Yeditepe J Dent. 2016; 12(1): 79-83 | DOI: 10.5505/yeditepe.2016.08370

Periodontal apsenin kombine periodontal tedavisi: Bir olgu sunumu

Hafize Öztürk Özener, H. Selin Yýldýrým, Leyla Kuru
Marmara Üniversitesi Diþ Hekimliði Fakültesi Periodontoloji Anabilim Dalý, Ýstanbul

Periodontal apse, periodontal dokularýn hýzlý yýkýmýyla karakterize akut iltihabi bir lezyondur. Bu vaka raporunda alt molar diþte geliþen akut periodontal apsenin kombine
periodontal tedavisinin sunulmasý amaçlanmýþtýr. Kliniðimize alt sað bölgesinde aðrý ve þiþlik þikayetiyle baþvuran 24 yaþýndaki sistemik olarak saðlýklý kadýn hastanýn klinik
muayenesinde 46 nolu diþin vestibülünde ödemli, kýrmýzý, düz ve parlak yüzeyli alveol mukozasý görüldü. Periodontal sondayla muayenede vestibülde 12 mm sondalama derinliði (SD) tespit edilirken radyolojik olarak periodontal dokularýn normal olduðu saptandý. Lezyona akut periodontal apse teþhisi kondu. Ýlk olarak apse drenajý ve baþlangýç periodontal tedavi (BPT) ile birlikte analjezik ve kombine antimikrobiyal tedaviye (amoksisilin + klavulanik asit 1000 mg 2×1, Metronidazol 500 mg 2×1, 1 hafta) baþlandý. BPT sonrasý keratinize yapýþýk diþeti elde etmek amacýyla serbest diþeti grefti uygulandý ve 6 hafta sonra 44, 45 ve 46 nolu diþlerin vestibül yüzeylerindeki diþeti çekilmelerinin tedavisi için mine matriks türevleri (EMDOGAÝN®) ile birlikte kuronale kaydýrýlan flep operasyonu yapýldý. 44, 45 ve 46 nolu diþlerin midbukkalinde sýrasýyla SD baþlangýçta 2 mm, 3 mm, 12 mm ve operasyondan 6 ay sonra 1.5 mm, 1 mm, 1.5 mm, diþeti çekilmesi dikey boyutu baþlangýçta 2 mm, 3.5 mm, 3.5 mm iken operasyon sonrasý 1 mm, 1 mm, 0.5 mm olarak ölçüldü. Periodontal apselerin kombine periodontal tedavisiyle estetik ve fonksiyonel olarak baþarýlý sonuçlar elde edilebilmektedir.

Anahtar Kelimeler: Diþeti çekilmesi, mine matriks türevleri, periodontal apse

---

Combined periodontal therapy of periodontal abscess: A case report

Hafize Öztürk Özener, H. Selin Yýldýrým, Leyla Kuru
Marmara Üniversitesi Diþ Hekimliði Fakültesi Periodontoloji Anabilim Dalý, Ýstanbul

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, 3 mm, 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.

Keywords: Enamel matrix derivatives, gingival recessions, periodontal abscess

---

ATIF KOPYALA