Departmental Bulletin Paper サポーティブペリオドンタルセラピーで5年間経過した広汎型重度慢性歯周炎患者の一症例

土藏, 明奈  ,  田村, 真依  ,  小川, 千春  ,  渋谷, 俊昭

Description
患者は46歳女性で、歯牙動揺と歯肉腫脹で来院され、全顎的に深いポケットを認めた。歯科医師と歯科衛生士による生活習慣に着目した介入を伴う歯周基本治療を行い、歯周外科治療を経てサポーティブペリオドンタルセラピー(SPT)へと移行し5年間経過している。その間に禁煙指導が奏功した一症例である。現在は定期的なSPTが継続され、再発の予防及び健康の増進を目指せることが示唆された症例を報告する。The patient, 46-year- old female presented with the complaint of the teeth mobility and gingival swelling. There was grade I and Ⅱ mobility in many of teeth. Periodontal examination revealed gingival swelling, 74.4% bleeding at probing sites, 57.7% plaque control record, and 41.4% of the sites had a periodontal pocket depth of 4 mm or more. Based on the clinical and radiographic findings, a diagnosis of generalize chronic periodontitis was assigned to the patient. According to these findings, treatment was started with an initial phase of mechanical therapy; including systematic scaling and planing of all accessible root surfaces and the introduction of meticulous oral hygiene. A thorough initial phase of mechanical therapy, the patient was motivated for better plaque control. We started supporting the smoking cessation in this period. The full-mouth flap surgery was performed including enamel matrix protein application. Reevaluation revealed decreased the sites of bleeding on probing, plaque control record and periodontal pocket depth. A postoperative radiograph 12 months later showed a significant bone formation. The patient was put on regular recall appointments for periodontal supportive therapy. The oral hygiene maintenance and compliance of the patient was excellent, and there were no signs of recurrence of the disease throughout the maintenance period more than five years. The patient was success for smoking cessation finally. This case is suggested that the collaboration with patient and dental professionals can improve the oral health and life conditions.
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