RESUMO
A variety of systemic drugs can lead to adverse effects in the oral environment. This article reports the case of a 61-year-old man who had a severe drug-induced gingival overgrowth (DIGO) caused by nifedipine. DIGO is relevant due to severe gingival enlargement, which causes disfigurement and blocks physiological and social functions such as mastication and speaking. Management of DIGO is always a challenge due to the patient's systemic condition. This article shows, step-by-step, how the treatment was executed and how the DIGO was reversed.
Assuntos
Anti-Hipertensivos/efeitos adversos , Crescimento Excessivo da Gengiva/induzido quimicamente , Nifedipino/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Captopril/uso terapêutico , Cálculos Dentários/complicações , Placa Dentária/complicações , Profilaxia Dentária , Hemorragia Gengival/induzido quimicamente , Hemorragia Gengival/terapia , Crescimento Excessivo da Gengiva/cirurgia , Crescimento Excessivo da Gengiva/terapia , Gengivectomia/métodos , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-IdadeRESUMO
Drug-induced gingival overgrowth (DIGO) is a significant problem for periodontologists and this side effect is frequently associated with three particular drugs: phenytoin, cyclosporin A and nifedipine. A case report of gingival overgrowth induced by nifedipine in an elderly patient treated with non-surgical periodontal therapy is described. A 75-year-old male with generalised gingival overgrowth reported the problem of oral malodour and significant gingival bleeding. The medical history revealed a controlled hypertensive state and Cerebral Vascular Accident (CVA) 3 years prior to consultation. The diagnosis was gingival overgrowth associated with nifedipine, no other risk factors being identified. The patient had been taking nifedipine for 18 months, but after the consultation with the patient's doctor, nifedipine was suspended, as the hypertension was controlled. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation and prophylaxis. Six months after the first intervention, clinical parameters revealed a significant improvement with a considerable reduction in gingival overgrowth, demonstrating the effect of non-surgical periodontal therapy in severe cases of gingival overgrowth. Non-surgical treatment of DIGO is a far less invasive technique than surgical approaches and has demonstrated an impressively positive treatment response. It should therefore be considered as a first treatment option for DIGO.
Assuntos
Crescimento Excessivo da Gengiva/terapia , Nifedipino/efeitos adversos , Vasodilatadores/efeitos adversos , Idoso , Profilaxia Dentária , Raspagem Dentária , Seguimentos , Hemorragia Gengival/induzido quimicamente , Hemorragia Gengival/terapia , Crescimento Excessivo da Gengiva/induzido quimicamente , Halitose/induzido quimicamente , Halitose/terapia , Humanos , Hipertensão/tratamento farmacológico , Masculino , Higiene Bucal , Aplainamento RadicularRESUMO
OBJECTIVE: To use the criteria set by the American Dental Association to evaluate the effectiveness of nightguard vital bleaching with 10% carbamide peroxide through a controlled randomized clinical trial. MATERIALS AND METHODS: Fifty volunteers allocated to either an experimental group(Opalescence PF 10%; OPA) or a control group (placebo; PLA) used a gel for 21 days. Observations of tooth colour were recorded at baseline, immediately after 3 weeks of use(day 21), and 30 days (day 30) and 6 months (day 180) after the treatment was finished. Colour was evaluated with the Vitapan classical shade guide and from the volunteers' degree of satisfaction. Tooth sensitivity and gingival bleeding were also assessed. RESULTS: The median increase in the lightness of the teeth in the OPA group was 3 units,based on the value-ordered Vitapan shade guide. This improvement in lightness was maintained for 6 months in 88% of this group. In the PLA group, 8% had a 2-unit reduction in tooth colour at day 21. Tooth sensitivity occurred in the OPA (36%) and PLA (8%)groups. Gingival bleeding was not associated with gel use. Volunteers' satisfaction was 92% for the OPA and 8% for the PLA group. CONCLUSIONS: With the protocol used, nightguard vital bleaching was an effective technique that had minimal and transient side effects that disappeared after treatment without causing sequelae or complications.
Assuntos
Oxidantes/administração & dosagem , Peróxidos/administração & dosagem , Clareamento Dental , Descoloração de Dente/tratamento farmacológico , Ureia/análogos & derivados , Adolescente , Adulto , Peróxido de Carbamida , Cor/normas , Dispositivos para o Cuidado Bucal Domiciliar , Sensibilidade da Dentina/induzido quimicamente , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Seguimentos , Hemorragia Gengival/induzido quimicamente , Humanos , Masculino , Oxidantes/efeitos adversos , Satisfação do Paciente , Peróxidos/efeitos adversos , Estatísticas não Paramétricas , Clareamento Dental/métodos , Ureia/administração & dosagem , Ureia/efeitos adversosRESUMO
UNLABELLED: The adverse effects of chemotherapy frequently involve the oral cavity, but the severity of oral complications caused by different chemotherapy protocols is unknown. OBJECTIVE: To compare the frequency of oral complications in patients with acute lymphoblastic leukemia treated with the GBTLI-93 and BFM protocols. PATIENTS AND METHODS: Twenty patients ranging in age from 2 to 13 years were submitted to visual and tactile examination of the teeth, periodontium and soft tissues on the day of admission and over the 3 weeks following the first phase of chemotherapy. RESULTS: No significant difference in the proportion of patients with complications was observed between the two protocols over the 3 weeks. Complications were more frequent immediately after administration of the chemotherapeutic agents, with a gradual decline over the following 3 weeks. CONCLUSIONS: Oral complications occur in patients with acute lymphoblastic leukemia irrespective of the chemotherapy protocol used for treatment, with a higher frequency being observed in the first week after the beginning of antineoplastic therapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Candidíase/induzido quimicamente , Hemorragia Gengival/induzido quimicamente , Mucosa Bucal/efeitos dos fármacos , Úlceras Orais/induzido quimicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Xerostomia/induzido quimicamente , Adolescente , Candidíase/epidemiologia , Criança , Pré-Escolar , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Masculino , Úlceras Orais/epidemiologia , Xerostomia/epidemiologiaRESUMO
The purpose of the present work was to observe local hemostatic function during dental surgery in patients under oral anticoagulant therapy with an INR between 1.7 and 2.5. Thirty seven dental treatments were performed in 15 patients. Group A: nineteen dental treatments (13 scalings, 1 root canal therapy and 5 dental extractions), treated with oral rinse with tranexamic acid (250 mg dissolved in 10 ml of water). Group B: eighteen dental procedures (13 scaling, 1 root canal therapy and 14 dental extractions), in which oral rinse was utilized. Antibiotics were indicated for those patients with root canal therapy or with signs of infection. A cool soft diet was recommended to all patients during the three days following the surgical procedure. Only in five (13.5%) dental extractions (1 from group A and 4 from B) bleeding prolonged was observed, however periodontal disease was also present in those patients hone of them required blood products or withdrawal of the anticoagulant. The results suggest that mouth washing with tranexamic acid prevents excessive oral bleeding in patients treated with oral anticoagulants with an INR between 1.7 and 2.5.