单纯牙周基础治疗对药物性牙龈增生的疗效观察

The effect of initial periodontal therapy on drug-induced gingival overgrowth

目的:在不停药亦不换药的情况下,评价单纯牙周基础治疗对钙通道阻滞剂导致的药物性牙龈增生的临床疗效,以探讨药物性牙龈增生的可行性治疗方案。方法:收集因服用钙通道阻滞剂引起牙龈增生的病人6例,在不停药亦不换药的情况下进行牙周基础治疗,包括口腔卫生宣教、洁治、刮治和根面平整术。在治疗前基线和治疗后1、3个月记录牙龈增生指数、菌斑指数、龈沟出血指数和探诊深度。复诊时进行必要的牙周基础治疗,加强口腔卫生宣教。结果:①治疗后1、3个月与基线相比,治疗后3个月与治疗后1个月相比,牙龈增生指数、龈沟出血指数、探诊深度都有明显改善,差异有统计学意义(P<0.05);②治疗前分别与治疗后1、3个月比较,菌斑指数差异均有统计学意义(P<0.05);治疗后1个月与3个月菌斑指数差别无统计学意义(P>0.05);③龈沟出血指数和菌斑指数呈中度正相关关系(r=0.546);④牙龈炎症逐步减轻,牙龈增生状况持续改善。结论:单纯牙周基础治疗对药物性牙龈增生有效,为不能停药亦不能换药的高血压病人提供了较合理的治疗方法。

AIM： To evaluate the clinical effect of initial periodontal therapy on gingival overgrowth induced by calcium channel blocker （CCB） without changing to other drugs or withdrawing of the CCB. METI-IODS ： Six cases with gingival overgrowth induced by CCB were included in this clinical study. Initial periodontal therapy including oral health instruction, supragingival scaling, subgingival scaling and root planning was done without changing to other drugs or withdrawing of the CCB. The sulcus bleeding index （SBI）, plaque index （PI）, probing depth （PD） and gin- gival hyperplastic index （GHI） were scored on labial sites of the anterior teeth. After initial periodontal therapy, the a- bove indices were examined again at 1 month and 3 month. RESULTS： SBI, PD and GHI index improved gradually and significant difference was found between different time points （P 〈 0. 001 ）. PI was significantly different between baseline, one month and three month after treatment （P 〈 0.001 ）, but no significant difference was found between one month and three month after treatment （P = 0. 414）. SBI was positively correlated with PI. CONCLUSION： Initial periodontal therapy is effective in reducing drug-induced gingival overgrowth. And this provides a rational means for those patients who can not change or withdraw the CCB.