Malek Rayhana, Gharibi Amina, Khlil Nadia, Kissa Jamila
Department of Periodontology, Casablanca Dental School, Casablanca, Morocco.
Contemp Clin Dent. 2017 Jul-Sep;8(3):496-500. doi: 10.4103/ccd.ccd_1181_16.
Necrotizing ulcerative gingivitis (NUG) is a typical form of periodontal diseases. It has an acute clinical presentation with the distinctive characteristics of rapid onset of interdental gingival necrosis, gingival pain, bleeding, and halitosis. Systemic symptoms such as lymphadenopathy and malaise could be also found. There are various predisposing factors such as stress, nutritional deficiencies, and immune system dysfunctions, especially, HIV infection that seems to play a major role in the pathogenesis of NUG. The treatment of NUG is organized in successive stages: first, the treatment of the acute phase that should be provided immediately to stop disease progression and to control patient's feeling of discomfort and pain; second, the treatment of the preexisting condition such as chronic gingivitis; then, the surgical correction of the disease sequelae like craters. Moreover, finally, maintenance phase that allows stable outcomes. This case report describes the diagnosis approach and the conservative management with a good outcome of NUG in a 21-year-old male patient with no systemic disease and probable mechanism of pathogenesis of two predisposing factors involved.
坏死性溃疡性龈炎(NUG)是牙周疾病的一种典型形式。它具有急性临床表现,其特征为龈乳头迅速坏死、牙龈疼痛、出血和口臭。还可能出现诸如淋巴结病和不适等全身症状。存在多种诱发因素,如压力、营养缺乏和免疫系统功能障碍,尤其是人类免疫缺陷病毒(HIV)感染,似乎在NUG的发病机制中起主要作用。NUG的治疗分几个连续阶段进行:首先,急性期治疗应立即进行,以阻止疾病进展并控制患者的不适和疼痛感;其次,治疗先前存在的疾病,如慢性龈炎;然后,对诸如牙间乳头缺损等疾病后遗症进行手术矫正。此外,最后是维持阶段,以确保取得稳定的治疗效果。本病例报告描述了一名无全身疾病的21岁男性患者坏死性溃疡性龈炎的诊断方法和保守治疗及良好疗效,以及所涉及的两个诱发因素的可能发病机制。