上颌前牙显微根尖手术附着龈切口美学修复1例  

A case of aesthetic restoration of attached gingival incision in endodontic microsurgery of upper anterior teeth

作　　者：陶慧敏 张艳丽 陈巧 肖海波 TAO Huimin;ZHANG Yanli;CHEN Qiao;XIAO Haibo(Department of Dentistry and Endodontics,Youyi Road Courtyard,Stomatological Hospital Affiliated to Hunan University of Chinese Medicine,Hunan,Changsha 410004,China)

机构地区：[1]湖南中医药大学附属口腔医院友谊路院牙体牙髓科,湖南长沙410004

出　　处：《中国医药科学》2024年第8期184-186,共3页China Medicine And Pharmacy

基　　金：2023年湖南中医药大学研究生创新课题立项项目(2023CX63)。

摘　　要：目的对上颌前牙因慢性根尖周炎需行显微根尖手术的病例,考虑术后牙龈软组织愈合美观问题,建议采用附着龈切口美学修复方法。方法对需行显微根尖手术的上颌前牙且患牙已行冠修复,边缘密合,附着龈宽度足够者,切口设计为附着龈切口,去除根尖病变区颊侧骨壁,彻底刮除病变组织,截除根尖3 mm,刮勺搔刮根尖区感染物。超声工作尖倒预备根管3 mm,三氧矿物聚合物(MTA)倒充填,胶原膜覆盖囊腔,复位黏骨膜瓣,缝合。结果患者7个月后复查,无不适,计算机断层成像技术(CBCT)示根尖区成骨,术区龈缘未见明显退缩。结论患牙为上颌前牙,位于美学区,且患牙修复体边缘密合,附着龈宽度足够,切口设计为附着龈切口,可以更好地修复软组织,避免牙龈退缩。Objective To consider the aesthetic problem of gingival soft tissue healing after endodontic microsurgery and suggest an aesthetic restoration method of gingival attachment incision for the case of maxillary anterior teeth requiring endodontic microsurgery due to chronic periapical periodontitis.Methods For the maxillary anterior teeth which require endodontic microsurgery and have been crown-restored,with close edges and enough width of attachment gingiva,the incision was designed as an attachment gingival incision,the buccal bone wall of the apical lesion area was removed,the lesion tissue was completely scraped off,the apex was cut off by 3 mm,and the infected tissue in the apical area was scratched with a spatula.The retro-preparation of 3 mm was made by ultrasonic tip and retrograde filling was made using mineral trioxide aggregate(MTA),the cavity was covered with collagen membrane,and the mucoperiosteal flap was reset and sutured.Results During reexamination carried out 7 months after surgery,the patient had no discomfort.Cone beam computed tomog raphy(CBCT)showed osteogenesis in the apical area,and the gingival margin in the operation area did not shrink obviously.Conclusion The affected tooth is the maxillary anterior tooth,which is in the aesthetic area,with close edge of the restoration and sufficient width of the attached gingiva.The incision is designed as an attached gingival incision,which can better repair the soft tissue and avoid gingival recession.

关 键 词：上颌前牙 显微根尖手术 皮瓣设计 附着龈切口 

分 类 号：R781[医药卫生—口腔医学]