中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (4): 269-283.DOI: 10.12337/zgkqjxjyzz.2025.04.010

• 病例分析 • 上一篇    下一篇

牙周-正畸-修复联合治疗安氏Ⅰ类错𬌗畸形伴下前牙牙龈退缩1例

程佳佳1,2, 陈广生1,2, 王茹楠1, 何欣1,2, 蒋宇杰1,2, 葛颂1,2, 高丽1,2,*   

  1. 1遵义医科大学口腔医学院;
    2遵义医科大学附属口腔医院牙周科
  • 出版日期:2025-07-31 发布日期:2025-07-31
  • 通讯作者: *高丽,联系方式:0851-28635724,电子邮箱:467278759@qq.com,通讯地址:贵州省遵义市新浦新区乌江大道89号,563000
  • 基金资助:
    国家临床重点专科建设项目(国卫办医政函[2023]213号); 遵义市科技计划项目[遵市科合HZ(2024)347]

Periodontal-orthodontic-prosthodontics Combined Treatment of Class I Malocclusion with Gingival Recession of Lower Anterior Teeth: a Case Report

Jiajia Cheng1,2, Guangsheng Chen1,2, Runan Wang1, Xin He1,2, Yujie Jiang1,2, Song Ge1,2, Li Gao1,2,*   

  1. 1School of Stomatology, Zunyi Medical University, Zunyi, Guizhou Province, P.R.China;
    2Department of Periodontology, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, Guizhou Provice, P.R. China
  • Online:2025-07-31 Published:2025-07-31
  • Contact: Li Gao. Tel: 0851-28635724. Email: 467278759@qq.com. Address: 89 Wujiang Avenue, Xinpu New District, Zunyi 563000, Guizhou Province, P.R. China.
  • Supported by:
    National Key Clinical Specialty Construction Project(No.213 [2023] of the Medical Administration Department, National Health Commission); Zunyi Science and Technology Plan Project [Zunshi Kehe HZ (2024) 347]

摘要: 目的:本文报道1例伴有下前牙牙龈退缩的安氏Ⅰ类错𬌗畸形患者的牙周-正畸-修复多学科联合诊疗过程,并探究其临床效果。诊治经过:该患者因下前牙牙龈退缩、有散在间隙及错𬌗畸形影响美观就诊,明确诊断及患者知情同意后,采用牙周基础治疗控制牙周炎症,游离龈移植(free gingival graft,FGG)术治疗牙龈退缩,并通过牙周辅助加速正畸成骨(periodontal accelerated osteogenic orthodontics,PAOO)术改善硬组织骨量不足,最后通过正畸关闭间隙、调整咬合,并配合修复治疗恢复缺失牙。结果:治疗后牙龈退缩显著改善,角化龈宽度增加,正畸牙移动安全完成,错𬌗畸形纠正,缺失牙功能与美观重建。治疗全程牙周情况良好,且下前牙牙龈龈缘水平位置稳定。治疗完成后2年随访,咬合关系及软组织形态维持良好,患者满意度高。结论:通过FGG术和PAOO术等再生性技术重建牙周软硬组织的支持,并采用渐进式移动策略,可控制牙龈退缩加重的风险。

关键词: 牙周-正畸-修复联合治疗, 错牙合畸形, 牙龈退缩, 牙周炎, 多学科联合治疗

Abstract: Objective: This paper reports the multidisciplinary treatment process of periodontal-orthodontic-restoration in a patient with Class I malocclusion with gingival recession of lower anterior teeth and explores its clinical effect. Diagnosis and treatment: The patient was affected by the gingival recession of the lower anterior teeth, the scattered space, and the malocclusion, which affected the aesthetic treatment. After the diagnosis and the patient's informed consent, the basic periodontal treatment was used to control the periodontal inflammation. Free gingival graft (FGG) was used to treat gingival recession, and periodontal accelerated orthodontic osteogenesis (PAOO) was used to improve the bone mass of hard tissue. Finally, orthodontic treatment was used to close the gap and adjust the occlusion and was combined with restorative treatment to restore the missing teeth. Results: After treatment, the gingival recession was significantly improved, the width of keratinized gingiva was increased, the orthodontic tooth movement was completed safely, the malocclusion was corrected, and the missing tooth function and aesthetic reconstruction were completed. The periodontal condition was good throughout the treatment, and the gingival margin of the lower anterior teeth was stable. After 2 years of follow-up, the occlusal relationship and soft tissue morphology were maintained well, and the patient satisfaction was high. Conclusions: The support of periodontal soft and hard tissue reconstruction through regenerative techniques such as FGG and PAOO, and the progressive movement strategy can control the risk of increased gingival recession.

Key words: periodontal-orthodontic-prosthodontics combined treatment, malocclusion, gingival recession, periodontitis, multidisciplinary combined treatment