重症B型血友病患者における感染歯の抜歯、骨移植、即時インプラント埋入、即時仮冠挿入

Infected tooth extraction, bone grafting, immediate implant placement and immediate temporary crown insertion in a patient with severe type-B hemophilia.

• Jose Luis Calvo-Guirado
• Georgios E Romanos
• Rafael Arcesio Delgado-Ruiz

抄録

出血性疾患が軟部組織の炎症および感染症と組み合わされると、歯科治療の前、治療中、または治療後に重度の出血性合併症を引き起こす可能性がある。一部の症例では、臨床療法と全身および局所の薬物療法を併用することで、治療成績と患者のQOLを向上させることが可能である。本症例は、重度のB型血友病患者である38歳の男性患者を対象に、感染歯を抜歯し、即時インプラントを埋入し、骨移植を行い、早期にインプラントを埋入することに成功した複合的なアプローチを初めて成功させた臨床例である。臨床治療に加えて、経口、全身、局所に薬物療法を行い、出血性合併症を予防し、患者のQOLを向上させた。

Haemorrhagic disorders combined with soft tissue inflammation and infection may lead to severe bleeding complications before, during or after dental treatment. In selected cases, a combined therapeutic approach involving clinical therapies and systemic and local medication could improve the treatment outcomes and the patient's quality of life. This clinical case report, presents for the first time a successful combined approach, completed in a 38-year-old male patient with severe type-B haemophilia in which an infected tooth was extracted, an immediate implant was inserted, bone grafting was performed and early implant loading was successfully applied. In addition to the clinical therapy, medication was provided orally, systemically and locally, thus preventing the haemorrhagic complications and improving the patient's quality of life.

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