臺灣博碩士論文加值系統

齒槽脊破壞嚴重的慢性牙周炎患齒，牙齒被拔除後，齒槽脊萎縮的很快，常造成以後贗復的困難，即使在這個位置作多次的骨移植和結締組織移植，要增加到原來齒槽脊高度的一半也很難，病人多次挨刀受苦，效果卻不理想，所以拔完牙，立即植入人工牙根，以獲得齒槽骨的高度，就顯得相當重要。

本病例報告的主要目的是對嚴重牙周病患者，拔完牙，立即置入人工牙根，齒槽骨高度獲得保留的評估。其結果支持如Novaes Jr和Novaes研究團隊所述，牙周發炎地區如果有適當的臨床術前術後追蹤如抗生素的使用，發炎地區有精緻的清除乾淨，植牙前齒槽脊清創徹底，初期的翻瓣手術能完全縫合，以及植體沒有暴露出來，則立即植牙並不是禁忌症，即使是對嚴重牙周病患者亦是如此。

The severely destroyed alveolar bone of the chronic severe periodontal teeth will atrophy even more quickly after the extraction of the teeth.This phenomenon often causes the difficulty of later prosthetics.Even if bone grafting and tissue grafting have been conducted many times at the same area,it is also hard to increase even half of the original height of alveolar bone .In order not to let patients suffer the pain from the operations and to improve the effectiveness of the operation,immediate implant placement into the socket after the extraction of the teeth to gain the height of alveolar bone is very important.
The objective of the case report was to evaluate the preservation of the height of the alveolar bone after the extraction of the teeth with the chronic severe periodontal disease.The results of this report support the conclusion that periodontal infected site may be not a contraindication for immediate implant and even for severe peridontal teeth if appropriate administration of periodontal infection has performed before implant placement,as describe by Novaes Jr. and Novaes coworkers,such as antibiotic administration,meticulous cleaning,and alveolar debridement before surgery.In addition,primary flap closure is also desirable when placing immediate implants,and avoid exposure of the implant must be considered.

壹、前　　言 1
貳、材料與方法 2
參、病例摘要分析 3
　　病例報告(一)：廣泛慢性嚴重牙周炎 3
＊拔牙後，立即置入人工牙根，以獲得齒槽骨的垂直高度，並且上下全口重建
　　病例報告(二)：局部慢性嚴重牙周炎 23
＊以Emdogain配合牙周手術、人工牙根、臼齒根叉分割、套疊式牙冠義齒贗復重建
　　病例報告(三)：廣泛慢性嚴重牙周炎 37
＊上頜：固定牙冠　　　　　　　
＊下頜：矯正擁擠齒列，保留三級搖動牙齒，以薄短內冠及全口覆蓋式義齒重建咬合
　　病例報告(四)：廣泛慢性嚴重牙周炎 49
＊喪失咬合高度患者，以薄短蓋內冠及全口覆蓋式義齒重建咬合
　　病例報告(五)：局部慢性牙周炎，牙脊嚴重萎縮的缺牙區及生理寬
度不足之補綴物 59
＊上頜：生理寬度不足之補綴物作牙周手術，使生物寬度有3mm。　　
＊下頜：牙脊萎縮的右後下缺牙區，以人工牙根重建咬合並擴張頰側牙齦寬度。　　　
　　病例報告(六)：局部慢性嚴重牙周炎 73
1.以人工牙根重建咬合　　　　　
2.以Emdogain作引導組織牙周再生手術
　　病例報告(七)：局部慢性牙周炎及缺牙 87
＊上頜：a.前牙：以固定牙冠改善美觀 　　　　
　　　　b.後牙：牙周手術配合Emdogain　
＊下頜：以人工牙根贗復缺牙
　　病例報告(八)：廣泛慢性嚴重牙周炎 100
＊上頜：薄短內冠及全口覆蓋式義齒
＊下頜：薄短內冠及全口覆蓋式義齒
　　病例報告(九)：廣泛慢性嚴重牙周炎 113
＊上頜：薄短內冠附加活動式假牙
＊下頜：薄短內冠附加活動式假牙
參、討論 128
肆、結論 149
伍、參考文獻 151
　　　

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