重度牙周炎患牙的保存治疗

重度牙周炎患牙,尤其是被判断为“预后无望”的患牙,其保存与否是困扰口腔医师的常见且重要的问题。针对这类患牙,临床医生不应轻易做出拔牙的决策,而应仔细检查病情,充分与患者沟通,找到正确的病因,根据患者的具体情况分析保存患牙的有利因素和不利因素,结合患者的意愿、依从性、经济能力等,综合考虑有无保存的可能。本文以单纯重度牙周炎、牙周来源的牙周牙髓联合病变和“真正的牙周牙髓联合病变”3种不同类型的重度牙周炎患牙为例,列举了重度牙周炎患牙的试保存治疗的过程,以期为重度牙周炎患牙的保存和拔牙决策提供参考。

The retention of severe periodontitis-involved tooth

Severe periodontitis-involved teeth,especially those considered as“prognosis hopeless”,are a common and important problem that plagues dentists.Clinicians should not make abrupt extraction decisions but rather carefully perform clinical examination,fully communicate with the patient,explore the correct etiological factors,and analyze the favorable and unfavorable factors according to the specifi c conditions of the patient.Patient’s willingness,compliance,and fi nancial ability should also be considered.This review begins with three typical cases,including simple severe periodontitis-affected teeth,primary periodontal lesion with secondary endodontic involvement teeth,and teeth with“true combined periodontalendodontic lesion.”The decision-making process of tooth extraction or retention in patients with severe periodontitis was also discussed to serve as future reference.