Güncü G N, Cağlayan F, Dinçel A, Bozkurt A, Ozmen S, Karabulut E
Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
Aust Dent J. 2007 Dec;52(4):295-9. doi: 10.1111/j.1834-7819.2007.tb00505.x.
Gingival enlargement is usually noted within one to two months after the initiation of nifedipine therapy. The aetiology of nifedipine-induced gingival overgrowth is uncertain. The aim of this study was to determine the relationship between plasma and gingival crevice fluid (GCF) nifedipine concentrations and the degree of gingival overgrowth in patients treated with nifedipine, and also to assess the correlations between clinical and pharmacological variables.
Eighteen patients taking nifedipine in regular doses for at least six months participated in the study. Gingival enlargement was evaluated with two indices to score vertical and horizontal overgrowth. Gingival index (GI), plaque index (PI), gingival bleeding time index (GBTI), probing depth (PD) and clinical attachment level (CAL) were also evaluated. GCF and plasma nifedipine concentrations were determined by using high performance liquid chromatography.
There was no significant difference between responders and non-responders for PI, GI and GBTI. The mean concentration of nifedipine in GCF was significantly greater than concentration in plasma. No significant difference was observed for GCF and plasma nifedipine concentration between responders and non-responders.
The present study showed that neither GCF nor plasma nifedipine levels appeared to be a risk factor for nifedipine-induced gingival overgrowth. Improving the oral hygiene in patients using nifedipine may help control the degree of drug-induced gingival enlargement.
硝苯地平治疗开始后一到两个月内通常会出现牙龈增生。硝苯地平引起牙龈过度生长的病因尚不确定。本研究的目的是确定硝苯地平治疗患者血浆和龈沟液（GCF）中硝苯地平浓度与牙龈过度生长程度之间的关系，并评估临床和药理学变量之间的相关性。
18名规律服用硝苯地平至少6个月的患者参与了本研究。用两个指标评估牙龈增生情况，以对垂直和水平方向的过度生长进行评分。还评估了牙龈指数（GI）、菌斑指数（PI）、牙龈出血时间指数（GBTI）、探诊深度（PD）和临床附着水平（CAL）。采用高效液相色谱法测定GCF和血浆中硝苯地平的浓度。
反应者与非反应者在PI、GI和GBTI方面无显著差异。GCF中硝苯地平的平均浓度显著高于血浆中的浓度。反应者与非反应者之间GCF和血浆中硝苯地平浓度无显著差异。
本研究表明，GCF和血浆中硝苯地平水平似乎均不是硝苯地平引起牙龈过度生长的危险因素。改善使用硝苯地平患者的口腔卫生状况可能有助于控制药物性牙龈增生的程度。
