多种口腔疾病患者的口腔全科治疗1例  

Comprehensive Treatment for A Patient with Multiple Rral Diseases:A Case Report

作　　者：刘绍清 邹士琦[1] 郝智莉[1] 吴煜[1] 吕品[1] Shaoqing Liu*;Shiqi Zou;Zhili Hao;Yu Wu;Pin Lv(Department of Stomatology,Peking University Third Hospital,Beijing,P.R.China)

机构地区：[1]北京大学第三医院口腔科

出　　处：《中国口腔医学继续教育杂志》2023年第4期254-263,272,共11页Chinese Journal of Stomatologial Continuing Education

基　　金：北京大学第三医院临床队列建设项目(项目编号:BYSYDL2019011)。

摘　　要：目的:本病例报道1例以前牙外伤脱位为初诊主诉,同时有多发龋、牙列缺损等多种口腔疾病患者的口腔全科治疗。诊治经过:在系统期排除颅脑损伤等全身重要脏器损伤;在急症处理期处理外伤的前牙,包括脱臼牙的再植、侧向脱位牙的复位固定等;在疾病预防控制期进行以菌斑控制为核心的口腔健康指导,牙周治疗控制牙周感染,根管治疗控制牙髓感染,充填治疗控制龋病感染,拔除治疗无望的残根和无对颌的第三磨牙;在功能和美观恢复期,对根管治疗后的牙齿和缺失牙进行修复治疗;进入维护期定期复查和维护治疗。结果:经过5.5年的维护和随访,在第4年时,再植牙因根外吸收伴根折拔除后行种植修复,患者龋病控制良好,根管治疗、牙周治疗及种植修复疗效稳定。结论:对于患有多种口腔疾病的患者,在进行全面检查和评估的基础上,与患者共同商议制定全面科学的治疗计划,并进行有序标准规范的治疗,注重疾病的病因分析和预防,有助于将复杂的口腔疾病问题简单化,并且有助于长期口腔健康的获得和维护。Objective:This article reports a case of a patient with multiple oral diseases,including anterior tooth avulsion,multiple caries and missing teeth,who underwent a comprehensive dental treatment.Diagnosis and treatment:After comprehensive dental examination,the patient's diagnoses included anterior teeth trauma,caries,wedge-shaped defect,chronic pulpitis,residual roots,chronic periodontitis and dentition defect.After ruling out systemic injuries such as cranial trauma,emergency treatment was performed to control acute symptoms and address the anterior tooth injury,including replantation of the avulsed tooth and fixation of the lateral luxated tooth.During the disease prevention and control period,oral hygiene instruction was provided with plaque control as the core,periodontal treatment to control periodontal infection,root canal treatment to control pulp infection,filling treatment to control carious infection,and extraction treatment for hopeless residual roots and wisdom teeth without opposing arch tooth.During the functional and aesthetic restoration period,teeth undergone root canal treatment and missing teeth were repaired.Regular follow-ups and maintenance treatments were performed during the maintenance period.Results:During 5.5 years of maintenance and follow-up,the replanted tooth was removed due to external root resorption and root fracture in the 4th year and replaced with an implant.The patient had good caries control,and the effects of root canal treatment,periodontal treatment,and implant restoration were stable.Conclusions:For patients with multiple oral diseases,a comprehensive and scientific treatment plan should be developed in consultation with the patient based on a comprehensive examination and evaluation.Standardized treatment focusing on etiology analysis and prevention can simplify laterally avulsion oral disease problems and help achieve and maintain long-term oral health.

关 键 词：口腔全科治疗 前牙外伤 脱臼牙再植 龋病易感因素 龋易感者的管理 

分 类 号：R78[医药卫生—口腔医学]