Neumann C, Willershausen-Zönnchen B, Klug C, Darius H
Poliklinik f-ur Zahnerhaltungskunde und Parodontologie, Augustusplatz 2, Mainz D-55131, Germany.
Eur J Med Res. 1996 Mar 19;1(6):273-9.
Calcium antagonists are widely used in treating acute and chronic coronary insufficiency disorders. A major side effect of long-term treatment is gingival hyperplasia. In the present study, 70 patients taking nifedipine for at least six months and 70 controls similar in age, gender, approximal hygiene and systemic disease with at least 6 anterior teeth in upper and lower arches were examined. Their periodontal conditions were determined by modified Sulcus-Bleeding-Index (mSBI), modified Approximal-Plaque-Index (mAPI), Community Periodontal Index of Treatment Needs (CPITN), a hyperplasia index quantifying the extent of gingival overgrowth, probing depths, clinical attachment loss and the modified Phenytoin-Gingival-Inflammation-Index (mPGI). A mild to moderate gingival hyperplasia was diagnosed in 21 of 70 patients resulting in a prevalence of 30% compared to 8.5% in controls. The hyperplastic changes were situated mainly in the anterior region of the dentition. Significant differences between both groups could be found comparing the severity of the gingival hyperplasia, the CPITN, mSBI, probing depths and the part of mPGI evaluating colour and turgor of the gingiva (p < 0.05). The severity of gingival overgrowth was strongly correlated with the inflammatory gingival changes, probing depths, the periodontal treatment need and the approximal hygiene of the patients. No statistically significant correlation could be found between the severity of gingival hyperplasia and the age and gender of the patient, or the dose or duration of nifedipine therapy. Gingival changes seemed to be more pronounced in patients with cardiovascular disorders than in patients under hemodialysis. The high incidence of gingival hyperplasia in patients receiving nifedipine on a long-term basis emphasises the role of the dentist and general practitioner in the early detection and prophylaxis of gingival changes and requires a thorough information to the patient concerning periodontal side effects.
钙拮抗剂广泛用于治疗急慢性冠状动脉供血不足疾病。长期治疗的一个主要副作用是牙龈增生。在本研究中，对70名服用硝苯地平至少6个月的患者以及70名年龄、性别、邻面卫生状况和全身疾病情况相似且上下牙弓至少有6颗前牙的对照者进行了检查。通过改良龈沟出血指数（mSBI）、改良邻面菌斑指数（mAPI）、社区牙周治疗需求指数（CPITN）、量化牙龈过度生长程度的增生指数、探诊深度、临床附着丧失以及改良苯妥英牙龈炎症指数（mPGI）来确定他们的牙周状况。70名患者中有21名被诊断为轻度至中度牙龈增生，患病率为30%，而对照组为8.5%。增生性改变主要位于牙列的前部区域。比较两组牙龈增生的严重程度、CPITN、mSBI、探诊深度以及评估牙龈颜色和质地的mPGI部分，发现两组之间存在显著差异（p < 0.05）。牙龈过度生长的严重程度与牙龈炎症改变、探诊深度、牙周治疗需求以及患者的邻面卫生状况密切相关。在牙龈增生的严重程度与患者的年龄、性别、硝苯地平治疗的剂量或持续时间之间未发现统计学上的显著相关性。心血管疾病患者的牙龈改变似乎比血液透析患者更为明显。长期接受硝苯地平治疗的患者中牙龈增生的高发生率强调了牙医和全科医生在早期发现和预防牙龈改变方面的作用，并且需要向患者充分告知牙周副作用的相关信息。
