Hafize ÖZENER ÖZTÜRK, H. Selin YILDIRIM, LEYLA KURU

Periodontal apsenin kombine periodontal tedavisi: Bir olgu sunumu

Periodontal apse, periodontal dokuların hızlı yıkımıyla karakterize akut iltihabi bir lezyondur. Bu vaka raporunda alt molar dişte gelişen akut periodontal apsenin kombine periodontal tedavisinin sunulması amaçlanmıştır. Kliniğimize alt sağ bölgesinde ağrı ve şişlik şikayetiyle başvuran 24 yaşındaki sistemik olarak sağlıklı kadın hastanın klinik muayenesinde 46 nolu dişin vestibülünde ödemli, kırmızı, düz ve parlak yüzeyli alveol mukozası görüldü. Periodontal sondayla muayenede vestibülde 12 mm sondalama derinliği (SD) tespit edilirken radyolojik olarak periodontal dokuların normal olduğu saptandı. Lezyona akut periodontal apse teşhisi kondu. İlk olarak apse drenajı ve başlangıç periodontal tedavi (BPT) ile birlikte analjezik ve kombine antimikrobiyal tedaviye (amoksisilin + klavulanik asit 1000 mg 2×1, Metronidazol 500 mg 2×1, 1 hafta) başlandı. BPT sonrası keratinize yapışık dişeti elde etmek amacıyla serbest dişeti grefti uygulandı ve 6 hafta sonra 44, 45 ve 46 nolu dişlerin vestibül yüzeylerindeki dişeti çekilmelerinin tedavisi için mine matriks türevleri (EMDOGAİN®) ile birlikte kuronale kaydırılan flep operasyonu yapıldı. 44, 45 ve 46 nolu dişlerin midbukkalinde sırasıyla SD başlangıçta 2 mm,3 mm, 12 mm ve operasyondan 6 ay sonra 1.5 mm, 1 mm,1.5 mm, dişeti çekilmesi dikey boyutu başlangıçta 2 mm, 3.5 mm, 3.5 mm iken operasyon sonrası 1 mm, 1 mm, 0.5 mm olarak ölçüldü. Periodontal apselerin kombine periodontal tedavisiyle estetik ve fonksiyonel olarak başarılı sonuçlar elde edilebilmektedir.

Combined periodontal therapy of periodontal abscess: A case report

Periodontal abscess is an acute inflammatory lesion characterized by rapid destruction of periodontal tissues. This case report is aimed to present the combined periodontal therapy of a periodontal abscess in mandibular molar. Twenty four year-old systemically healthy female patient was attended to our clinic with complaints of pain and swelling at right mandibular region. Edematous, red, smooth and shiny alveolar mucosa was observed. A probing depth (PD) of 12 mm was measured on the vestibule of tooth #46 with normal radiographical findings; acute periodontal abscess was diagnosed. Firstly abscess drainage and initial periodontal treatment (IPT) were applied with adjunctive antimicrobial therapy. After IPT, in order to obtain keratinized attached gingiva, free gingival graft procedure was performed. Six weeks after the surgery enamel matrix derivatives (EMDOGAIN®) with coronally advanced flap was applied for the treatment of gingival recession on the vestibular surface of the teeth #44, #45 and #46. PD of the teeth #44, #45 and #46 were 2 mm, 3mm, 12 mm at baseline, respectively, and 1.5 mm, 1 mm,1.5 mm at 6 months; recession depth of the teeth #44, #45 and #46 were 2 mm, 3.5 mm, 3.5 mm at baseline, and 1 mm, 1 mm, 0.5 mm at 6 months, respectively. Aesthetically and functionally successful results can be obtained with combined approach in the treatment of periodontal abscess.

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