• Journal of Periodontal and Implant Science
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• 제30권2호
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• pp.359-374
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• 2000

Cyclosporine A(CsA) is a widely used immunosuppressant for transplant patients and is also used for the treatment of a wide variety of systemic diseases with immunologic disorders. However, its use is frequently limited because of complications such as nephrotoxicity or gingival hyperplasia. Although several hypotheses have been postulated for CsA-induced gingival hyperplasia, i.e. various cytokine effects of inflammatory cells, existence of plaque or CsA itself, but its pathogenesis is still unclear. For experimental chronic CsA toxicity, salt depletion has been shown to increased susceptibility of rodents to the effects of CsA, and this maneuver facilitates production of arteriolopathy and interstitial fibrosis in kidney that mimic the changes found in human. The purpose of this study was to evaluate pathogenesis of CsA-induced gingival hyperplasia by comparing changes between CsA administration groups of normal standard diet and those of low salt diet group. Specific pathogen-free, 20 to 25 days old(120 to 150 g), male Fisher-344 rats(KIST, Korea), 120 to 150g of body weight, were assigned to four groups of six animals each after one week of adaptation period for powder food. Group 1 received olive oil($300{\mu}l/g\;of\;diet$) with normal standard diet(0.4% of sodium)(NSD). Group 2 received CsA(Cypol-N, Jonggundang, Korea; $300{\mu}g/g\;of\;diet$) with normal standard diet(NSD+CsA). Group 3 received same amount of olive oil with low salt diet(0.05 % of sodium, Teklad Premier, U.S.A.)(LSD). Group 4 received same dose of CsA with low salt diet(LSD+CsA). Rats were pair fed and were sacrificed after six weeks. Renal histologic lesions associated with CsA, consisted of cortical interstitial fibrosis, tubular atrophy and hyalinization of arterioles and the impairment of renal function including increase of serum creatinine and decrease of glomerular filtration rate was more severe in low salt diet group. These were proved as the results of activated of renin-angiotensin system in the kidney by low salt condition. Meanwhile the degree of gingival hyperplasia at incisor and molar tooth was less severe in low salt diet group compared with normal sodium diet group. Hyperplastic gingiva showed mild epithelial hyperplasia and expanded underlyng stroma which consisted of matrix increasement, capillary proliferation and dilatation. While the number and the activation of fibroblasts were increased, inflammatory cells were rare in the stroma. The immunohistochemistry for TGF-${\beta}_1$ in the kidney and gingiva revealed stronger positive in LSD+CsA in kidney but in gingiva of NSD+CsA. These results suggested followings; Gingival hyperplasia can be developed without inflammatory cells infiltration and seemed not induced by CsA by itself. The major role for gingival hyperplasia by CsA would be the secondary effect of TGF-${\beta}$, which maybe upregulated by CsA administration. Low salt diet can attenuate this hyperplasia perhaps by decreasing the activation of $TGF-{\beta}$.

• Journal of Periodontal and Implant Science
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• 제24권2호
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• pp.357-375
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• 1994

The purpose of this study was to investigate the differences of histochemical characteristics in inflammatory fibrous gingival hyperplasia (FGH), phenytoin-induced gingival hyperplasia(PIGH), idiopathic gingival hyperplasia(IDGH) and control groups (healthy and inflammatory gingiva) by immunohistochemical method with various antibodies and histomorphological analysis. In immunohistochemical finding, antibodies to inflammatory cells (T/B lymphocytes, macrophages, other monocytes), proliferating cell nuclear antigen(PCNA), epidermal growth factor(EGF), factor VIII, and type I collagen were used. 1. The inflammatory infiltrates in FGH were less than those in inflammatory gingiva. The composition of inflammatory cells of PIGH was similar with that of FGH. IDGH showed a similar histologic findings with healthy gingival tissue. 2. In FGH, the number of fibroblasts and newly-formed collagen fibers was increased. No significant increase of fibroblasts and the dense accumulation of thick collagen fibers were seen in PIGH. The increase of fibroblasts and the dense accumulation of thick collagen were seen in IDGH. 3. PCNA-positive cells were localized mainly in the area accumulated with inflammatory cells and blood vessels, significantly increased in all hyperplastic tissue groups, and distributed evenly in IDGH. 4. The distribution of EGF were not observed in healthy gingiva but detected locally in area with confluent blood vessels,without significant difference between the other tissue groups. This results suggest that inflammation plays a significant role in inducing hyperplastic change of gingival tissue. While in DIGH, drug itself as well as inflammation seems to attribute to hyperplastic change.

• The Journal of Advanced Prosthodontics
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• 제6권6호
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• pp.555-558
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• 2014

Focal epithelial hyperplasia (FEH) is a human papillomavirus (HPV)-induced alteration of the oral mucosa that presents with a clinically distinct appearance. While other HPV-infected lesions such as squamous papilloma, verruca vulgaris, and condyloma acuminatum involve the skin, oral mucosa, and genital mucosa, FEH occurs only in the oral mucosa. The affected oral mucosa exhibits multiple papules and nodules with each papule/nodule being flat-topped or sessile. The affected region resembles the normal color of oral mucosa rather than appearing as a white color since the epithelial surface is not hyperkeratinized. Almost all cases present with multiple sites of occurrence. This rare, benign epithelial proliferation is related to low-risk HPV, especially HPV-13 and -32, and is not transformed into carcinoma. We report a case of FEH that arose on the attached gingiva of an East Asian male adult related to prosthesis without detection of any HPV subtype in HPV DNA chip and sequencing.

• 대한소아치과학회지
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• 제29권4호
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• pp.581-585
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• 2002

Focal epithelial hyperplasia(FEH)는 구강편평상피의 국소적인 증식으로 사람유두종바이러스(Human papilloma virus)에 의해 유발되는 것으로 알려져 있다. 보통 어린 나이에 호발하며 종종 젊은 성인에서 발생하기도 한다. 협,순측 및 설측 점막에 호발하지만 치은이나 혀의 병소(lesions of tongue)도 보고된 바 있다. 이 병소는 전형적으로 다발성인 부드럽고 촉진 시 압통이 없는 편평한 구진이나 반의 형태를 갖는다. 종종 유두상의 표면을 보이기도 한다. 각각의 병소는 비교적 작고 분리되어 있으며 잘 경계지어진다. FEH의 조직학적 특징은 구강 상피의 유극세포증(acanthosis)이다. 그 밖에 바이러스에 의한 세포병리학적 변화를 나타내는 구멍세포(koilocyte)나 유사분열상 세포(mitosoid cell)가 관찰되기도 한다. 본 증례의 5세 여자환아는 치은의 돌기성 병소를 주소로 연세대학교 치과대학병원 소아치과에 내원하였다. 임상구강검사 결과 무경형의 유두상 구진(sessile papillary papules)이 상악 좌우측 제 2 유구치 협측 치은에서 관찰되었다. 촉진 시 동통은 없었다. 조직학적 검사를 위해 조직생검을 시행하였으며, 유극세포증이 관찰되었다. 이에 FEH로 진단되어 보고하는 바이다. FEH는 몇 달이나 몇 년 이내에 자발적으로 소멸하므로 일반적으로 치료는 불필요하다. 다만 진단적인 이유나 심미적인 이유로 보존적인 절제술을 시행하기도 한다. 이러한 치료 후 재발의 위험은 최소한이며, 악성 전이 가능성 역시 거의 없다.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.383-386
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• 1986

저자 등은 8년간 dilantin의 복용으로 상하악간에 전반적인 치은비대증을 나타낸 환자를 치은절제술과 치은성형술을 시행하고 계속적인 치석제거와 치은연하소파술을 시행하여 재발됨이 없이 심미적으로나 기능적으로 만족한 결과를 얻었기 이에 보고하는 바이다.

• 동의생리병리학회지
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• 제24권3호
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• pp.470-475
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• 2010

Calcium-channel blockers such as nifedipine could be associated with gingival overgrowth. The aim of this study was to examine the role of Paeonia lactiflora Pallas(PLP) on nifedipine-induced gingival hyperplasia along with submandibular secretory function in rats. Animals in divided groups received nifedipine (250 mg/kg) alone and in PLP(100, 200 mg/kg) in orally administration for 3 weeks. Pure submandibular saliva was collected intraorally by micropolyethylene cannula and the mandibular gingiva was examined by means of dissecting microscope for signs of redness, tickness, inflammation and exuda. Twenty-one days nifedipine treatment induced gingival hyperplasia accompanied with reduced salivary flow rate and concentrations total protein, epidermal growth factor(EGF) and calcium in comparison with normals. Co-treatment of animals with nifedifine and PLP protected from gingival hyperplasia and retained flow rate, and concentrations of total protein, EGF and calcium in normal levels.

• 대한소아치과학회지
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• 제25권3호
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• pp.499-505
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• 1998

Idiopathic gingival hyperplasia is a rare condition of undetermined etiology. The enlargement is usually associated with the emergence of the teeth into the oral cavity and may regress after extraction. The enlarged gingiva may be primarily attributed to hyperplasia of the subepithelial layer that is relatively avascular and consists of densely arranged collagen bundles and numerous fibroblasts. The recommended time for treatment is after completion of eruption of permanent teeth. But the most important thing is the patient's psychological and esthetic needs. Lately, Schluger has proposed modified gingivectomy procedure with horizontal, internal beveled incision for thinning of the flap resulting in less pain and bleeding after treatment, minimal opportunity of infection. The purpose of this report is to document a case of 8-year-old girl who had registered in Dept. of Pediatric Dentistry of Seoul National University dental hospital for treatment of her gingival hyperplasia and delayed tooth eruption

• 대한치과의사협회지
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• 제52권12호
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• pp.720-725
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• 2014

Generalized gingival enlargement, also known as gingival hyperplasia or hypertrophy, is defined as an abnormal diffuse overgrowth of gingival tissues. There are several causes of generalized gingival enlargement and they can be grouped into four categories: hereditary gingival fibromatosis, medication-induced, inflammatory, and systemic or neoplastic causes of gingival enlargement. This paper reviews the clinical features, differential diagnosis and significance of generalized gingival enlargements.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권4호
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• pp.346-349
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• 2005

Metastatic tumours to oral soft tissue are uncommon and accounts for approximately 1% of malignant oral neoplasms. Because of its rarity and clinical appearance of benign nature, the diagnosis of a metastatic lesion in the oral soft tissue may be challenging, both to clinicians and pathologists. We analyzed the clinical data of 9 patients who had metastatic carcinoma to oral soft tissues. The metastatic site to oral soft tissue was the gingiva in all cases. The most common primary site was lung (6 cases) followed by liver (2 cases) and breast (1 case). The clinical appearance resembled gingiva hyperplasia, pyogenic granuloma or gingival swelling. In one case, the metastatic gingiva lesion was found before detection of primary cancer. The mean survival time after diagnosis of metastatic lesion was 3 months. Although this metastatic lesion is rare, oral and maxillofacial surgeon should recognized that benign inflammatory lesion may be the metastatic malignant lesion or the first sign of undiagnosed underlying malignancy.

• 대한소아치과학회지
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• 제36권1호
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• pp.145-149
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• 2009

Sturge-Weber Syndrome은 드문 선천성 질환으로 안면의 삼차신경 분포영역에 포도주양 반점(port wine nevus)을 나타내고, 녹내장 등의 안구 증상과 간질, 편측마비 등의 신경학적 증상 등을 동반한다. 또한 구강 내 증상으로 구강 점막의 편측성 혈관 증식, 치은의 혈관 증식, 치은 비대, 거대치, 편측성 거대설, 상악 또는 하악의 혈관 이상, 치아 맹출 이상 등을 나타낸다. 본 증례는 Sturge-Weber Syndrome으로 진단된 8세 남아의 구강 내 증상과 설강직증의 치료를 위해 설소대 절제술을 시행하여 양호한 결과를 보여 이를 보고하고자 한다.