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通过切除术治疗大麻引起的牙周炎的管理:临床报告。

Management of cannabis-induced periodontitis via resective surgical therapy: A clinical report.

出版信息

J Am Dent Assoc. 2017 Mar;148(3):179-184. doi: 10.1016/j.adaj.2016.10.009. Epub 2016 Nov 18.

Abstract

BACKGROUND AND OVERVIEW

There is a lack of clinical research on the potential effect of cannabis use on the periodontium as well as its effect on treatment outcomes. The aim of this case report is to illustrate the clinical presentation of periodontal disease in a young woman who was a chronic cannabis user, as well as successful treatment involving motivating the patient to quit cannabis use and undergo nonsurgical and surgical therapy.

CASE DESCRIPTION

A 23-year-old woman sought care at the dental clinic for periodontal treatment. During a review of her medical history, the patient reported using cannabis frequently during a 3-year period, which coincided with the occurrence of gingival inflammation. She used cannabis in the form of cigarettes that were placed at the mandibular anterior region of her mouth for prolonged periods. Localized prominent papillary and marginal gingival enlargement of the anterior mandible were present. The mandibular anterior teeth showed localized severe chronic periodontitis. The clinicians informed the patient about the potentially detrimental consequences of continued cannabis use; she was encouraged to quit, which she did. The clinicians performed nonsurgical therapy (scaling and root planing) and osseous surgery. The treatment outcome was evaluated over 6 months; improved radiographic and clinical results were observed throughout the follow-up period.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Substantial availability and usage of cannabis, specifically among young adults, requires dentists to be vigilant about clinical indications of cannabis use and to provide appropriate treatments. Behavioral modification, nonsurgical therapy, and surgical therapy offer the potential for successful management of cannabis-related periodontitis.

摘要

背景与概述

目前缺乏关于大麻使用对牙周组织潜在影响及其对治疗结果影响的临床研究。本病例报告的目的是说明一名慢性大麻使用者年轻女性牙周病的临床表现,以及通过促使患者戒烟大麻并接受非手术和手术治疗取得的成功治疗效果。

病例描述

一名 23 岁女性因牙周治疗到牙科诊所就诊。在回顾她的病史时,患者报告说在 3 年内经常使用大麻,这与牙龈炎症的发生时间一致。她以将大麻烟放在口腔下颌前区并长时间吸食的方式使用大麻。下颌前牙区局部可见明显的牙龈乳头和边缘增生。下颌前牙呈现局部严重的慢性牙周炎。临床医生告知患者继续使用大麻可能产生的潜在有害后果;鼓励她戒烟,她做到了。临床医生进行了非手术治疗(洁治和根面平整)和骨手术。治疗结果在 6 个月内进行评估;在整个随访期间观察到改善的影像学和临床结果。

结论和实际意义

大麻的大量供应和使用,特别是在年轻人中,要求牙医警惕大麻使用的临床指征,并提供适当的治疗。行为改变、非手术治疗和手术治疗为成功管理与大麻相关的牙周炎提供了潜力。

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