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題名 | 以人工培養粘膜取代牙科植體周圍移植皮膚--病例報告=Skin Graft Replaced by Cultured Mucosa around Dental Implant--Report of a Case |
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作者 | 蔡啟穎; 上田實; 任爾崇; 陳文和; 陸炯志; Tsai, Chi-ying; Ueda, Minoru; Zen, Er-chung; Chen, Win-ho; Luk, Kwing-chi; |
期刊 | 中華民國口腔顎面外科學會雜誌 |
出版日期 | 19990300 |
卷期 | 10:1 民88.03 |
頁次 | 頁53-62 |
分類號 | 416.96 |
語文 | chi |
關鍵詞 | 骨整合牙科植體; 前庭成形術; 人工培養粘膜; |
中文摘要 | 骨整合牙科植體周圍的軟組織狀態,對於牙科植體的成功率,扮演著重要的角色。在此報告一病例:日本籍男性病患,因罹患下顎鱗狀細胞癌,手術切除全部腫瘤,包括大範圍下顎骨切除以及頸部廓清術,並取帶皮、帶血管之腓骨游離瓣做口腔重建。術後追蹤18個月無癌症復發,種上Branemark牙科植體。再經過6個月骨整合期後,口腔內狀況為下顎骨平坦、無前庭區、皮瓣厚、並有粗糙、發毛、發汗、惡臭等現象。乃決定以前庭成形術及人工培養粘膜取代皮瓣,改善植體周圍之軟組織環境。人工粘膜的做法是,採用病患自身之口腔粘膜組織做細胞培養,經過3星期的培養後,長成約1000倍的人工培養粘膜。在植牙體第二次手術時,先做前庭成形術,接上植體支柱牙,然後在骨膜上覆蓋人工培養粘膜,固定一個星期,發現人工培養粘膜已完全附著於骨膜之上,過厚皮膚及過度角化現象已獲得改善,發汗、發毛、惡臭現象消失,最後交由補綴醫師進行假牙製作。 |
英文摘要 | The soft tissue around osseointegrated dental implant plays a very important role to the success of implants. Here we report a case: a Japanese male patient suffered oral squamous cell carcinoma and recieved segmental resecrtion of the mandible and neck dissection. Rehabilitation was performed by vascularized fibular bone graft. After 18 months, there was no sign of recurrence, then Branemark dental implants were installed. After 6 months, flatten lower ridge without vestibule was noted the skin flap was thick and rough, hairy, sweaty with bad odor in the oral cavity. We decided to improve the condition by doing vestibuloplasty and replacement of the skin graft with artificial culture mucosa (ACM). We took healthy oral mucosa specimen from the same patient, and sent it to the laboratory for cell culture. After 3-week culture, the ACM was about 1000 times of the original size. At the second stage of dental implant surgery, we performed the vestibuloplasty first, connected the abutment, then covered the periosteum by the ACM. One week later, the ACM was completely attached to the periosteum, the previous problems were solved. Finally, the patient was referred to the prosthodontist for further treatment. |
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