Straka Michal, Varga Ivan, Erdelský Ivan, Straka-Trapezanlidis Michaela, Krňoulová Jana
Department of Dentistry, Slovak Medical University, Bratislava, Slovakia.
Department of Histology and Embryology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
Neuro Endocrinol Lett. 2014;35(7):567-76.
Side effect of medicamentous treatment in hypertension therapy and angina pectoris with calcium channel blockers related to fibrotic gingival enlargement were examined.
In our study we deal with clinico-histopathological and microbiological knowledge from this field underpinned by two case reports treated with antihypertensive therapy using calcium channel blockers. In the first case report we were largely concerned with microbiological findings from the area of periodontal pseudopockets diagnosed through a DNA analysis and appropriate antibiotic therapy. In a patient treated with a preparation from amlodipine group we proceeded to a complex treatment involving the change of hypertension therapy, introduction of professional and home oral hygiene and also following surgical and prosthetico-aesthetic rehabilitation.
Case Report 1 who was for a long term medicated with a preparation from the nifedipine group of antihypertensives we detected the presence of periodontal pseudopockets with probing depth of 4 to 7 mm with positive BOP and with marked rigid fibrotic gingival enlargement accompanied with considerable foetor ex ore. In a patient from the Case Report 2 who was for a long term medicated with a preparation from the amlodipine group of antihypertensives with large gingival overgrowth angiogenesis was characterized by cuboidal endothelial cell lining. In the samples under a layer of stratified epithelium there was present dense fibrous connective tissue comprising largely of collagen fiber bundles.
Bacterial composition in the patient with a high degree of gingival enlargement and periodontal pseudopockets 4 to 7 mm deep represented a typical spectrum of bacteria occuring in chronic forms of periodontitis. However, we cannot determine, if such distribution of bacteria was primary before the application of nifedipine antihypertensives, or it originated later after the formation of typical anaerobic setting of false periodontal pockets.
研究钙通道阻滞剂用于高血压治疗及心绞痛治疗时，药物治疗的副作用与牙龈纤维性增生之间的关系。
在本研究中，我们通过两例使用钙通道阻滞剂进行抗高血压治疗的病例报告，探讨了该领域的临床组织病理学和微生物学知识。在第一例病例报告中，我们主要关注通过DNA分析诊断出的牙周袋区域的微生物学发现以及适当的抗生素治疗。对于一名使用氨氯地平组制剂治疗的患者，我们进行了综合治疗，包括改变高血压治疗方案、引入专业和家庭口腔卫生措施，以及后续的外科手术和修复美学康复。
病例报告1中，一名长期服用硝苯地平组抗高血压制剂的患者，我们检测到存在牙周袋，探诊深度为4至7毫米，探诊出血阳性，伴有明显的硬性纤维性牙龈增生，并伴有相当程度的口臭。在病例报告2中，一名长期服用氨氯地平组抗高血压制剂且牙龈过度增生的患者，血管生成以内皮细胞呈立方形为特征。在分层上皮层下的样本中，存在致密的纤维结缔组织，主要由胶原纤维束组成。
牙龈高度增生且牙周袋深度为4至7毫米的患者的细菌组成代表了慢性牙周炎中出现的典型细菌谱。然而，我们无法确定这种细菌分布是在应用硝苯地平抗高血压药物之前就是原发性的，还是在典型的厌氧性假性牙周袋形成后才出现的。
