- 期刊
由病理組織學評估－牙齦炎性增生伴隨皮脂腺增生案例
Histopathological Evaluation of an Inflammatory Gingival Hyperplasia Case with Sebaceous Hyperplasia
摘要
臨床上造成牙齦肥大或增生的原因包括，藥物引起和特發性或遺傳性，少數為病因不明。這些表徵也會因局部牙菌斑刺激而加劇，造成更顯著的牙齦增大。本篇文章報告一個牙齦炎性增生的病例，並探討其致病的機轉。一位69歲的男性，來院的主訴為全口牙齦腫大、出血，造成咀嚼功能及美觀上的困擾。臨床檢查發現為全口嚴重牙周炎伴隨牙齦增生。病人沒有服用與牙齦增生相關的藥物或是有全身性的疾病。遺傳理學檢查並無異常，家族中也沒有相似的發現。治療方式包括，口腔衛教、基礎治療、拔除預後無望的牙齒和進行牙齦切除及骨修整。術後定期回診。病理結果為合併炎性及纖維性的牙齦增生。手術後一年觀察並無復發的跡象。這個牙齦炎性增生的案例，經過牙周治療及口腔衛生的教導，維持穩定的牙周健康，並恢復咀嚼功能及美觀。（臺灣牙周醫誌，20(3):245-259,2015）
並列摘要
＂Background＂: Clinically detectable overgrowth of the gingiva is caused by a variety of etiological factors and is exacerbated by local bacterial plaque accumulation. In addition to drug-induced and hereditary factors, an idiopathic origin is also one of the etiological factors, but is rarely found. This is a case report of a patient who suffered from inflammatory gingival hyperplasia and received periodontal managements. The underlying mechanisms and the related pathogenic factors are also discussed here. ＂Case Report＂: A 69-year-old male complained of full mouth gingival bleeding with recurrent gingival enlargement that was affecting his mastication and aesthetics. Severe chronic periodontitis with gingival overgrowth was found. Complete medical and dental records were obtained. It was found that no medication associated with gingival overgrowth had been taken by the patient and, overall, he was relatively healthy. There were also no specific findings with respect to any genetic disorder that has been related to gingival overgrowth. The treatment plan included oral hygiene instruction, mechanical debridement, the extraction of teeth that could not be saved and the surgical removal of hyperplastic fibrous tissue; these were carried out during a series of gingivectomy and osseous surgery treatments. In order to assess the outcome of the surgical treatments, the patient was followed up every month. The histopathological results confirmed the diagnosis of inflammatory fibrous hyperplasia of the gingiva. At the one year follow-up, the morphology and the appearance of the gingival surface was found to be normal. ＂Conclusions＂: This is a case of generalized inflammatory gingival hyperplasia and the gingival enlargement subsided without recurrence after periodontal management. The importance of supportive periodontal therapy in order to maintain gingival health is emphasized. (J Taiwan Periodtontol, 20(3):245-259, 2015)