在积极治疗结束时获得的全景x线片上观察到第三磨牙的阻生状态,确定第二磨牙的外根吸收风险较低,但仍发生了第二磨牙的外根吸收。本研究结果提示,对于下颌第三磨牙存在,体长较短且未进行过拔除治疗的病例,有必要定期获取x线图像或预防性拔除第三磨牙,以避免第二磨牙发生ERR。
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引用次数: 1
Effects of Cuspal Inclination and Luting Agent on Fracture Load Values in Composite Resin CAD/CAM Crowns. 复合树脂CAD/CAM牙冠中牙尖倾斜度和胶合剂对断裂载荷值的影响。
IF 0.5 Q3 Medicine Pub Date : 2022-05-25 DOI: 10.2209/tdcpublication.2020-0017
Gen Kuroishi, Mamoru Yotsuya, Syuntaro Nomoto, R. Hisanaga, Toru Sato
The purpose of this study was to evaluate whether change in cuspal inclination influences the fracture load values of composite resin computer-aided design/computer-aided manufacturing (CAD/CAM) crowns. Abutment teeth and CAD/CAM crowns were prepared as they would be for treating a mandibular first premolar with two cusps. The CAD/CAM crowns were designed so that 1) the principal stress lines would be radially distributed from the two points of contact with the indenter to the occlusal area of the abutment (Type I), or 2) the principal stress lines would pass outside the occlusal area of the abutment (Types II and III). The CAD/CAM crowns were mounted on the abutments using one of two types of resin or polycarboxylate cement. Fracture load values were measured using a universal tester. The Type I CAD/CAM crowns exhibited the highest mean fracture load value, followed by the Type II crowns and then the Type III crowns, with significant differences seen between all types (p<0.05). The luting agent used (resin or polycarboxylate cement) showed no effect on the fracture load value. With the Type II and Type III crowns, significant differences in the fracture load value were observed between the Super-Bond and Hy-Bond polycarboxylate cement groups (p<0.05).
本研究的目的是评估牙尖倾斜度的变化是否会影响复合树脂计算机辅助设计/计算机辅助制造(CAD/CAM)牙冠的断裂载荷值。制备了基牙和CAD/CAM牙冠,因为它们将用于治疗具有两个尖的下颌第一前磨牙。CAD/CAM牙冠的设计使得1)主应力线将从与压头的两个接触点径向分布到基牙的咬合区域(类型I),或者2)主应力线将穿过基牙的牙咬合区域之外(类型II和III)。使用两种类型的树脂或聚羧酸水泥中的一种将CAD/CAM牙冠安装在基牙上。使用通用测试仪测量断裂载荷值。I型CAD/CAM冠的平均断裂载荷值最高,其次是II型冠,然后是III型冠,所有类型之间存在显著差异(p<0.05)。所用的粘接剂(树脂或聚羧酸水泥)对断裂载荷值没有影响。对于II型和III型牙冠,Super-Bond和Hy-Bond聚羧酸水泥组之间的断裂载荷值存在显著差异(p<0.05)。
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引用次数: 1
New Method of Dental Personal Identification of Disaster Victims Using Oral Scanner. 用口腔扫描仪对灾难受害者进行牙科个人识别的新方法。
IF 0.5 Q3 Medicine Pub Date : 2022-05-25 DOI: 10.2209/tdcpublication.2021-0035
Yasutaka Nakamura, N. Kasahara, M. Hashimoto
Dentistry plays an important role in the identification of victims in large-scale disasters. The current poor status of and problems with victim identification work were highlighted in the aftermath of the Great East Japan Earthquake of March 11, 2011, in which some 10,000 people lost their lives. The techniques of dental identification therefore need to be improved if they are to cope with the problems associated with identification that will accompany the predicted Tokai earthquake and other unexpected large-scale disasters in the future. The purpose of this study was to determine the effectiveness of applying a digital impression-taking device employed in regular dental care to dental personal identification. The Trophy 3DI pro (Yoshida Dental) was applied to a total of 150 dental models. The diagnosis was accurate in 2,096 teeth from a sample of 2,100 comprising 1,240 non-treated teeth, 670 treated teeth, and 190 missing teeth, yielding a 99.8% level of statistical precision. These results suggest that the level of accuracy offered by this impression-taking device indicates that it would be a useful tool in establishing personal identification in disaster victims.
牙科在识别大规模灾难受害者方面发挥着重要作用。2011年3月11日东日本大地震造成约1万人丧生,这凸显了目前受害者身份鉴定工作的糟糕状况和问题。因此,如果要解决与识别相关的问题,牙齿识别技术需要改进,这些问题将伴随着预测的东海地震和未来其他意想不到的大规模灾难。本研究的目的是确定将常规牙科护理中使用的数字印模设备应用于牙科个人识别的有效性。Trophy 3DI pro(Yoshida Dental)应用于总共150个牙科模型。在2100颗样本中,2096颗牙齿的诊断是准确的,其中包括1240颗未经治疗的牙齿、670颗经过治疗的牙齿和190颗缺失的牙齿,统计精度达到99.8%。这些结果表明,这种印象采集设备提供的准确度表明,它将是建立灾难受害者个人身份的有用工具。
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引用次数: 0
Treatment of Chronic Periodontitis with Periodontal Surgery Including Regenerative Therapy Using Recombinant Human Fibroblast Growth Factor-2 and Papilla Preservation Technique: A Case Report with a Two-year Follow-up. 牙周手术治疗慢性牙周炎,包括使用重组人成纤维细胞生长因子-2和乳头保存技术的再生治疗:一例病例报告和两年随访。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-05-25 DOI: 10.2209/tdcpublication.2021-0048
Saki Nakane-Koyachi, K. Imamura, A. Saito
This report describes a case of generalized chronic periodontitis requiring periodontal therapy including periodontal regeneration. The patient was a 59-year-old man who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of mobility in tooth #47. Periodontal examination at the first visit revealed that 32.1% of sites had a probing depth of ≥4 mm and 32.7% of sites bleeding on probing. Radiographic examination revealed vertical bone resorption in #26 and horizontal resorption in #12, 13, 42, and 43. Based on a clinical diagnosis of severe chronic periodontitis, initial periodontal therapy consisting of plaque control, scaling and root planing, occlusal adjustment, caries treatment, and placement of an occlusal splint was performed. Tooth #47 was extracted due to bone resorption extending as far as the root apex. After reevaluation, surgical periodontal treatment was performed at the selected site. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 and papilla preservation technique was performed for #26. To reduce periodontal pockets, open flap debridement was implemented for #12, 13, 42, and 43. After reevaluation, the patient was placed on supportive periodontal therapy (SPT). Periodontal regenerative therapy with rhFGF-2 and modified papilla preservation technique yielded an improvement in angular bone resorption which has been properly maintained for two years. Periodontal therapy with open flap debridement resulted in an improvement in horizontal bone resorption. Continued SPT is needed to maintain a stable periodontal condition.
本报告描述了一例需要牙周治疗的全身性慢性牙周炎,包括牙周再生。患者是一名59岁的男子,他去了东京牙科学院穗岛医院,主要主诉47号牙齿活动不便。第一次就诊时的牙周检查显示,32.1%的牙周穿刺深度≥4mm,32.7%的牙周在穿刺时出血。射线照相检查显示26号患者垂直骨吸收,12号、13号、42号和43号患者水平骨吸收。根据严重慢性牙周炎的临床诊断,进行了初步牙周治疗,包括牙菌斑控制、洁治和牙根刨削、咬合调整、龋齿治疗和放置咬合夹板。47号牙齿由于骨吸收一直延伸到根尖而被拔出。重新评估后,在选定的部位进行牙周外科治疗。使用重组人成纤维细胞生长因子(rhFGF)-2和乳头保存技术对#26进行牙周再生治疗。为了减少牙周袋,对#12、13、42和43进行了开放式皮瓣清创术。重新评估后,患者接受支持性牙周治疗(SPT)。rhFGF-2和改良乳头保存技术的牙周再生治疗改善了角骨吸收,并已适当维持了两年。开放式皮瓣清创的牙周治疗改善了水平骨吸收。需要持续的SPT来维持稳定的牙周状况。
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引用次数: 0
Treatment for Chronic Periodontitis with Class II Furcation Involvement: A Case Report with Four-year Follow-up. 慢性牙周炎伴ⅱ类分叉累及的治疗:一个四年随访的病例报告。
IF 0.5 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2022-05-25 DOI: 10.2209/tdcpublication.2021-0047
Yurie Kitamura, H. Aoki, A. Saito
This report describes a case of generalized chronic periodontitis requiring periodontal treatment including surgery. The patient was a 64-year-old man who visited the Tokyo Dental College Suidobashi Hospital with the chief complaint of pain in tooth #27. An initial examination revealed a probing depth (PD) of ≥4 mm at 38.2% of sites and bleeding on probing at 26.5% of sites. Radiographic examination revealed vertical bone resorption in # 27, 34, and 47, and horizontal resorption in other areas. Based on a clinical diagnosis of severe chronic periodontitis, initial periodontal therapy consisting of plaque control, scaling and root planing was performed. Both #27 and #47 were extracted due to bone resorption extending as far as the root apex. After initial periodontal therapy, sites with a PD of ≥4 mm were observed at 16.7% of sites. Furcation involvement was observed in #16, 17, 36, and 37. The need and options for periodontal surgery based on these findings were explained to the patient. Open flap debridement was implemented for #16, 17, 31, 34, 36, and 37 to reduce periodontal pockets. After reevaluation, the patient was placed on supportive periodontal therapy. The results of the periodontal examination at first visit revealed a periodontal pocket depth of 6 mm and 7 mm in #16 and 17, respectively, and class II furcation involvement in both. Periodontal therapy with open flap debridement resulted in an improvement in horizontal bone resorption where there was class II furcation involvement. This improvement has been adequately maintained over a 4-year period.
本报告描述了一例需要牙周治疗(包括手术)的全身性慢性牙周炎。患者是一名64岁的男子,他去了东京牙科学院穗岛医院,主要主诉是27号牙齿疼痛。初步检查显示,38.2%的部位探测深度(PD)≥4 mm,26.5%的部位探测时出血。射线照相检查显示27号、34号和47号区域垂直骨吸收,其他区域水平骨吸收。根据严重慢性牙周炎的临床诊断,进行了初步的牙周治疗,包括牙菌斑控制、洁治和牙根刨削。#27和#47都是由于延伸到根尖的骨吸收而被提取的。在最初的牙周治疗后,16.7%的部位观察到PD≥4mm。在#16、17、36和37中观察到涉及分叉。根据这些发现向患者解释了牙周手术的必要性和选择。16号、17号、31号、34号、36号和37号患者进行了开放式皮瓣清创术,以减少牙周袋。重新评估后,患者接受支持性牙周治疗。第一次就诊时的牙周检查结果显示,#16和17的牙周袋深度分别为6mm和7mm,两者均涉及II级分叉。开放式皮瓣清创的牙周治疗改善了涉及II级分叉的水平骨吸收。这一改进在4年的时间里得到了充分的保持。
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引用次数: 0
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Bulletin of Tokyo Dental College
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