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目的评价牙周基础治疗及维护期治疗对使用硝苯地平导致牙龈增生的治疗效果。方法选择2010年9月至2011年12月在佳木斯大学附属口腔医院牙周黏膜病科就诊的因高血压服用硝苯地平导致牙龈增生20例,随机分为试验组（10例）和对照组（10例）,在均不更换药或未停药的情况下,试验组进行牙周基础治疗和维护期治疗,而对照组仅进行牙周基础治疗。在治疗前和治疗后1、12个月时记录各组患者牙龈增生指数（GHI）、茵斑指数（PLI）、龈沟出血指数（SBI）和探诊深度（PD）。结果试验组在观察期间,各项指标（GHI、PLI、SBI、PD）持续改善（P〈0．01）,牙龈炎症减轻,牙龈增生状况明显改善且未复发;对照组在基础治疗后1个月牙龈各项指标改善（P〈0．01）,但12个月后复诊时牙龈出血等复发,且各指标与治疗前比较差异无统计学意义（P〉0．05）。结论牙周基础治疗可改善硝苯地平引起的牙龈增生,定期维护治疗对于预防硝苯地平导致的牙龈增生复发疗效明显。     

硝苯地平药物不良反应致牙龈增生6例

临床资料:6例病人均为男性,年龄43~70岁。服药时间最短1年,最长4年。6例病人停药后牙龈增生均有明显好转及改善。现将典型病例详述如下:患者男,70岁。患高血压,2002年服用硝苯地平控释片(拜欣同)60 mg/d。2004年改换服用硝苯地平缓释片(尼福达)20 mg/次2次/d。据病人口述此时牙龈已有增生其增生组织质地坚韧略有弹性,呈粉红色不易出血。探查牙周袋深约6mm,龈上结石( ),牙齿不松动,牙龈黏膜无破溃,自述刷牙时无出血。既往无药物过敏史,除牙龈组织增生外,无下肢浮肿。除患高血压外无其它慢性疾病。临床诊断:硝笨地平引起的药源性牙龈肥厚(增生…     

硝苯地平性牙龈增生的临床研究

目的 研究服用硝苯地平患者牙龈增生的发病情况。方法 对75名服用硝苯地平患者作牙周检查。并与134名非服用者作对照。结果 服用硝苯地平患者牙龈增生的发病率和发病严重程度均明显较对照组高。结论 提示服用硝苯地平是导致牙龈增生的重要原因。     

牙周非手术治疗对硝苯地平导致的老年人牙龈增生的疗效观察

目的:评价牙周非手术治疗对硝苯地平导致的老年人牙龈增生的治疗效果。方法:选取硝苯地平导致的牙龈增生患者18例,在基线和牙周非手术治疗后1个月、3个月、6个月、12个月分别记录菌斑指数、探诊深度、出血指数和牙龈增生指数。18例患者共13例完成了12个月的观察。结果:在观察期间,各指数持续改善(P<0.05),牙龈炎症持续减轻,牙龈增生状况明显改善。结论:牙周非手术治疗可改善硝苯地平引起的老年人牙龈增生的程度。     

硝苯地平致药物性牙龈增生的危险指征分析

目的调查北京石景山区人群服用硝苯地平后出现药物性牙龈增生的患病率，并分析其危险指征。方法在北京石景山区进行横向调查，将616例患高血压或冠心病的个体纳入本项研究，其中205例患者服用硝苯地平（nifedipine）≥0．5年，411例未服用钙拮抗剂的患者作为对照组。通过问卷了解每例患者的人口学特征、刷牙出血情况、吸烟、糖尿病及用药情况，临床检查12颗前牙的龈沟出血指数（sulcus bleeding index，SBI），同时用照片评价法判断牙龈增生的程度和菌斑指数。以牙龈增生程度≥38．6％作为判断个体牙龈增生的阈值。结果服用硝苯地平的患者牙龈增生的患病率为7．3％，显著高于对照组的1．2％。Logistic回归分析结果表明，仅有SBI是该地区个体出现明显牙龈增生的相关因素（OR=5．92，P=0．001）。结论牙龈炎性反应是药物性牙龈增生的一个重要协同因素。     

一位药物性牙龈增生患者的诊断、治疗和长期疗效

本文报告了1例服用环孢素和硝苯地平相关牙龈增生（肥大）患者的诊断、治疗和长期疗效。该患者在未更换全身用药情况下对牙龈增生进行了成功治疗。治疗的主要目的是降低牙龈增生的程度,进而恢复牙齿的健康、功能和美观。治疗过程是先行牙周基础治疗,后行牙周手术治疗,术后观察2年．牙龈增生未见复发。     

非硝苯地平钙离子拮抗剂与牙龈增生的关系研究

目的:探讨服用非硝苯地平的钙离子拮抗剂(除硝苯地平之外的其他钙离子拮抗剂)与牙龈增生的关系.方法:选择北京医院内科高血压门诊就诊的成年高血压病患者,进行问卷调查和口腔健康检查.分为服用非硝苯地平钙离子拮抗剂的患者(简称服药组)及从未服用过钙离子拮抗剂的患者(简称对照组).问卷调查内容包括患者的一般状况,高血压患病史,服药史以及口腔卫生习惯等.口腔健康检查包括菌斑指数(plaque index PLI)、简化牙石指数(simple calculus index CI-S)、以及牙龈增生指数(gingival hyperplasia index HI)的检查和记录.结果:对照组患者牙龈增生患病率6.03%,服药组患者牙龈增生患病率31.25%,两者间的差异有显著性(P＜0.001),并且服药组患者中严重牙龈增生的患病率19.23%也显著高于对照组1.59%(P＜0.001).对照组平均HI值为1.4%,服药组平均HI值为10%,两者间的差异有显著性(P＜0.001).结论:服用非硝苯地平钙离子拮抗剂与高血压患者牙龈增生的患病间有显著相关性.     

服用硝苯地平后牙龈增生以及未增生患者牙龈成纤维细胞生物特性比较

目的：观察服用硝苯地平后牙龈增生和未增生患者牙龈成纤维细胞（nifedipine responders gingival fibro-blasts NIFr-HGF,nifedipine non-responders gingival fibroblasts NIFn-HGF）超微结构、细胞周期变化以及增殖能力的差异性,以探讨该药导致牙龈增生的可能作用机理。方法：采用透射电镜观察NIFr-HGF、NIFn-HGF的超微结构,利用流式细胞仪、MTT法检测和比较2种细胞经硝苯地平诱导后其细胞周期以及增殖能力的差异性。结果：与NIFn-HGF相比较,NIFr-HGF内粗面内质网扩张;受硝苯地平诱导后其增殖明显加强。结论：NIFr-HGF合成蛋白质的能力可能较NIFn-HGF强,且前者对于硝苯地平的反应也明显强于后者,这提示两类细胞的细胞生物学特性以及对钙离子拮抗剂的反应能力存在差异,药物性牙龈增生的发生可能存在细胞异质性。     

Wnt1、β-catenin在硝苯地平引起的药物性牙龈增生中的表达

目的:探讨Wnt/β-catenin信号通路相关蛋白Wnt1、β-catenin在硝苯地平引起的药物性增生的牙龈组织中的表达.方法:选择正常牙龈对照组、(未服药)高血压牙龈增生组、硝苯地平引起的药物性牙龈增生组各10例,用Western-Blot和RT-PCR检测牙龈组织中Wnt1、β-catenin的表达.结果:药物性牙龈增生组的牙龈组织中Wnt1、β-catenin蛋白及mRNA表达水平显著高于正常牙龈对照组(P＜0.05)和高血压牙龈增生组(P＜0.05).结论:硝苯地平引起的药物性牙龈增生的牙龈组织中Wnt1、β-catenin表达水平增高,可能通过Wnt/β-catenin信号通路促进牙龈成纤维细胞的增殖导致牙龈纤维化.     

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目的探讨钙拮抗剂诱导的牙龈增生与钙拮抗剂种类和牙周局部因素的关系。方法2007年3月至10月对河北省人民医院心血管内科和口腔科门诊240例服用钙拮抗剂类药物患者进行牙周检查,记录牙龈增生指数、出血指数和菌斑指数等。结果240例患者中64例(26.67%)发生了牙龈增生,服用不同类型钙拮抗剂的患者间牙龈增生的发生率差异无统计学意义(P均>0.05)。牙龈增生程度越重,菌斑指数和出血指数均值越高,与0度组相比,Ⅰ～Ⅳ度牙龈增生组的菌斑指数和出血指数差异均有统计学意义(P均<0.01)。结论钙拮抗剂诱导的牙龈增生程度与牙周局部因素密切相关,与钙拮抗剂种类无关。     

Nifedipine-induced gingival hyperplasia: a clinical and in vitro study

Two cases of gingival hyperplasia associated with long-term administration of nifedipine, a drug that dilates coronary arteries, are reported. The clinical and histopathological features of the gingival hyperplasia induced by nifedipine were similar to those induced by phenytoin, an anticonvulsant drug. In the present cases, gingival inflammation had developed before drug administration. In one case, extensive dental plaque control in addition to surgical removal of the overgrown gingival tissues resulted in satisfactory progress without the need to discontinue drug administration, suggesting that the preexisting gingival inflammation was involved in the development of this periodontal disease. In the other case, change from nifedipine to another drug resulted in spontaneous recovery, strongly suggesting that the drug had induced the gingival hyperplasia. Nifedipine had no direct effects in vitro on proliferation or collagen synthesis of gingival fibroblastic cells from one of the patients. Study of these two cases suggests that both local inflammatory factors and long-term administration of nifedipine were responsible for the gingival hyperplastic changes observed.     

硝苯地平介导药物性牙龈增生的研究进展

药物性牙龈增生(DGO)是临床常见性牙周疾病.硝苯地平(NIF)为第1代钙离子拮抗剂,其副作用可引发DGO.在NIF介导的DGO中,与程序性细胞死亡相关的调节基因B细胞淋巴瘤/白血病-2基因和c-myc以及转录因子又头框蛋白在抑制细胞程序性死亡的过程中起重要作用.成纤维细胞表面所表达的补体受体具有异质性,与DGO的发生密切相关.炎症因子和黏附分子对DGO的作用也不可忽视.下文就近年来NIF介导DGO的国内外相关研究进展作一.     

Clinical assessment of gingival hyperplasia in patients treated with nifedipine

Abstract Gingival hyperplasia caused by the use of nifedipine has been extensively reported. In this paper, the gingiva of 18 patients suffering from cardiopathy and treated with nifedipine were compared with those of 10 patients with cardiac disorders who had not been treated with calcium antagonists and with a no-treatment group of 12 patients. Nifedipine produced gingival hyperplasia although patients who had not been treated with calcium antagonists also had mild hyperplasia. Hyperplasia first appeared in the interproximal areas, an observation which may be important for early detection. There was a direct correlation between the degree of hyperplasia and the bacterial plaque score. When we studied the influence of administration time and dose of nifedipine with the degree of hyperplasia, no statistically significant differences were found.     

Nifedipine-induced gingival hyperplasia

Nifedipine-induced gingival hyperplasia was first reported in 1984. Nifedipine is a relatively new drug used in the treatment of ventricular arrhythmias and angina. This article reports a case of gingival hyperplasia induced by the drug and reviews the cases reported so far in the literature.     

硝苯地平对人牙龈成纤维细胞内钙离子含量的影响

目的:探讨硝苯地平对牙龈成纤维细胞内Ca2 含量的影响.方法:体外培养人牙龈成纤维细胞,Fluo-3染色,激光共聚焦显微镜下观察加入不同浓度硝苯地平后荧光强度的变化.结果:硝苯地平能抑制DHP类钙钙离子指示剂通道BayK8644引起的牙龈成纤维细胞内钙离子含量增加(P<0.05),不同浓度硝苯地平的作用之间没有剂量-效应关系.结论:硝苯地平引起牙龈增生可能与抑制牙龈成纤维细胞内钙离子含量有关.     

硝苯地平对人牙龈成纤维细胞内Ca2+含量影响的激光共聚焦显微观察

目的:探讨硝苯地平对牙龈成纤维细胞内Ca2 含量的影响。方法:体外培养人牙龈成纤维细胞,钙离子指示剂F luo-3染色,激光扫描共聚焦显微镜下观察加入不同浓度硝苯地平(NIF终浓度分别为1200、32.4 ng/mL)后荧光亮度的变化。结果:硝苯地平能抑制DHP类钙通道激动剂Bay K8644引起的牙龈成纤维细胞内钙离子含量增加(P<0.05),不同浓度硝苯地平的作用之间没有剂量-效应关系。结论:硝苯地平引起牙龈增生可能与抑制牙龈成纤维细胞内Ca2 含量有关。     

Incidence of verapamil-induced gingival hyperplasia in a dental population.

The records of 5,000 dental patients were reviewed for history of verapamil use between 1987 and 1990. Twenty-four dentate patients who received verapamil for more than 1 year were identified. Of these, gingival hyperplasia occurred in 1 patient (4.1%) that was limited to the mandibular attached gingiva. Onset of gingival overgrowth was associated with drug dosage, bacterial accumulation, and gingival inflammation. Histologically, the findings resembled that seen in hyperplasia induced by phenytoin, cyclosporin, and other calcium channel blockers. Our data suggest that gingival hyperplasia caused by verapamil occurs less frequently than nifedipine-induced gingival hyperplasia.     

Nifedipine induced gingival enlargement in an edentulous patient: a case report with one year follow up

Background

Gingival enlargement due to calcium channel blockers is a common complaint reported by patients. It can be localized or generalized and can range from mild to severe, affecting patients appearance and function. Nifedipine induced gingival enlargement is noticed only in 10 % of patients and very few cases of Nifedipine induced gingival enlargement in an edentulous patient have been documented in the literature.

Case presentation

Here in, we report a case of gingival enlargement in a 70?year old hypertensive edentulous patient who was on low dose Nifedipine therapy. Patient wanted complete dentures. We planned to excise the overgrowth and followed up for 1 year.

Conclusion

Nifedipine induced gingival enlargement noticed only in 10 % of patients. Hence, there is a need for physicians and dentist to make a coordinated treatment plan and practice care while prescribing these drugs which are associated with gingival overgrowth.