Systemic Observation-Surgical Periodontic Approach In The Management Of Amlodipine Induced Gingival Enlargement

C. Prahasanti, Michael Ganda Wijaya, Rahmidian Safitri, Hardini Dyah Astuti, Poernomo Agoes
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Abstract

Background: Drug induced gingival enlargement is frequently observed in patients taking three main group of drugs like calcium channel blockers (CCBs), immunosuppressant’s and anticonvulsants. Amlodipine belongs to the dihydropyridine-a third generation calcium channel blockers agents that may cause the side effect of drug-induced gingival enlargement and oral bacteria intervention due to calculus retention. This case report describes the management of gingival enlargement in a hypertensive patient taking amlodipine. Purpose: This case report was aimed to discuss the treatment and maintenance of systemic observationsurgical periodontic approach to restore gingival enlargement. Case Report: A 47-years old man was referred to the Department of Periodontology, Faculty of Dentistry, Airlangga University complaining of swellings and bleeding on his gingiva in all region. He felt very uncomfortable as the swelling interfered while chewing and sometimes there was bleeding spontaneously and halitosis. He had hypertension since 5 years and was on medications Captopril 12,5 mg daily during 4 years and Amlodipine 5mg daily during last 1 year. A provisional diagnosis and systemic observation-periodontal phases treatment were taken to restore gingival enlargement condition. Case Management: Systemic observation of medication use, periodontal phases treatment such as scaling root planning, periodontal surgery as flap surgery, home oral hygiene maintenance, control recall every month during first 3 months were taken. Conclusion: The successful of combination carefully systemic observation-surgery periodontal approach are promising to maintain Amlodipine induced gingival enlargement.
系统观察-牙周手术方法治疗氨氯地平诱发的牙龈增生
背景:服用钙通道阻滞剂(CCBs)、免疫抑制剂和抗惊厥药等三大类药物的患者经常会出现药物性牙龈增生。氨氯地平属于二氢吡啶类第三代钙通道阻滞剂,可能会导致药物引起的牙龈增生和牙结石滞留导致的口腔细菌干预等副作用。本病例报告描述了一名服用氨氯地平的高血压患者牙龈增生的处理方法。目的:本病例报告旨在讨论系统观察牙周治疗方法恢复牙龈增生的治疗和维护。病例报告:一名 47 岁的男子被转诊到 Airlangga 大学牙科学院牙周病学系,主诉其所有区域的牙龈肿胀和出血。他感到非常不舒服,因为肿胀影响了咀嚼,有时还会自发出血和口臭。他患有高血压 5 年,4 年来每天服用卡托普利 12.5 毫克,最近 1 年每天服用氨氯地平 5 毫克。为了恢复牙龈增生的状况,他接受了临时诊断和系统观察-牙周阶段治疗。病例管理:对用药情况进行系统观察,进行牙周阶段治疗,如洗牙、根管计划、牙周手术(如翻瓣手术)、家庭口腔卫生维护,并在前 3 个月每月进行对照回顾。结论系统观察与牙周手术相结合的方法有望成功维持氨氯地平诱发的牙龈增生。
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