Lyon Kenneth F
Arizona Veterinary Dentistry and Oral Surgery, 86 West Juniper Avenue, Gilbert, AZ 85233, USA.
Vet Clin North Am Small Anim Pract. 2005 Jul;35(4):891-911, vii. doi: 10.1016/j.cvsm.2005.02.001.
Gingivostomatitis (GS) with various patterns of disease may require antiviral therapy, steroids, laser fulguration, immunomodulation drugs, or nonsteroidal anti-inflammatory drugs. The use of cyclosporine as an immunomodulation drug has long-term benefits in reduction of the immunologic events that contribute to GS. Whole-mouth extraction or partial extraction (premolars and molars), with radiographic conformation that all root remnants have been removed, may be the most viable option in nonresponsive and or intractably painful stomatitis in noncompliant cats or dogs. Oral inflammation subsided after extraction without the need for further medication in approximately 70% of the cats from two studies with previous chronic unrelenting oral disease. The combination of immunomodulation with cyclosporine together with laser resection of proliferative tissue should be recommended if extraction of teeth is not desired. Removal of proliferative oral tissues by lasing (carbon dioxide laser) removes the tissue that maybe producing tissue antigens and the area where bacteria are sequestered. The use of anti-inflammatory medications is recommended in the management of GS. Therapeutic success is achieved when there is elimination of proliferative tissue and inflammation.
不同疾病模式的龈口炎（GS）可能需要抗病毒治疗、使用类固醇、激光烧灼、免疫调节药物或非甾体抗炎药。使用环孢素作为免疫调节药物在减少导致GS的免疫反应方面具有长期益处。对于不配合治疗的猫或狗，若患有无反应性和/或顽固性疼痛性口炎，全口拔牙或部分拔牙（前磨牙和磨牙）并通过影像学确认所有牙根残留均已清除，可能是最可行的选择。在两项针对先前患有慢性持续性口腔疾病的猫的研究中，约70%的猫拔牙后口腔炎症消退，无需进一步用药。如果不想拔牙，建议将环孢素免疫调节与激光切除增生组织相结合。通过激光（二氧化碳激光）切除增生的口腔组织可去除可能产生组织抗原的组织以及细菌聚集的区域。在GS的治疗中建议使用抗炎药物。当增生组织和炎症消除时，治疗即取得成功。
