Aral Cüneyt Asim, Dilber Erhan, Aral Kübra, Sarica Yagmur, Sivrikoz Oya Nermin
Assistant Professor, Department of Periodontology, Faculty of Dentistry, Sifa University , Izmir, Turkey .
Assistant Professor, Department of Prosthetic Dentistry, Faculty of Dentistry, Sifa University , Izmir, Turkey .
J Clin Diagn Res. 2015 Dec;9(12):ZD12-5. doi: 10.7860/JCDR/2015/14737.6974. Epub 2015 Dec 1.
Gingival enlargements modified by medications are becoming more common because of the increased use of inducing drugs, and may create speech, mastication, tooth eruption, periodontal, and aesthetic problems. We hereby present a case of a 54-year-old man with 12-month history of generalized gingival enlargement in the keratinized gingiva was referred to our clinic. The patient had a history of kidney transplant and was under medication of cyclosporine and nifedipine. After medical consultation, cyclosporine was changed to tacrolimus and nifedipine was changed to captopril. Gingivectomy was performed using a diode laser, and scaling and root planning were performed. At five months postoperative, the gingival enlargements relapsed and diode laser-assisted surgery was repeated. The patient was followed-up on second postoperatively at 18 months and no relapse was seen. Diode laser-assisted gingivectomy was found to be useful for coagulation during surgery and decreased postoperative bleeding. Recurrence risk of cyclosporine and nifedipine-induced gingival overgrowth is high, thus, there is a great need for prolonged care of patients following treatment and prosthetic restoration.
由于诱导药物使用增加，药物性牙龈增生变得越来越常见，并且可能引发言语、咀嚼、牙齿萌出、牙周和美观问题。我们在此报告一例54岁男性患者，其角化牙龈出现广泛性牙龈增生已有12个月，转诊至我们诊所。该患者有肾移植病史，正在服用环孢素和硝苯地平。经医学会诊后，将环孢素换成他克莫司，硝苯地平换成卡托普利。使用二极管激光进行牙龈切除术，并进行了龈下刮治和根面平整。术后五个月，牙龈增生复发，再次进行了二极管激光辅助手术。术后18个月对患者进行第二次随访，未见复发。发现二极管激光辅助牙龈切除术在手术中有助于凝血，并减少术后出血。环孢素和硝苯地平引起的牙龈过度生长复发风险很高，因此，治疗后对患者进行长期护理和修复治疗非常必要。
