臺灣博碩士論文加值系統

近二十多年來，牙周病的治療，已有突破性的發展。大量使用牙周再生及骨再生，包括不可吸收、可吸收再生膜，牙周整形術，及骨整合植牙來幫助口腔的重建。在美觀和功能上的最終建立，我們可以使用以上的技術來達成，但是成功的病例還是要依靠精確的計劃及確實的實行。
牙周補綴治療的長期成功必須決定於整個病例的設計，這又受到牙周健康的支柱牙、良好的咬合觀念、及確實的維持治療的影響。而這個目標最好是藉由牙周、補綴的專家，甚至擴充到根管治療、矯正治療及口腔外科醫師整體團隊的合作來達成。
這篇臨床論文包括九個牙周補綴病例，除了基本的牙周治療外，更包括了引導組織再生術、引導骨頭再生術，以及植牙手術的相互應用，全部的臨床結果都不錯。

In the last two decades, comprehensive dentistry has seen a breakthrough and wide spread use of periodontal and bone regeneration, included nonabsorbable and absorbable regenerative membrane, periodontal plastic surgery, and osseointergated implant assisted oral reconstruction. Both the esthetics and functions of the final construction can be dramatically enhanced using theses techniques, but success is dependent on precise planning and execution.
Long-term success in periodontal-prosthetic treatment depends on case design that is influenced by the number and location of periodontally healthy abutment teeth, sound occlusal concepts, and maintenance therapy. This goal can best be achieved with a team approach that includes the periodontist and general practitioner or prosthodontist, and which may be expanded to involve the endodontist, orthodontist, and oral surgeon.
This clinical thesis included 9 periodontal -prosthetic cases that had the standard therapeutic sequence and the surgery of GTR or GBR with regenerative membranes, or dental implant surgery and all clinical outcomes were good.

論文內容：
I、 前言：
II、 臨床病例報告：
壹、 牙周─引導骨再生術（GBR）─補綴贗復（使用Gore-Tex® 再生膜）
貳、 牙周─引導組織再生術（GTR）；（使用Vicryl® 再生膜）
參、 牙周─瓣膜翻開牙根刮平術─補綴贗復（使用改良式C.S.C.假牙及固定假牙贗復）
肆、 牙周─單一植體植入─補綴贗復（單一牙冠）
伍、 牙周─牙科矯正─游離牙齦移植手術─補綴贗復（固定牙橋）
陸、 牙周─牙根平整數─補綴贗復（固定牙橋及可撤式活動假牙）
柒、 牙周─多顆植體植入─引導骨再生術（GBR）─補綴贗復（固定牙橋）；（使用Gore-Tex® 再生膜）
捌、 牙周─引導骨再生術（GBR）─補綴贗復（第一次使用BioOss®＋Capset®，第二次使用Unigraft®＋PeriAid®再生膜）
玖、 牙周─引導骨再生術（GBR）─補綴贗復（使用HA＋Vicryl® 再生膜）
III、病例討論：
Part I－GTR 與GBR之探討
Part II－牙周整形與黏膜牙齦手術─游離牙齦移植術
Part III－牙科種植體周圍炎（Peri-implantitis）的治療策略
Part IV－贗復補綴
IV、參考資料：

1.曾春祺。各種不同再生材料用於再生手術的比較。中華牙周醫誌5.No2. : 73-77, 2000。
2. Cortellini P, Tonetti M. Focus on intrabony defects: guided tissue regeneration.
Periodontal 2000,22:104-132,2000.
3. Lundgren D, Nyman S, Mathisen T, Isaksson S, Klinge B. Guided bone regeneration of cranial defects, using biodegradable barriers:an experimental pilot study in the rabbit.J Cranio Maxillofac Surg,20:257-260,1992.
4. Hammerle CHF, Schmid J, Lang NP,Olah AJ.Temporal dynamics of healing in rabbit cranial Defects using guided bone regeneration. J Oral Maxillofac Surg, 53:167-174,1995.
5. McGinnis M,Larsen P, Miloro M, Beck FM. Comparison of resorbable and nonresorbable guided bone regeneration materials: A preliminary study.
Int JOral Maxillofac Implants,13:30-35,1998.
6. Schenk RK, Buser D, Hardwick WR, Dahlin C. Healing pattern of bone regeneration in membrane-protected defects. A histologic study in the canine mandible. Int J Oral Maxillofac Implants,9:13-29,1994.
7.陳瑞雲、董醒任。可吸收阻隔膜於引導骨再生的應用。中華牙周醫誌4.No2. : 79-93, 1999。
8. Dahlin C, Gottlow J, Linde A, Nyman S. Healing of maxillary and mandibular bone defects using a mambrane technique. Scand J Plast Reconstr Hand Surg, 24:13-19,1990.
9. Nyman S. Bone regeneration using the principle of guided tissue regeneration. J Clin Periodontal, 18:494-98,1991.
10. Dahlin C, Alberius P, Linde A. Osteopromotion for cranioplasty. An Experimental study in rats using a membrane Technique. J Neurosurg, 74:48491,1991.
11. Zitmann NU, Naef R, Scharer P. Resorbable versus nonresorbable membranes in
combination with Bio-Oss for guided tissue regeneration. Int J Oral Maxillofac Implants,12:844-852,1997.
12. Hurzeler MB, Quinoner CR, Hutmacher D, Schupbach P. Guided bone regeneration around dentalimplants in the atrophic alveolar ridge using a bioresorbable barrier. An experimental study in the monkey. Clin Oral Impl
Res,8:323-331,1997.
13. Bergsma EJ, Brujn W, Rozema FR, Bos RM, Boering G. Late tissue response to poly(L-lactide) bone plates and screws. Biomaterials, 16:25-31,1995.
14.楊冠儀 洪純正 蔡吉政，牙釉衍生物在牙周骨缺損的臨床治療，中華牙周醫誌6.No4. : 261-266, 2001。
15. Pontoriero R, Wennstrom J, Lindhe J. The use of barrier membranes and enamel matrix proteins in the treatment of angular bone defects. A prospective controlled clinical study. J Clin Periodontol, 28:397-403, 2001.
16.Bjorn H. Free transplantation of gingival propria. Swed Dent J,22:684-689,1963.
17.Nabers CL. Extension of vestibular fornix utilizing a gingival grafts. Case history. Periodontics,4:77,1966.
18.Miller PD Jr. Root coverage using a free soft tissue autograft following citric acid application. Part 1: Technique. Int J Periodont Rest Dent,2(1):65-70,1982.
19.Miller PD Jr. Root coverage with the free gingival graft. Factors associated with incomplete coverage. J Periodontol ,58(10):65-70,1982.
20.Borghetti A. Gardella JP. Thick gingival autograft for the coverage of gingival recession: a clinical evaluation. Int J Periodont Rest Dent,10(3):216-219,1990.
21.Holbrook T. Ochsenbein C. Complete coverage of the denuded root surface with a one-stage gingival graft. Int J Periodont Rest Dent,3(3):8-27,1983.
22.Batenhorst KF. Bowers GM. Williams JE jr. Tissue changes resulting from facial tipping and extrusion of incisor in monkeys. J Periodontol, 45(9):660-668, 1974.
23.Maynard JG jr. Wilson RD. Diagnosis and management of mucogingival problems in children. Dent Clin North Am, 24(4):683-703, 1981.
24. 侯桂林 蔡吉政，改良式雙重冠活動假牙的臨床應用II.牙周與補綴治療，
臺灣齒科醫學會雜誌 12：490-499, 1989.
25. Yalisove IL, Dietz JB: Telescope prosthetic therapy-Biomechanics of the crown and sleeve-coping prosthesis. 1st ed. P27, Philadelphia, Strickley Co.,1977.
26. Silverman ES: Use of the crown and sleeve-coping design in the treatment of
rapidly advancing periodontitis. Compend contin Educ Dent 8:97-102,1986.
27. Hou GL: Modified CSC-telescope denture for the remaining teeth in severaly
advanced periodontitis. A longitudinal study of 8 years.. submitted for publication.