Dongari A, McDonnell H T, Langlais R P
Dental School, University of Texas Health Center at San Antonio.
Oral Surg Oral Med Oral Pathol. 1993 Oct;76(4):543-8. doi: 10.1016/0030-4220(93)90027-2.
Certain anticonvulsants, cyclosporine, and a variety of calcium channel blockers have been shown to produce clinically and histologically similar gingival enlargements in certain susceptible patients. These drugs appear to be similar with respect to their pharmacologic mechanism of action at the cellular level. The primary target tissue is the most essential difference among them. Therefore it is tempting to speculate that these agents may act similarly on a common secondary target tissue, such as gingival connective tissue, and cause a hyperplastic response. This tissue reaction may involve a disturbance of calcium ion influx into specific cell populations with a resulting alteration in collagen metabolism and other host cell response mechanisms. A connection between ion exchange, folate uptake, collagenase activation, and bacterial inflammation may exist. Until a more effective approach can be developed from future research results, treatment should continue to emphasize plaque control, professional debridement, and resective gingival procedures to improve function, esthetics, and access for home care.
某些抗惊厥药、环孢素以及多种钙通道阻滞剂已被证明，在某些易感患者中会产生临床和组织学上相似的牙龈增生。就这些药物在细胞水平的药理作用机制而言，它们似乎是相似的。它们之间最主要的区别在于主要靶组织。因此，人们不禁推测，这些药物可能对一个共同的次要靶组织（如牙龈结缔组织）产生相似的作用，并引发增生反应。这种组织反应可能涉及钙离子流入特定细胞群的紊乱，从而导致胶原代谢和其他宿主细胞反应机制的改变。离子交换、叶酸摄取、胶原酶激活与细菌性炎症之间可能存在联系。在未来的研究结果能开发出更有效的方法之前，治疗应继续强调菌斑控制、专业清创以及切除性牙龈手术，以改善功能、美观和家庭护理的便利性。
