Jun
【案例分享】31年忠實牙周維護患者心中的可歌與可泣！
31年前（1993）我剛從美國回台即來就診的吳先生，如今73歲決定退休告老還鄉，今天依依不捨來做最後一次牙周維護治療，因為明天就要回屏東老家了！
40歲出頭就帶著全口一半以上幾乎「都被宣判無救的重度牙周炎牙」來請我治療，這位亦師亦友的忠實患者，當時只希望能多為一些還能使用的牙齒請命、少拔一點牙，不要在事業正起飛時就同時戴上全口（兩床）活動假牙。
5顆牙周無救牙的犧牲，配合牙周病治療保留17顆牙，上顎以三段牙冠牙橋，只有下顎使用牙冠與局部活動假牙完成第一次全口重建，吳先生很讚許牙周保存對固定與活動假牙的助益，並且維持了12年，直到……
13年後（2006）下顎活動假牙緊接上顎前牙的橋墩牙陸續發難，彼時事業有成的吳先生決定以植牙重建缺牙區，結果花費4年（2010）才完成第二次全口重建，期間拔5顆牙置入11顆植牙，並維持所有自然牙都成單冠。
10年前（2014）僅餘的7顆根管牙中的6顆，都因折裂而再以4顆植牙取代，使最後以5顆自然牙與15顆植牙的全口27顆牙組合維持至今！
18年來吳先生擁有植牙的歲月中，驚人的發現植牙置換的10顆牙中，僅1顆牙周無救牙、卻有9顆結構無救牙，這些短命牙皆經根管→釘柱→牙冠→折裂四部曲！！這是任何人皆會抱怨連連的動盪前8年。後因發現只要植牙介入的區域就是新穩定咬合的信賴區，而使吳先生最終仍選擇不離不棄，且不論是約診、治療建議及口腔衛教都配合極佳，總是固定每半年回診洗牙和維護治療，保持全口牙周健康，15顆植牙只呈現微量生理骨吸收，這應該是吳先生口腔最值得與放心的投資吧！！
A compliant 31 years long term follow-up patient, Mr. Wu, came for his last maintenance visit to my clinic to say good-bye due to remote relocation after retirement.
With tears in both our eyes he overviewed what was good or bad treatment decisions over the past 31 years. Periodontal & dental implant therapies appeared to be beneficial & sustaining, however, endodontic treatments for him seemed worthless, he said.
I stressed both periodontal and endodontic treatments were all endeavored to conserve his natural dentition. Nevertheless, I wouldn’t object to what he said is wrong who was born with such a poor tooth-structured teeth, after tragically suffering from 9 consecutive replacements of endodontic treated, post-cored, crowned & fractured teeth in just a few years.
Mutually thankful to each other for these years we both shared our passion in dentistry. With 18 years of 15 implants gradually inserted empowering his oral function, recent stabilized 10 years maintenance may seem to warrant his confident future for hopefully another 31 years.
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