Permalink : http://hdl.handle.net/2115/73663

KEYWORDS : 矯正歯科治療;精神遅滞;重度歯周炎患者;上顎前突;包括歯科治療;orthodontic treatment;mental retardation;periodontitis;maxillary protrusion;comprehensive treatmen

精神遅滞と重度歯周炎を有する上顎前突症患者に，矯正歯科治療を含めた包括歯科治療を行うことで，安定した咬合を得ることができたので報告する． 　患者は33歳10か月の女性．重度歯周炎による強い歯の動揺を主訴として来院した．上顎前歯の著しい唇側傾斜と空隙歯列，過蓋咬合を呈し，強い咬唇癖が認められた．歯周基本治療後，矯正歯科治療を開始した． 　歯周炎による歯槽骨の低下に配慮し，矯正力は弱く，歯科矯正用アンカースクリューを用いて上下顎前歯の唇側傾斜の改善並びに空隙の閉鎖を行った結果，前歯部の舌側傾斜による挺出と大臼歯の近心移動を防ぐことができた． 　動的治療期間は2年6か月であった．保定は補綴物を連結した永久保定とし，保定8年が経過した現在も咬合は安定している．
In this paper we will report a case of maxillary protrusion with severe periodontitis and mental retardation, good results were obtained by comprehensive treatment, including orthodontic treatment. A 33-year-old female with the chief complaints of pathologic teeth mobility was diagnosed as severe generalized chronic periodontitis, maxillary protrusion, the proclined maxillary anterior teeth, spaced arch and deepbite. This patient had finished the initial periodontal therapy before orthodontic treatment. Considering decreased alveolar bone height, the upper and lower dental arches were aligned with light force and using temporary anchorage devices for retraction. The extrusion of the incisors and the mesial movement of the molars were avoided. The orthodontic treatment lasted for 2 years and 6 months. The maxillary teeth were fixed by prosthetic restoration as the permanent retention. 8 years after retension, fine occlusion is obtained.