Ⅲ期C级牙周炎正畸患者上前牙龈乳头缺陷伴牙龈退缩1例  

Treatment of gingival papilla loss with gingival recession in orthodontic patients with stageⅢgrade C periodontitis:a case report

作　　者：赵美林[1] 赵依琼 黄姣[1] Zhao Meiin;Zhao Yiqiong;Huang Jiao(Stomatological Hospital of Chongqing Medical University,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education,Chongqing 401147,China)

机构地区：[1]重庆医科大学附属口腔医院、口腔疾病与生物医学重庆市重点实验室、重庆市高校市级口腔生物医学工程重点实验室,重庆401147

出　　处：《国际口腔医学杂志》2025年第3期333-340,共8页International Journal of Stomatology

基　　金：重庆市科学技术局项目(CSTB2022BSXM-JCX0047)。

摘　　要：完善的牙周非手术治疗和正畸治疗可以改善牙周炎患者的口腔健康、功能和美观,对于重度牙周炎患者,在牙周系统治疗后可能出现牙龈退缩和龈乳头缺陷等美学问题,需要个性化多学科合作治疗。本案例报道1例Ⅲ期C级牙周炎患者在牙周非手术治疗、前牙区单纯翻瓣术及正畸治疗后出现上前牙唇侧牙龈退缩及龈乳头缺陷,通过术前X线测量及诊断饰面分析,评估可以降低接触点到牙槽嵴顶的距离到5 mm内,并获得较理想的牙冠美学效果。通过设计“T”型结缔组织瓣及唇侧冠向复位瓣重建龈乳头及改善唇侧牙龈退缩,通过复合树脂贴面修复降低接触点位置并进一步修复黑三角。术后2年获得邻面附着水平的明显改善,理想的唇侧根面覆盖效果,以及较好的龈乳头形态,改善了患牙的预后,并有利于美学效果的长期保持。长期的临床效果需要进一步的临床观察。Comprehensive periodontal nonsurgical treatment and orthodontic treatment can improve the oral health,function,and aesthetics of patients with periodontitis.For patients with severe periodontitis,aesthetic problems,such as gingival recession and gingival papillary defects,may occur after periodontal system treatment,requiring personalized multidisciplinary collaborative treatment.This article reports a case of a patient with stageⅢgrade C periodontitis who underwent periodontal nonsurgical,simple flap,and orthodontic treatments in the anterior tooth area and labial-gingival retraction and gingival papillary defect repair in the anterior teeth.Preoperative X-ray measurement and diagnostic mock-up analysis revealed that the distance from the contact point to the alveolar ridge crest could be reduced to less than or equal to 5 mm and an ideal aesthetic effect of the dental crown could be achieved.A T-shaped connective tissue flap and lip coronal-positioned flap were designed to re‐construct the gingival papilla and improve the lip gingi‐val recession.Composite resin veneers were used to lower the contact point position and repair black triangles.Re‐markable improvement in clinical attachment level,ideal root coverage effect,and good gingival papilla morphology were achieved two years after surgery.These changes improved the prognosis of the affected teeth and facilitated the long-term maintenance of aesthetic effects.Long-term cli-nical outcomes require further clinical observation.

关 键 词：黑三角 牙周炎 正畸 翻瓣术 牙龈退缩 龈乳头重建 根面覆盖 贴面 

分 类 号：R781.4[医药卫生—口腔医学]