Department of Periodontology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;
Rom J Morphol Embryol. 2022 Jan-Mar;63(1):253-259. doi: 10.47162/RJME.63.1.29.
Periodontal pathology is often represented by increases in gingival volume, with pronounced inflammatory phenomena. These manifestations require a more accurate diagnosis and knowledge of the etiopathogenic factors involved. The periodontal treatment applied must be related with the etiopathogenic circumstances. Periodontal disease sometimes has a complex appearance, with intertwined local and systemic favorable factors that make it difficult to include it in a certain taxonomic form. Also, in general, the adult patients have associated chronic diseases that involve the administration of several drugs, which induce on long-term both therapeutic and side effects. Furthermore, diseases in the oral cavity may occur frequently, which require complex and associated dental and periodontal treatment, also occlusal rebalancing, which is a real interdisciplinary challenge. In this case report, periodontal status is determined by a combination of local and systemic favorable factors. However, the histopathological analysis of the gingival samples revealed inflammation without characteristic fibrous hyperplasia changes of the Amlodipine calcium channel blocker (CCB) administration, the antihypertensive medication of the patient. Thus, Amlodipine does not have a hyperplasic effect on gingival mucosa in all cases. Therefore, even if they are more expensive, investigations must be complex, if necessary, in establishing the involvement of the side effect of the systemic medication in periodontal pathological changes. CCB systemic medication is essential, even vital, for maintain the arterial pressure at normal values, should not be altered without the real indication and to the recommendation from a specialist doctor, and the periodontal treatment must be focused to eliminate the local factors.
牙周病常表现为牙龈体积增加，并伴有明显的炎症现象。这些表现需要更准确的诊断和了解相关的病因发病机制。应用的牙周治疗必须与病因发病机制相关。牙周病有时表现复杂，局部和全身有利因素相互交织，使其难以归入某一特定分类形式。此外，一般来说，成年患者常伴有涉及多种药物治疗的慢性疾病，这些药物在长期使用过程中会产生治疗和副作用。此外，口腔疾病可能经常发生，需要进行复杂的联合牙科和牙周治疗，以及咬合再平衡，这是一个真正的跨学科挑战。在本病例报告中，牙周状况是由局部和全身有利因素共同决定的。然而，对牙龈样本的组织病理学分析显示炎症，而没有患者所服用的氨氯地平钙通道阻滞剂（CCB）降压药物的特征性纤维性增生变化。因此，氨氯地平并非在所有情况下都会对牙龈黏膜产生增生作用。因此，即使更昂贵，也必须进行复杂的检查，如果有必要，还需要调查全身药物的副作用是否参与牙周病理变化。CCB 全身药物对于将动脉血压维持在正常水平至关重要，不应在没有真正指征和专科医生建议的情况下改变，牙周治疗必须集中消除局部因素。
