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药物性牙龈增生的临床表现与治疗:病例系列

Clinical presentation and management of drug-induced gingival overgrowth: A case series.

作者信息

Fang Li, Tan Bao-Chun

机构信息

Department of Stomatology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian 223800, Jiangsu Province, China.

Departments of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China.

出版信息

World J Clin Cases. 2021 Nov 16;9(32):9926-9934. doi: 10.12998/wjcc.v9.i32.9926.

Abstract

BACKGROUND

We report three patients with drug-induced gingiva overgrowth (DIGO) caused by nifedipine, a calcium channel blocker, who were treated and followed up for 1-3 years. We discussed their symptoms, treatment process, treatment prognosis, and follow-up results.

CASE SUMMARY

All the patients had a history of nifedipine treatment to control hypertension. Besides nifedipine, Patient 1 was prescribed immunosuppressant cyclosporine A to control nephritis, which is also implicated in GO. Thus, we assumed that a synergistic effect between the drugs contributed to the severity of Patient 1's condition. This condition has been reported to be more pronounced in patients with periodontitis. In the course of treatment, Patients 1 and 2 did not stop or change drugs. After initial periodontal treatment, periodontal surgery, and later periodontal support and better plaque control, their gingival hyperplasia was well managed and controlled. Under the guidance of a physician, Patient 3 replaced her calcium-channel blocker drug with losartan potassium and hydrochlorothiazide tablets. She received initial treatment without surgery, obtaining a good curative effect.

CONCLUSION

Patients' compliance, self-plaque control, and professional periodontal therapy have a vital role in treating and preventing the recurrence of DIGO.

摘要

背景

我们报告了3例由钙通道阻滞剂硝苯地平引起的药物性牙龈增生(DIGO)患者,对其进行了1至3年的治疗和随访。我们讨论了他们的症状、治疗过程、治疗预后及随访结果。

病例摘要

所有患者均有服用硝苯地平控制高血压的病史。除硝苯地平外,患者1还因控制肾炎服用了免疫抑制剂环孢素A,环孢素A也与牙龈增生有关。因此,我们推测药物之间的协同作用导致了患者1病情的严重程度。据报道,这种情况在牙周炎患者中更为明显。在治疗过程中,患者1和2未停药或换药。经过初始牙周治疗、牙周手术,以及后期的牙周维护和更好的菌斑控制,他们的牙龈增生得到了良好的管理和控制。在医生的指导下,患者3将其钙通道阻滞剂药物换成了氯沙坦钾氢氯噻嗪片。她未进行手术即接受了初始治疗,取得了良好的疗效。

结论

患者的依从性、自我菌斑控制及专业的牙周治疗对治疗和预防药物性牙龈增生的复发起着至关重要的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8727/8610926/74d0b9ea6fcf/WJCC-9-9926-g001.jpg

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