田害!国

Treatment concept of Dr.」ean-Pier「e Garde容la (SurgeOn) and

Dr. Ch「istian Richelme (prosthodon亡ist), Marse冊e, France

)大きな組織欠損を修正するために、自家骨とGeist=ch Bio-Oss⑪を混ぜて、

インプラント周囲欠損を充填すること。

〉下顎切歯の抜歯術は上顎切歯の抜歯にも有効なテクニックである。

>早期インプラント埋入。

[監修]

築山鉄平

匪療法大 雄之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 歯周病専門医

タフツ大学歯周病科 非鴬勘助教(Assistant p「ofesso「)

Geis軸chBiomateriaIs fax+41414925639

WWW.geistiichヤharma.com

◎Geistiich Pharma AG

Business Unit Biomaterials

CH-6110 Woihusen

Phone十41 41 492与6う0

ヽ細/

①\寸08三〇蚕小

ヽ容/

Treatment concepts for Per日mp漢antitis by PD Dr・ Frank Schwarz’

Dr. Na巾a Sahm and Pro亀Dr.Juergen BeckerrDuesseidorf; Germany

粉骨内欠損と歯槽宮上欠損コンポーネントに対する治療戦術。

菩治療のステップ:感染除去、インプラント形成、骨造成/

GBRによって良好な結果を提供することができる。

〉ガイストリツヒ・バイオオス、ガイストリツヒ・バイオガイド、

ガイストリツヒ・ミューコグラフトは軟組織密生の治療コンセプトの重要な要素である。

ば〇回

N○○しこ.〇m寸示

[監修]

築山鉄平

医療法大 雄之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 薗周病専門医

タフツ大学歯周病科 非萬勘助教(Assistant p「ofessor)

Geき虹日昌C罪BiomateriaIs fax+41414925639

WWW.geis出ch-Pharma.com

④Geis輔ch Pharma AG

Business Unjt Biomaterials

CH葛6110 Woihusen

Phone十41 41 492与6 30

郎睦脂抽脂艦艇r鋼鱒$

Co「te=in畔& tonett!, M.S. (2OOO). intrabony defects: guided tissue regeneration (GTR).

Cortel帖i P, Tonetti MS. (2OO5). C冊cal performance ofa regene「ative

Cortel帖P. Reconstructive pe「iodontal surgery:

and access ¶ap surgery」ouma) of C冊ca! Pe「iodontology

o\さ8>.乙寸m「小

Pe「iodontoIogy 2OOO 22, 1O4‾132.

strategy for血rabony defects: S⊂ien描c evidence and c帖cal

a cha=enge for modem periodontoIogy言nt Dentj 2OO6; 56 supp!

experience. j Periodonto上 Ma「;76(与):う41づ0.

Cortei臨, P-, Carnevale, G., Sanz, M. & Tonetti, M.S. (「998). Treatme[t Of deep and sha=ow int「abony defects. A mu廟center randomized contro帖ed

「0

Corte帖暗, Pin主Prato, G. & TonettL M. (「996).The modified pap冊preservation

of Penodontics ∂nd Resto「ative Dentistry 14, 8‾15.

technique w刷bio「esorbable barrier memb「anes

corte帖, P., Prato, G.P, & TonettL M.S. (1999). The slmP(ified pap冊preservattom flap. A novel surgical

Periodontics and Restorative Dentistry 19, 589‾599.

Corte=in暗, P面-P「ato, G. & tone時M言1995). Periodontal 「egeneratfon of huma両面abony defects with

Cortel帥, P. & Tonett主M. (1999). Radiographic defect angle influences the outcome of

Tonettl MS, Corte冊P; L綱g NP, Suva可E, Adriaens P Dubravec D, FonzarA・ Fou「mousis

of human intrab。ny defects with GTR/bone replacement

cl涌cal trla上Journa! of C廟ical Periodonto)ogy25, 98十987

in the treatment of int「abony defects. Case reports. lnte「natio脱( 」ouma)

approach fo「 the management of soft tissues川手egenerative procedures両ternatlOna=ourna! of

tita血m reinforced membranes. A cont「o帖ed c臨ca廟a=ournai of PeriodontoIogy 66, 797-8O3.

GTR therapy両ntrabony defects. Joumai of DentalResearch 78, 38「 (abstract).

Raspe…ti G, Rossi R, S間estri M, Topo町Wa販∂mm B’Zybutz M. (2004). C陣al outcomes fo冊wing t「eatment

cont「o=ed c帖ca剛al. 」 C冊Periodonto上Sep;31(9):77O-6.material or access flap alone. A m面center randomized

Fonzar, A., Dub「avec, D. & Adrfaen§, P. (2OOT) The slmP臨d pap陸preservation flap in the

」our棚( of Periodonto(。gy 72, 17Ol1712.outcomes and postope「ative morbidity・

p, Tonett主M.S., Lang, N.P., Suvan直) Zucche町G.' Vangsted’T.・ S"vest「i' M.' Ross峠・, McCial暗,

regenerative treatment of deep intrabony defects: C。nical

Linares A, Corte帖P,しang NP, Suvan J, T。nettl MS' Guided tissue

pred了ctors and outcomes」 C=n Periodo爪o1 2006; 33: 35十358.

Tonetti MS, Fourmousis L Suva時Cortellin亘r B「agger U,しarlg NP;

comes fo=owing regene「ative therapy of deep lntrabony defects.

regeneration′deprote面Zed bovine bone mine「al or pap冊prese「vation flapalone for treatment o白nt「abony defects誹radiographic

European Research Group on PeriodontoIogy (ERGOPER-O). (2OO4). Hea間g’POSt-OPerative morbidity

」 Cl活Periodontol. Dec;31(12)‥1092-8.

evaluation in a case cohort.j。urnal of PeriodontoIogy 72, 559づ69.

and patient perception of out

L, Tonetti MS, Co「te冊i P, Lang NP, Microbial coIonisation

二O Cortellin暗, P面-Prato, G. & tonetti, M. 0994)・ Periodontal

pattern predict the outcomes of su「gical

regeneration 。f human inf「abony defects. V E何ect oforal

pinl`Prato, G. &Tonetti, M. (1996).しOng term Stab航y ofc臨cal attachmentfo=owinggnded

軸刷er 「粥轟n8

t「eatment of冊rabony defects. 」 C冊Periodonto! 2OO6; 33:62’68.

hygiene on long term stability. 」oumal of ClinicalPeriodonto(ogy 21, 606‾61O.

tissue regeneration ancI conventiona冊erapy. 」ourna! of C嗣cal

survival fo嘉lowing regenerative treatment of intrabony

pinl-Prato, G. & Tonetti, M. (1996). Pe「iodonta汗egeneration of huma証ntrabony defects with

Corte旧主P" Pin主Prato, G. &Tonetti, M.

defects. 」 Periodontol. May;75(5):672-8.

PeriodontoIogy 23, 106‾11l.

bioreso「bable membranes. A controlled c臨cal trial. 」ournal of Periodontoiogy 67, 217-223.

(1995). The modl轟d pap陸preservation technique. A new surgical

Cortel暗号& Tonetti, M. (2000). Evaluation of the effect of tooth v剛ty or"egenerative

approach for interproximal regeneratlVe PrOCedures. Jouma) of Periodonto!ogy 66,

outcomes in intrabony defects. 」ou「nal of C冊cal Periodont。!ogy 28, 672’679.

cortellln時Tonett- MS (20O7) A m面ma川y invasive su「gical technique (MIST) with enameinatrix derivate

of C帖cal Pe「iodontoIogy; 34: 87-93.

ln the 「egeneratjve treatme=t of intrabony defects‥ a nOVeはpproach to帥tmorbidlty弓Oumal

co「tel臨i P Tonetti MS (2OO7) M面mally irIVaSive su「gic∂l technique (MIST) and enamel mat「-Xderivative (EMD) l[

う4: 「082-1088.

intrabony defects. (l) Cl面cal outcomes and morbidity. Journal of C冊ical Per10dontoIogy;

R. C. & Corte帖, P. (1993). Periodonta圧egeneration of human infrabony defects. Diagno5tic st「ate8ie§ tO

TonettL M,,帥一Prato, G. & Corte冊, P (1996). Guided tisSue regene融lOn Of deep intrabony defects m strategiea"y面portant

†0netti, M., Corte冊, P., Suvan, J.E., Ad「iaens, P, Bald主C., Dubravec, D吉OnZar, A吉OurmOSis'

detect bone ga叫ourna! of PertodontoIogy 64, 269‾277.

prosthetic abutments而ternational 」ourna) of PeriOdontics and Restorative

上Magnan主C., Muller-Campanile} V' Pat「on主S., Sanz, M., Vangsted’T.' Zaba(egu出P剛叶ato, G・ &しang,

N.P. (「998). Genera"zabiwly of the added benefits of guided tissue regeneration冊e t「eatment of deep int「abony defects. Eva幽on in a m時cente「 「andomized co剛ed c!証eal t坤Ournal of Pe「了

Odontoiogy 69, 118う-1192・

Tonettl, M” Lang, N.R, Co「tel陣P. et aL (2002). Enamei

PeriodontoIogy;29:317-25.

Tsitoura E, Tucker R, Suv∂「 j, Laure= L, Corte臨時Tonettl

derivative. J C冊Peri。donto1 2OO4; 31:643‾647.

ma廟x proteins in the regenerative ther∂Py Of deep面abony defects.A multicenter randomlZed controlled c)inical tria上」ourna) of Cl面cal

M. Base"ne r∂dlOg「aPhic defect angle ofthe intrabony defect as a prognostic -ndicatorin regene「ative periodontal surge「y with enamel matrix

労Blades: Swam-Morton鵬, Swa旧主Morton LTD, She簡eld, England and Micro USM 69OO・ Sabie lndustries,Vjsta CA, USA

ー「1,W」.Gore&} Sutures: Gore-teX CV-6 P6K23A needle RT - 13 and CV-7 P7K13A needle RT

鑑の輔弼粗

> Dr. PierpaoIo Corte帖,Via Carlo Bott∂ 16,5O136 Flo「ence・圃y

teiephone: +39 055 24395O, fax: +39 055 247803l・ e-ma=rstudiocortel

[監修]

築山鉄平

医療法大 雄之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 歯周病専門医

タフツ大学歯周病科 非常勤勘教(Assistant p「Ofessor)

iini@co「te帖n主191.it

Ass, FlagstaffAZ, USA

Ge百親睦師

◎Geis輔ch Pharma AG

Business Unit BiomateriaIs

CH-61「0 Woihusen

Phone十41 41 492与630

はぎ1!国

\書四

T「eatment concept of D「. PierpeoIo C⑱rte輔車容ore畦e,圃y

結審美領域の歯周組織再生。

〉広汎性重度歯周炎。

ネ広汎性重度歯肉炎と広範囲なプラーク残存

〉深く(「0mm)広い「壁性垣内欠損

削れ距毒曲①鵬配の醐鱒Region x aesthetic regiOn

Singie tooth gap

Bony situation X bone defect p「esent

Soft tissue situation recessIOn

X inflamed

X軸ckbiotype

X prima「ywound closure possible

X intac亡pap用ae

X adequate ke「atinised mucosa

Furtherperiodontalexamination x fu= mouth pほquescore:99%

X fu“ mouth bleeding score: 10O%

non-aeSthetic region

multipie tooth gap

no bone defect present

X nO reCeSSiOn

in危cted

thin biotype

primary wound dosure not possible

impaired, missing pap冊e

inadequate keratinised mucosa unevent帥

\ニ4

丁「ea亡me師concept of Dr. PascaさVa冨e雨i串

Un盲vers旺y ⑱千Cors滝a膏rance

〉ラテラルアプローチ並びに同時・待機埋人での上顎洞挙上術。

〉自家骨グラフトの回避

〉轟申隔並びに上顎洞膜の穿孔への対処

1

Litera七ure refe「ences

①\の○∞○)乙.乙∞富市

田喜田

DeI Fabbro M., Testori T., Francetti L., Weinstein R言 冊」 Periodontics Restorative De時24:565-577;2OO4

Wa=∂Ce S., F「oum S.; Ann Periodontol, 8:328-343;2OO3

Vaient面P., Abensur D.; lnt」 Oral Max用ofac而Plants, 18:556-560;2003

Ha=mann M., Sennerby L., Lundgren S.巾t」 OraI Max用ofac 而p置∂nts, 17, PP: 63与-64う, 2002

Valent面P., Abensur D., Wenz B., Peetz M., Schenk R.; lnt」 Periodontics Restorative

[監修]

築山鉄平

医療法大 雄之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 歯周病専門医

タフツ大学歯周病科 非鴬勤助教(Assistant profess。r)

Dent 2000;20

Ge冒虹日昌C兜

◎Geis輔ch Pharma AG

Business Unit Biomateriais

CH-6110 Woihusen

Phone +41 41 492 5630

Biomaterials fax+41414925639

WWW.geis捕ch葛Pharma.com

The「apy concept of Prof Ma亡teo Chiapasco’University of

M=an, ltaiy

\J掴輔弼輔弼購鞘の

Region

Bony situation

Soft tissue situation

lmpiantation

>自家骨、 Geist=chBio Oss⑲、 GeistlichBio-Gide⑪を使った垂直的歯槽堤増生

[監修]

築山鉄平

医療法人 雅之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 歯同病専門医

タフツ大学歯周病科 非常勤胡散(Assistant professo「)

Ge冒st漢冒chBiomaterials ∴fax +41 41 492 5639

WWW.geis捕ch-Pharma"COm

③Geis輔ch Pharma AG

Business Unit Biomaterials

CH-6110 Woihusen

Phone十41 41 492う6う0

ヽノ

①)①O乙さ.卜蝶富の

帥繭輔弼棚職制黛Region

田喜田

\_/

Treatment concept of Dr・日stvan Urban, Loma Linda

University, USA

?吸収性メンブレンGeist=ch B10-Gide⑪と、自家海綿骨とGeis捕ch Bio-Oss⑱の

コンビネーショングラフトを利用した水平的歯槽堤増大術。

≫ソーセージテクニックのデモンストレーションとその説明oGeis川ch Bio-Oss⑪は

骨移植材料を安定させ、また非可動性の「ソーセージの皮」のように作用する。

aesthetic region

S涌gie亡○○th gap

Bony situation x bone defect present

So什ti§Sue Situation

impIantation

「eCe§S!On

活用amed

軸ck biotype

X primarywound cIosure poss潮e

血act pap冊e

adequate kerat面§ed mucosa

X uneVen帝山

s面し直aneousIy with bone

augmentation (1 step)

× non-aeSthetic region

m埴回e t○○th gap

no bone defect present

nO 「eCeSSlOn

涌fe c蒔d

thin biotype

primary wound dosure not possible

impaired, missing pap紺ae

inadequatきlくe「at証sed mucosa

X SuCCeSSiveiy to b〇日e

augmentation (2 steps)

酢自治脂抽脂

一Buse「 D, lngimarsson S, Dula K恒SSi A, Hirt HP, Beser UC工Ong-term Stab紺ty ofosseointeg「ated申ants in augmented bone: A5-year P「OSPeCtive study in par潮y

edentulous patients. Int 」 Periodontics Resto「ative Dent 20O2; 22:109‾117.

∠ Urban lA, 」ovanovic S, Lozada 」L. Vertic∂=idge細gmentation using guided bone regeneration (GBR) in three.c旧cal scena「ios prior to implant placement:

A ret「ospective study of 35 patients 12 to 72 months after ioading.冊」 Oral Max用ofac lmplants 2009;24:う02-う10.

Zitzmann NU, Scharer P, Marinello CP Long-term reSuits ofimpants t「eated with guided bone regeneration: A5-year PrOSPeCtive study. lnt」 Oral Max用ofac lmplants

2001;16:う与すう66.

4 Hammerle CH帥ng RE, Yaman D, Lang NP. Ridge augmentation by applying bioresorbab-e membranes and deprote面zed bovine bone mineral: A repo「t of tweive

consecutive cases. Clin Or∂‖mpI Res 2008;19:19-25.

5 U「ban lA, Nagursky H工OZada jL: Horizonta同dge augmentation with a resorbable membrane and particulated autogenous bone with or without anorganic bovine

lnt 」 Ora‖VIax川ofac lmplants 2Ol「;26(2)‥404-14.bone-derived minerai: A prospective case series in 22 patients,

6 Rothamel D, Schwarz F, Sculean A, Herten M, Scherbaum W, Becker」・Biocompati輔y ofvarious collagen membranes in cuitures of human PDL fibroblasts and human

osteobIast-1ike ceils. C=n Ora=mplants Res. 20O4;15(4):443つ・

Schwarz F, Rothamel D, Herten M, W。stef。d M, Sager M, Ferrari D, Becke申mmunohistochemica剛a「acte「ization of guided bone regeneration at a dehiscence-tyPe

defect using d膚erent barrie「 membranes: An

鈍師瞳聡

experimental study in dogs. Clin Oral impiants Res. 2008;19(4)‥402-1う・

Ant主刷ammato「y medication: 50 mg diciofenac, Cataflam⑪, Novartis Phamaceuticais

〇〇回

①\き重さ.「「学乞

Local anesthetic: Artican古idrochlo「ide with adrena冊e l/100,OOO

Suture materiai (ePTFE): GORE-TEX⑪ cv-5 Sutu「e, W.L. Gore & Associates直C.

而piant: Branemark System⑧, Nobel Biocare

Fixation pins: Master-Pin System' Meisinger

鎧の師部謹

) Dr. 1stvan Urban, Sodras utca 9, Budapest, Hunga「ylO26

telephone: +363094621O3, fax:十3612OO4449, e-ma旧stvan@implant.hu, Website:

[監修]

築山鉄平

医療法大 雄之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 歯周病専門医

タフツ大学歯周病科 非幣勤助教(Assistant p「Ofessor)

⑥Geistiich Pha「ma AG

Business Unit Biomateria漢s

CH-6110 Wolhusen

Phone十41 41 492与630

WWW.implant.hu

Ge童虹靴軸Biomaterials fax+41414925639

WWW.geistiich-Pharma.com

(

Trea師e咄C⑱nCePt by Dr. Danie且e Cardaropo串

師vate P「act盲ce,丁u「in, Iモa冒y

〉歯肉退縮被覆術。

岩歯肉バイオタイプ修正治療

少歯冠部会層弁

」旺e聡も脚e肥千e「ences

l Wennstr6m 」, Pini Prato G. Mucogingival therapy-Periodontal plastic surge「y. I冊ndhe 」, Ka両g丁しang N (eds). C帖cai Periodonto10gy and lmplant Dentistry. Copen

hagen: Munksgaard, 20O3:576‾649.

2

wennstr6m J. Mucoginglva冊erapy. Ann Periodonto1 1996串671十06.

3

corte冊i P Clause「 C, Prato GP. HistoIogic assessment of new attachmentfo冊wing the treatment ofa human buccal recession by means ofa guided tissue regene「ation

P「OCedure. 」 Periodonto1 1993;64:387‾391.

4

Wang HL, Bunya「atavej P, Labadie M, ShyrY, MacNe=

5

M紺erPD.Aclass胎cationofmarginal

RL. Comparison of2 c旧cai techniques for t「eatment of gingivaI 「ecession. 」

tissue 「ecession. 1nt 」 Periodontics Restorative Dent 1985宰8‾13.

PeriodontoI 2OOl;72:13O十1311.

①\Nささ.小し辛m

6 pini Prato G, ClauserC, Corte冊P,Tinti C,Vincenzi G, Pagliaro U. Guidedtissue regeneration versus mucogingival surgery両hetreatmentofhuman buccal recessions.

1996;67:1之16122う.

7 Tatakis DN, Trombe岨・ Gingival recession treatment: Guided tissue regeneratton with bioabsorbable membrane versus connective tissue graf= Periodontol

A 4-yea「 fo=ow珂P Study. 」 Pe「iodontoi

2〇〇〇;71: 299-307.

8

Ainamo A, Bergenholtz A, Hugoson A, AinamoJ. Location ofthe mucogingiva=unction 18 years after apica=y repositioned flaP Surgery. 」 C冊Periodontol 1992;19:49_52-

9 Matarasso S, Cafiero C, Coraggio F, Vaia E, de Pao-i S. Guided tissue regene「ation versus corona町y repositioned flap in the treatment ofrecession with double pap陸e'

lnt 」 Periodontics Resto融ive Dent 1998笹444-453.

「0 Amarante ES, Leknes KN, Skavland川eT. Corona=y positioned flap procedures with orwithout a bioabsorbable membrane in the treatment of human gingival recession.

」 Periodonto1 2OOO;71:989-998.

11 Cardaropoli D, Cardaropoli G川ea冊g ofGingival Recessions Using a Colagen Membrane with a Deminerahed Xenograft: A Randomized Controiled C出血a冊al冊」

Periodontics Restorative Dent. 2009 Feb;29(1):与9-67.

S鵬師話冒e臆

> Sutures: Resopren 5/0 (Resorba, Germany) and GlycoIon 5/0 (Resorba, Germany)

C①師部鳴

> Dr. Danieie Cardaropol主Corso Ga用eo Ferraris148, lO129 Turin直aly

teiephone‥十39.011.323683, fax:十39.01「・323683, e-ma圧dacardar@tin-it’Website‥

亡監修]

築山鉄平

医療法人 雅之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 歯周病専門医

タフツ大学歯周病科 非常勤助教(Assistant professor)

国〇回

WWW.Ca rda ropo旧t

Ge昌親日暗証Biomaterials

④Geis輔ch Pharma AG

Business Unit Biomateriais

CH葛6110 Wo旧usen

phone十4「 41 492う6う0

fax十4「 41 492う6う9

WWW.geis耶ch-Pharma.com

田喜田

竃害長田

=れ宙cat盲on p「⑱制e

Clinical Procedure by Assoc. P「of. D「・ Dietmar Weng・

師vate Practice, Sta「nberg, Germany

判事乗のインプラント埋人に備え、

(リツジフリザベーション) 。

頬側骨欠損を伴う歯槽胃に対して行った抜歯後歯槽堤保存術

Area aesthetic regi。n

X SingIetooth gap

Bone situation X bone defect p「esent

Soft tissue situation recessIOn

X thick biotype

primary wound dosure possible

X sufficient kerat面sed mucosa

unremarkable

lmplantation X atthe same time as

bone augmentation (1 step)

× non-aeSthetic region

m埴ipie t○○th gap

no bone defect present

X no 「ecesslOn

th涌bio亀ype

X prima「ywo即d dosure not possible

insu楠cient kerat面sed mucosa

干oilow涌g

bone augmentation (2 steps)

[監修]

築山鉄平

医療法大 雄之会 つきやま歯科医院 勤務

米国歯周病学会ボード認定 歯周病専門医

タフツ大学歯周病科 非常勘助教(Assistant professor)

Gei丸さ百C門BiomateriaI§∴ fax +41 41 492 56 39

WWW.geis朝chapharma.com

◎Geis輔ch Pharma AG

Business Unit Biomaterials

CH-611O Wo漢husen

phone十41 41 492与6う0

ばSウ

ue)きNミ.曾山しい