治癒5歲公橘貓的繼發性咬合創傷及創傷性肉芽腫

和氣是一隻已節育的混種公橘貓，就診時為4歲、6.9公斤(15.2磅)。飼主於半年前發現患貓有口腔紅腫的症狀，曾在他院進行兩次拔牙治療但無改善，貓會有持續流口水的症狀，經本院陳重威獸醫師於門診檢查，確認為咬合創傷(occlusal trauma)造成的創傷性肉芽腫(traumatic granuloma)，這是因為左下第一臼齒(309)被拔除，導致對咬的左上第四前臼齒(208)過度萌發、持續刺激牙齦而造成。
 
陳重威醫師的治療方式是調整患貓的咬合，讓對咬牙不會再持續接觸刺激到病灶區。
陳重威醫師將左上第四前臼齒(208)咬合面的尖端稍微修磨並以樹脂封填，避免口腔細菌感染牙髓，經過兩個半月的治療，和氣的咬合創傷及肉芽腫順利癒合，也不再有流口水的情形，治療後為體重上升7.1公斤(15.7磅)，仍持續上升中。
 
咬合創傷指的是由於不正常或過大的咬合力，導致牙周組織的發炎、紅腫及破壞，長期的發炎與刺激甚至可能會導致該處齒槽骨的流失、或是牙根部位的齒吸收（tooth resorption），而因為是異常咬合所致，內科藥物更不可能有實際的治療效果。
 
咬合創傷主要分為兩大類：
1.原發性咬合創傷(primary occlusal trauma)：因不正常或過大的咬合力，作用在原本健康的牙周組織，而造成的牙周組織傷害。
2.繼發性咬合創傷(secondary occlusal trauma)：病患因為牙周疾病導致牙周組織支撐牙齒的能力下降，無法承受原本的咬合力道，進而產生的咬合創傷型態。
 
和氣之前有接受過拔牙治療，屬於「繼發性咬合創傷」(secondary occlusal trauma)，藉由這個案例，再次提醒大家牙齒的功能和重要性、以及缺牙會造成的後遺症及併發症，盡可能保留狗貓的牙齒，對他們的口腔健康極為重要。
 
想知道牙齒的功能與重要性，請參考本院YouTube頻道【陳重威獸醫師-阿威獸醫師的開口啟齒】影片《狗貓有牙齒超重要》

 
想看更多本院治療咬合創傷的個案，請參考以下連結：https://www.hellopeter.com.tw/contents-14.html
 
哈囉彼得動物醫院 ｜HelloPeter Veterinary Hospital
院長 陳重威獸醫師 ｜Dr. Richard Chen
YouTube頻道：【阿威獸醫師的開口啟齒】www.youtube.com/@DrRichardChen_vet
（04）2472-8828
台中市南屯區東興路二段29號｜No. 29, Sec. 2, Dongxing Rd., Nantun Dist., Taichung City 408, Taiwan
醫院官網Website: www.hellopeter.com.tw
門診時間：週一至週五10:00~20:00（門診為預約制），週六可接受預約門診及手術，週日公休。
 
【Added on November 17, 2023】Healing secondary occlusal trauma and traumatic granuloma in a 5-year-old neutered male orange tabby cat
 
Ho-Chi (the name means “harmonious”) is a neutered mixed-breed male orange tabby cat, 4 years old, weighing 6.9 kg (15.2 pounds) at the time of the initial examination. The owner noticed oral swelling in the affected cat six months ago, and despite two extraction treatments at another hospital, there was no improvement. The cat continued to experience persistent drooling. Upon examination by Dr. Chung-Wei Chen at our hospital, it was confirmed to be traumatic granuloma caused by occlusal trauma. This resulted from the extraction of the left mandibular 1^st molar (309), leading to overeruption of the left maxillary 4^th premolar (208), causing continuous stimulation to the gingiva.
 
Dr. Chung-Wei Chen's treatment involved adjusting Ho-Chi's occlusion to prevent further contact with the affected area. The tip of the left maxillary 4th premolar (208) was slightly trimmed and filled with resin to prevent oral bacterial infection of the pulp. After two and a half months of treatment, Ho-Chi's occlusal trauma and granuloma healed successfully. There was no longer any drooling, and the cat's weight increased by 7.1 kg (15.7 pounds) post-treatment, with a continuing upward trend.
 
Occlusal trauma refers to inflammation, swelling, and damage to periodontal tissues due to abnormal or excessive biting force. Prolonged inflammation and stimulation can lead to loss of alveolar bone or tooth resorption at the root, and internal medication is unlikely to have practical therapeutic effects in cases of abnormal occlusion.
 
There are two types of occlusal trauma:
1. Primary occlusal trauma - periodontal tissue injury caused by abnormal or excessive occlusal force acting on originally healthy periodontal tissue.
2. Secondary occlusal trauma - due to periodontal disease, the ability of the periodontal tissue to support the tooth is lost, and the patient is unable to withstand the original occlusal force, resulting in occlusal trauma.
 
Ho-Chi had previously undergone tooth extraction treatment, falling under “secondary occlusal trauma”. This case serves as a reminder of the functionality and importance of teeth, as well as the consequences and complications of tooth loss. Preserving the teeth of dogs and cats is crucial for their oral health.
 
To understand the functionality and importance of teeth, refer to our hospital's YouTube channel: https://youtu.be/HfozEv7mpZo

 
For more cases of our hospital treating occlusal trauma, please visit the following link: https://www.hellopeter.com.tw/contents-14.html
 
HelloPeter Veterinary Hospital
Director: Dr. Chung-Wei Chen (Dr. Richard Chen)
YouTube channel: www.youtube.com/@DrRichardChen_vet
Phone: +886-4-2472-8828
Official Website: www.hellopeter.com.tw/en/
 
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