使用側向移位翻瓣術合併上皮下結締組織移植體治療矯正及正顎手術後之局部嚴重牙根裸露：病例報告

Root Coverage with Laterally Positioned Pedicle Flap and Subepithelial Connective Tissue Graft on Localized Severely Denuded Root Surface after Surgical Orthodontic Treatment in Cleft Lip and Palate: A Case Report

一位具唇裂病史之27歲女性，於正顎手術及矯正治療後，在右上顎第一小臼齒頰側罹患牙齦嚴重萎縮、齒根裸露，口內頰側前庭亦可見疤痕組織於多處形成。由於和鄰牙之間並無齒間骨質喪失且有足夠的附連牙齦組織，本病例於是選擇使用側向移位翻瓣術合併上皮下結締組織移植體來做牙根覆蓋，術後一年仍有百分之百的牙根覆蓋率。於臨床文獻中，尚無應用側向移位翻瓣術合併上皮下結締組織移植體來治療正顎手術後局部嚴重牙齦萎縮之病例，本病例的治療成果顯示此術式應用在該類患者上能得到良好的長期預後及可預測性。

A 27-year-old female patient with secondary cleft deformity and malocclusion was initially treated with reconstructive surgery. However, localized severely gingival recession on the upper right first premolar and massive scar tissue over the buccal vestibular area were formed after the surgical orthodontic treatment. The surgical technique of choice in this patient was laterally positioned pedicle flap (LPF) combined with subepithelial connective tissue graft (SCTG) because of the area adjacent to the recession defect showed a great amount of attached gingiva and without interproximal bone loss. The complete root coverage in the surgical site was observed one year later. To the best of our knowledge, there is no report available on the application of LPF combined with SCTG to treat gingival recession after surgical orthodontic treatment and the result of this report demonstrates the possibility of predictable root coverage and clinical attachment gain.