Bullon P, Machuca G, Martinez-Sahuquillo A, Rios J V, Velasco E, Rojas J, Lacalle J R
Department of Periodontology, School of Dentistry, University of Seville, Spain.
J Clin Periodontol. 1996 Jul;23(7):649-57. doi: 10.1111/j.1600-051x.1996.tb00589.x.
It is established that phenytoin, cyclosporin and some calcium antagonists produce gingival overgrowth, but it is not known how this condition may respond to causal periodontal treatment. In order to find out, a longitudinal study was carried out, over a year, comparing a group of patients who were given nifedipine (NG, n = 18) and another group who were given diltiazem (DG, n = 13) with 2 others: one comprised cardiopathic patients who took no calcium antagonists (CG, n = 12) and the other contained patients who were medically healthy, with moderate periodontitis (HG, n = 12). On their basal visit, they were examined and instructed in oral hygiene, and then given causal periodontal treatment, being seen again at 4 and 8 months, when hygiene instructions were reinforced. They were seen for the last time at 12 months, when they were again examined. Groups NG and DG, on their basal visit, showed larger gum size than groups HG and CG, which was statistically significant; on their final visit, these differences remained only at the interproximal level. The number of patients with gingival overgrowth-taking the average of group HG as a minimal value-was much higher in groups CG (92%), DG (100%) and NG (89%) on the basal visit; on the final visit, the differences remained only in groups DG (85%) and NG (83%). The probing pocket depth reduction was much greater in groups HG and CG than in DG and NG, basically due to a greater gaining on clinical attachment level. The % of sites in which the pocket depth improved by more than 2 mm was 39.8% in HG, 54.5% in CG, 23.7% in DG and 28.7% in NG. The % of sites where the attachment gain by more than 2 mm was 46.2% in HG, 55.5% in CG, 22.8% in DG and 21.4% in NG. The amount of plaque and bleeding on probing, which was similar in all groups on the basal visit, decreased throughout the study, especially between the basal and 2nd visit in groups HG and CG. We have demonstrated that patients that take nifedipine and diltiazem show a larger gum size and their response to causal periodontal treatment is poorer than in the healthy and the cardiac groups.
已证实苯妥英、环孢素和一些钙拮抗剂会导致牙龈增生，但尚不清楚这种情况对病因性牙周治疗会有怎样的反应。为了弄清楚这一点，开展了一项为期一年的纵向研究，将一组服用硝苯地平的患者（硝苯地平组，n = 18）和另一组服用地尔硫䓬的患者（地尔硫䓬组，n = 13）与另外两组进行比较：一组是未服用钙拮抗剂的心脏病患者（心脏病组，n = 12），另一组是患有中度牙周炎的健康患者（健康组，n = 12）。在基线访视时，对他们进行检查并给予口腔卫生指导，然后进行病因性牙周治疗，在4个月和8个月时再次就诊，此时强化卫生指导。在12个月时最后一次就诊，再次对他们进行检查。硝苯地平组和地尔硫䓬组在基线访视时牙龈尺寸大于健康组和心脏病组，具有统计学意义；在最后一次访视时，这些差异仅在邻面水平存在。以健康组的平均值作为牙龈增生的最小值，在基线访视时，心脏病组（92%）、地尔硫䓬组（100%）和硝苯地平组（89%）牙龈增生患者的数量要高得多；在最后一次访视时，差异仅存在于地尔硫䓬组（85%）和硝苯地平组（83%）。健康组和心脏病组的探诊深度降低幅度远大于地尔硫䓬组和硝苯地平组，这主要是由于临床附着水平的改善更大。探诊深度改善超过2 mm的部位百分比在健康组为39.8%，心脏病组为54.5%，地尔硫䓬组为23.7%，硝苯地平组为28.7%。附着增加超过2 mm的部位百分比在健康组为46.2%，心脏病组为55.5%，地尔硫䓬组为22.8%，硝苯地平组为21.4%。在基线访视时所有组的菌斑量和探诊出血情况相似，在整个研究过程中均有所减少，尤其是健康组和心脏病组在基线访视和第二次访视之间。我们已经证明，服用硝苯地平和地尔硫䓬的患者牙龈尺寸更大，并且他们对病因性牙周治疗的反应比健康组和心脏病组差。
