Abstract:

Molars with severe periodontal lesions are often accompanied by deep pockets and severe bone resorption，and inflammation in the apical area of maxillary molars can also spread to the corresponding maxillary sinus，which causes thickening of maxillary sinus mucosa. It will not only affect the normal function of patients′ paranasal sinuses，but also increase the difficulty and risk for implantation after the loss of maxillary molars. Minimally invasive extraction and thorough debridement combined with site preservation of the maxillary molars can not only control the infection of the sockets and restore the profile of alveolar ridge，but also reduce the inflammatory thickening of the corresponding maxillary sinus mucosa. This paper presented a case of a maxillary molar with severe periodontal lesions which received minimally invasive extraction with thorough debridement and site preservation before implantation and restoration as well as the follow-up，and the alteration of thickness of the corresponding maxillary sinus mucosa before and after tooth extraction was compared and analyzed，which provides evidence and clinical experience for the treatment of such cases.

Key words: periodontitis, maxillary molars, minimally invasive extraction, mucosal thickening

摘要：

罹患重度牙周病变的磨牙常伴有深牙周袋与严重的牙槽骨吸收，同时累及上颌磨牙根尖区的炎性病变亦可扩散至上颌窦内引起上颌窦黏膜出现增厚样改变。这不仅会影响患者鼻窦正常功能，还会为对应上颌磨牙丧失后的种植治疗设计和实施增加难度和风险。对待拔上颌磨牙进行微创拔牙、彻底清创，同期行位点保存术，不仅能够有效控制拔牙位点的感染，保存牙槽嵴轮廓，同时可减轻上颌窦黏膜炎症反应性增厚。文章完整展示了1例罹患重度牙周病变的上颌磨牙实施微创拔牙、彻底清创同期行位点保存术后完成种植修复治疗后定期随访的全过程，并对拔牙前后对应上颌窦黏膜厚度的变化特点进行了比较分析，为此类病例的临床处置提供了一定依据与参考意义。

关键词: 牙周炎, 上颌磨牙, 微创拔牙, 黏膜增厚