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第37巻 第2号 >

原因薬物変更後に全顎的に著明な歯肉腫脹を呈した薬物性歯肉増殖症の1例

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Title: 原因薬物変更後に全顎的に著明な歯肉腫脹を呈した薬物性歯肉増殖症の1例
Other Titles: A case of drug-induced gingival overgrowth exacerbated after changing causative drug
Authors: 谷脇, 裕人1 Browse this author
小林, 國彦2 Browse this author →KAKEN DB
黒嶋, 雄志3 Browse this author →KAKEN DB
北村, 哲也4 Browse this author →KAKEN DB
原田, 祥二5 Browse this author
山崎, 裕6 Browse this author →KAKEN DB
Authors(alt): Taniwaki, Hiroto1
Kobayashi, Kunihiko2
Kuroshima, Takeshi3
Kitamura, Tetsuya4
Harada, Shoji5
Yamazaki, Yutaka6
Keywords: gingival hyperplasia
calcium channel blockers
initial periodontal therapy
complete denture
薬物性歯肉増殖症
Ca拮抗薬
歯周基本治療
全部床義歯
Issue Date: Mar-2017
Publisher: 北海道歯学会
Journal Title: 北海道歯学雑誌
Volume: 37
Issue: 2
Start Page: 162
End Page: 167
Abstract: 薬物性歯肉増殖症に対して原因薬物を変更し,歯周基本治療を行っていたところ,全顎的に著明な歯肉腫脹が出現した症例の紹介を受け,摂食困難な状況から抜歯および義歯装着により良好な機能回復が得られたので,その概要を報告する.  患者は82歳,女性で十数年前より歯肉腫脹を自覚し,年に数回近医歯科で歯周基本治療を受けていた.3年前,近医内科にて降圧薬をCa拮抗薬(アムロジピン)からアンジオテンシンⅡ受容体拮抗薬(オルメサルタン)へ変更したが症状の改善は認められなかった.その約3年後,全顎的に著明な歯肉腫脹が出現し,摂食困難となったため当科を受診した.初診時の口腔内所見では,全顎の歯槽部頬舌側に結節状で分葉状の著明な歯肉腫脹が認められ,左側上下顎臼歯部ではほぼ歯冠全体を被覆していた.歯肉表面は平滑で弾性やや硬であった.現在歯の動揺度は2~3度で,歯周ポケットは前歯部を除き8mm以上であった.血液検査と病理検査で腫瘍性病変は否定されたため,全身麻酔下にて現在歯すべての抜歯と,全顎にわたる歯肉切除術と歯肉整形術を併せて施行した.術後1か月から上下顎全部床義歯作製を開始し,その1か月後に完成した.術後1年以上経過しているが経過良好である.
In this study we report on a case of drug-induced gingival overgrowth exacerbated after changing thecausative drug, which was successfully treated.  An 82-year-old woman was aware of gingival swelling ten years before and had been treated by periodontal initial therapy at a dental clinic several times a year. She changed from a calcium channel blocker (amlodipine) to an angiotensin II receptor blocker (olmesartan) by an internal medicine doctor three after, but there were no improvements of the symptoms. Three years later, she complained of an eating disorder caused by severe exacerbated gingival overgrowth and was referred to our department. During the first examination, marked nodular pedunculated gingival swelling of the whole alveolar region in both the labial and lingual sides of her lower and upper teeth was observed. Swollen gingiva had covered almost the entire crown of the left maxillary and mandibular molars. The gingival surface was smooth and its elasticity was relatively hard. Periodontal examination revealed that tooth mobility was within the 2-3 class and the probing depth was greater than 8 mm in all sites but the anterior teeth. As a malignant lesion was ruled out by a blood test and pathological examination, she underwent an operation to extract all of her teeth, gingivectomy, and gingivoplasty under general anesthesia. We began to fabricate maxillary and mandibular complete dentures one month after the operation. The dentures were fitted one month after the start of fabrication. There was no recurrence more than one year after operation.
Type: article
URI: http://hdl.handle.net/2115/65511
Appears in Collections:北海道歯学雑誌 = Hokkaido Journal of Dental Science > 第37巻 第2号

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