药源性牙龈增生

Drug-Induced Gingival Overgrowth

目的探讨药源性牙龈增生的致病机制及其防治方法,为临床合理用药提供参考。方法检索国内外有关文献,进行文献综述。结果引起药源性牙龈增生的药物主要有钙拮抗剂、抗癫痫药物和免疫抑制剂环孢素A等。致病机制多种多样,但主要与降低牙龈成纤维细胞表面α2β1整合素与胶原的亲和力、降低胶原的吞噬作用,从而导致Ⅰ型胶原的堆积有关。合理选药和保持口腔卫生是预防牙龈增生的有效方法,牙龈切除仍然是治疗严重牙龈增生的主要方法。结论药源性牙龈增生可影响咀嚼、语言、刷牙和美容,但一般无严重的临床后果,医务工作者和患者对药源性牙龈增生都应有所认识。

OBJECTIVE To investigate the pathogenic mechanisms and the methods of prevention and cure of drug-induced gingival overgrowth,and provide the information for rational use of drugs in clinic.METHODS To retrieve relate literatures in domestic and abroad,and review the literatures.RESULTS The main drugs that induced gingival overgrowth are calcium antagonists,antiepileptics and immunosuppressive agents cyclosporine A.The pathogenic mechanisms of drug-induced gingival overgrowth are multiformity.The main mechanism is reduceing the affinity of α2β1 integrin and collagen,and the phagocytosis of collagen,and inducing accumulation of type Ⅰ collagen.Reasonable drug selection and maintaining oral hygiene are the effective methods preventing drug-induced gingival overgrowth.The main method of therapy for drug-induced gingival overgrowth is gingivectomy.CONCLUSION Drug-induced gingival overgrowth may affect the mastication,speech,toothbrushing and physiognomy,but there is not serious clinical outcomes,and it should be learned by medical workers and patients.