重度牙周炎致牙齿松动脱落患者前牙美学区综合治疗1例报告及文献复习

目的：探讨重度牙周炎致前牙松动脱落患者的治疗和美学修复，阐明多学科综合治疗对前牙美学区的治疗效果，为其临床应用提供参考。方法：患者，男性，57岁，因上下前牙松动不适半年余就诊。专科检查见11、21、22、41松动Ⅲ°，42松动Ⅱ°。经多学科会诊后，行牙周基础治疗，炎症控制后，拔除11、21、22、41、42并行即刻种植，富血小板纤维蛋白（PRF）联合引导骨再生（GBR）技术修复种植体周围骨缺损。因患者美学要求，12、13、23、31、32、33、43根管治疗后行牙体预备，13-23、33-43行固定修复。结果：种植术后显示种植体位置良好，种植体周围骨量充足，口内见牙龈软组织愈合良好，牙槽嵴丰满度较好；修复完成后较好地恢复了患牙的咀嚼发音功能，患者对美学效果满意。结论：通过多学科综合治疗的应用，成功实现了对重度牙周炎患者前牙美学区的种植修复，为前牙美学区的诊疗开辟了新途径。

Comprehensive treatment of anterior esthetic zone in patient with loosening and falling of teeth induced by severe periodontitis:A case reeport and literature review

Objective:To investigate the treatment and aesthetic restoration of anterior tooth loosening and falling in the patient with severe periodontitis,and to clarify the curative effect of multidisciplinary treatment in the anterior esthetic zone,and to provide reference for its clinical application.Methods:The male patients was 57 years old,and saw a dcotor becasuse of anterior teeth loosening and discomfort for more than half a year.The specialized examination:11,21,22,41 Ⅲ°loose,42 Ⅱ°loose.After multidisciplinary consultation,the teeth were treated with periodontal therapy.After inflammation was controlled,11,21,22,41,42 were removed for immediate implantation.The platelet rich fibrin(PRF)combined with guided bone regeneration(GBR)was used to repair the bone defect around the implants.Because of the aesthetic requirements of the patients,tooth preparation was performed for 12,13,23,31,32,33,43 after root canal therapy.Fixed restorations were performed in 13-23 and 33-43.Results:After operation,the implant was well positioned and the bone surrounding the implant was adequate.The soft tissue in the mouth healed well and the degree of the alveolar ridge was better.After restoration, the masticatory and phonation function of the teeth were restored,and the patients were satisfied with the aesthetic effect.Conclusion:Through the application of multidisciplinary treatment,the implant repair of the anterior esthetic zone of the patient with severe periodontitis is successfully achieved,which opens a new way for the diagnosis and treatment of the anterior esthetic zone.