구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제33권1호
  • /
  • Pages.34-41
  • /
  • 2017
  • /
  • 2384-4353(pISSN)
  • /
  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
권호 표지
DOI QR코드

DOI QR Code

약물성 치은비대로 인한 병적인 치아 이동이 있는 환자에서 치주치료 이후 자발적 치아 이동을 보인 증례

Spontaneous teeth migration after periodontal treatment in the patients with drug-induced gingival enlargement

  • 최윤경 (부산대학교병원 치과진료센터) ;
  • 정경화 (부산대학교병원 치과진료센터) ;
  • 김소연 (부산대학교병원 치과진료센터) ;
  • 전혜미 (부산대학교병원 치과진료센터) ;
  • 최점일 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 이주연 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 주지영 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 권은영 (부산대학교병원 치과진료센터)
  • Choi, Youn-Kyung (Dental Clinic Center, Pusan National University Hosptial) ;
  • Jung, Kyoung-Hwa (Dental Clinic Center, Pusan National University Hosptial) ;
  • Kim, So-Yeun (Dental Clinic Center, Pusan National University Hosptial) ;
  • Jeon, Hye-Mi (Dental Clinic Center, Pusan National University Hosptial) ;
  • Choi, Jeomil (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Lee, Ju-Youn (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Joo, Ji-Young (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Kwon, Eun-Young (Dental Clinic Center, Pusan National University Hosptial)
  • 투고 : 2017.01.03
  • 심사 : 2017.01.28
  • 발행 : 2017.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

치은비대와 연관된 대표적인 3가지 약물은 항경련제, 칼슘 길항제, 면역 억제재 등이다. 약물성 치은 비대를 위한 치료에서 근본적인 원인인 약물 대체가 선행되면 재발의 위험 등은 훨씬 낮아지는 이점이 있으나, 대체가 어려울 때는 치주치료와 철저한 유지관리가 병행되어야만 한다. 본 연구에서는 약물성 치은비대로 병적인 치아 이동이 일어난 경우, 약물 교체 없이 치주 치료로 염증이 해소 되면서 자발적으로 치아 이동이 함께 일어난 증례를 보고하고자 한다. 본 증례의 환자들도 치주치료 이후 적극적인 정기 점검을 통해 안정적으로 유지될 수 있었다.

Anticonvulsants, calcium channel blockers and immunosuppressants are representative drugs related with gingival enlargement. Clinical signs and symptoms caused by drug-induced gingival enlargment frequently appear within 1 to 3 months after medication. At initial stage, it is limited to attached gingiva but may extend coronally and interfere with esthetics, mastication and speech. Interproximal spaces are common beginning area and pathologic teeth migration could be occurred by the lesion. Withdrawal or substitution of medication would be the most effective treatment of drug-induced gingival enlargement. However, periodontal treatment and further supportive periodontal therapy should be provided where change in medication is impossible. The present study reports the cases which show the resolution of inflammation with spontaneous teeth migration without change in medication. In all cases discussed in this report could be efficiently managed with proper periodontal treatment and further supportive periodontal therapy.

키워드

참고문헌

  1. Dongari-Bagtzoglou A; Research, Science and Therapy Committee, American Academy of Periodontology. Drug-associated gingival enlargement. J Periodontol 2004;75:1424-31. https://doi.org/10.1902/jop.2004.75.10.1424
  2. Casetta I, Granieri E, Desidera M, Monetti VC, Tola MR, Paolino E, Govoni V, Calura G. Phenytoin-induced gingival overgrowth: a community-based cross-sectional study in Ferrara, Italy. Neuroepidemiology 1997;16:296-303. https://doi.org/10.1159/000109700
  3. Ellis JS, Seymour RA, Steele JG, Robertson P, Butler TJ, Thomason JM. Prevalence of gingival overgrowth induced by calcium channel blockers: a community-based study. J Periodontol 1999;70:63-7. https://doi.org/10.1902/jop.1999.70.1.63
  4. Boltchi FE, Rees TD, Iacopino AM. Cyclosporine A-induced gingival overgrowth: a comprehensive review. Quintessence Int 1999;30:775-83.
  5. Hassell TM, Hefti AF. Drug-induced gingival overgrowth: old problem, new problem. Crit Rev Oral Biol Med 1991;2:103-37. https://doi.org/10.1177/10454411910020010201
  6. Meraw SJ, Sheridan PJ. Medically induced gingival hyperplasia. Mayo Clin Proc 1998;73:1196-99. https://doi.org/10.4065/73.12.1196
  7. Hallmon WW, Rossmann JA. The role of drugs in the pathoge1nesis of gingival overgrowth. A collective review of current concepts. Periodontol 2000 1999;21:176-96. https://doi.org/10.1111/j.1600-0757.1999.tb00175.x
  8. Somacarrera ML, Lucas M, Scully C, Barrios C. Effectiveness of periodontal treatments on cyclosporine-induced gingival overgrowth in transplant patients. Br Dent J 1997;183:89-94. https://doi.org/10.1038/sj.bdj.4809430
  9. Seymour RA, Smith DG. The effect of a plaque control programme on the incidence and severity of cyclosporin-induced gingival changes. J Clin Periodontol 1991;18:107-10. https://doi.org/10.1111/j.1600-051X.1991.tb01698.x
  10. Kantarci A, Cebeci I, Tuncer O, Carin M, Firatli E. Clinical effects of periodontal therapy on the severity of cyclosporin A-induced gingival hyperplasia. J Periodontol 1999;70:587-93. https://doi.org/10.1902/jop.1999.70.6.587
  11. Hancock RH, Swan RH. Nifedipine-induced gingival overgrowth. Report of a case treated by controlling plaque. J Clin Periodontol 1992;19:12-4. https://doi.org/10.1111/j.1600-051X.1992.tb01141.x
  12. Mavrogiannis M, Ellis JS, Thomason JM, Seymour RA. The management of drug-induced gingival overgrowth. J Clin Periodontol 2006;33:434-9. https://doi.org/10.1111/j.1600-051X.2006.00930.x
  13. Walker CR Jr, Tomich CE, Hutton CE. Treatment of phenytoin-induced gingival hyperplasia by electrosurgery. J Oral Surg 1980;38:306-11.
  14. Goharkhay K, Moritz A, Wilder-Smith P, Schoop U, Kluger W, Jakolitsch S, Sperr W. Effects on oral soft tissue produced by a diode laser in vitro. Lasers Surg Med 1999;25:401-6. https://doi.org/10.1002/(SICI)1096-9101(1999)25:5<401::AID-LSM6>3.0.CO;2-U
  15. Khocht A, Schneider LC. Periodontal management of gingival overgrowth in the heart transplant patient: a case report. J Periodontol 1997;68:1140-6. https://doi.org/10.1902/jop.1997.68.11.1140
  16. Jin LJ, Cao CF. Clinical diagnosis of trauma from occlusion and its relation with severity of periodontitis. J Clin Periodontol 1992;19:92-7. https://doi.org/10.1111/j.1600-051X.1992.tb00446.x
  17. Gaumet PE, Brunsvold MI, McMahan CA. Spontaneous repositioning of pathologically migrated teeth. J Periodontol 1999;70:1177-84. https://doi.org/10.1902/jop.1999.70.10.1177