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目的:从口腔健康和全身健康两方面阐述重度牙周炎的多学科联合治疗的意义。方法:利用病例报告1例重度慢性周牙炎伴错(牙合)畸形的患者和1例慢性广泛型重度牙周炎伴2型糖尿病的患者的多学科联合治疗。结果:1例重度慢性周炎伴错(牙合)畸形的患者通过在牙周系统治疗的基础上,通过牙周、牙体牙髓、正畸等多学科的综合治疗有效恢复患者的美观和功能,并保持疗效长期稳定;1例慢性广泛型重度牙周炎伴2型糖尿病的患者经过完善细致的牙周基础治疗不仅可以控制牙周炎症,改善牙周的各项临床指标,同时可以降低空腹血糖和糖化血红蛋白,从而达到牙周炎和糖尿病的双向改善。结论:重度牙周炎多学科联合治疗的目的即是控制菌斑、消除炎症,终止疾病发展,恢复和重建患牙的功能与美学,维持长期疗效、防止复发,对一些无望保留的患牙,通过牙周再生性手术并联合正畸、修复等治疗手段改变患牙的预后;伴有全身疾病的重度牙周炎在多学科治疗中同时还应积极配合内科医生进行全身疾病的治疗和监控。对于慢性重度牙周炎,基础治疗后还需要定期的牙周维护治疗,如果无患者自身良好而有效的菌斑控制,多学科联合治疗可能会全盘皆输。
Objective: To expound the significance of multidisciplinary combined treatment of severe periodontitis from the aspects of oral health and general health. METHODS: A multidisciplinary combination of 1 case of severe chronic peri-oditis with malocclusion and 1 case of chronic extensive type severe periodontitis with type 2 diabetes was reported. Results: One patient with severe chronic dermatitis and malocclusion was able to effectively restore the patient’s aesthetic appearance by comprehensive treatment of periodontal system, dental pulp, orthodontics and other multidisciplinary treatments on the basis of periodontal system treatment Function, and to maintain long-term efficacy and stability; 1 case of chronic extensive type of severe periodontitis with type 2 diabetes after thorough and periodontal basic treatment can not only control periodontal inflammation, improve the clinical indicators of the periodontal, and can reduce Fasting blood glucose and glycated hemoglobin, so as to achieve two-way improvement of periodontitis and diabetes. Conclusion: The purpose of multidisciplinary combined treatment of severe periodontitis is to control plaque, eliminate inflammation, stop the development of the disease, restore and reconstruct the function and aesthetics of the affected teeth, maintain long-term curative effect and prevent relapse. For some teeth with no hope of retaining, Through periodontal regenerative surgery combined with orthodontics, repair and other treatment methods to change the prognosis of the affected teeth; accompanied by systemic disease of severe periodontitis in multidisciplinary treatment should also actively cooperate with the physician for the treatment and monitoring of systemic diseases. For chronic severe periodontitis, regular periodontal maintenance treatment is also required after basic treatment, and multidisciplinary combination therapy may lose in the absence of good and effective plaque control.