SİKLOSPORİN-A VE AMLODİPİN KULLANIMINA BAĞLI DİŞETİ BÜYÜMESİNİN ND:YAG LAZERLE TEDAVİSİ: OLGU SUNUMU

Öz

Organ transplantasyonlarında kullanılan temel bir immünosüpresan olan siklosporin-A (Cs-A) ve antihipertansif amlodipinin kullanımına bağlı oral komplikasyonlar gelişebilmektedir. Bu komplikasyon- ların en yaygın olanlarından biri dişeti büyümeleridir. Bu olgu, böbrek transplantasyonu nedeni ile uzun dönem Cs-A ve amplodipin kullanımı sonucu dişeti büyüme şikayeti gelişen bir hastanın tedavi öncesi ve sonrası klinik durumunu ortaya koymaktadır. Sunulan vakada aşırı büyüyen dişeti dokularında Nd: YAG lazerle yapılan cerrahi işlemi takiben dikkatli plak kontrolü ile dişeti dokusunda yeterli ölçüde iyileşme sağlanmıştır. Cerrahide Nd: YAG lazer kullanımı cerrahi sonrası gelişebilen kanama, ağrı gibi komplikasyonları azaltmıştır.

Anahtar Kelimeler

• Siklosporin-A, Amlodipin

TREATMENT OF CYCLOSPORIN A AND AMLODIPINE INDUCED GINGIVAL OVERGROWTH WITH ND:YAG LASER ( CASE REPORT)

Öz

Oral complications may develop due to use of immunosuppresantcyclosporine-A (Cs-A), which is basic drug in organ transplantation, and antihypertensive amlodipine. One of the most common of these complications is gingival overgrowth. This case demonstrates clinical status of a patient before and after the treatment, who has developing gingival overgrowth complaint after long-term use of amlodipine transplantation. In the presented case, sufficient improvement of gingival tissues was provided by careful plaque control following surgical procedures with Nd: YAG laser in excessive gingival overgrowth tissues. Rising complications after surgical operations such as bleeding and pain can decrease by use of Nd: YAG laser

Anahtar Kelimeler

• Cyclosporine-A,Amlodipine,Gingival Overgrowth,Nd-YAG Laser

Kaynakça

1. Lafzi A, Farahani RM, Shoja MA. Amlodipine- induced gingival hyperplasia. Med Oral Patol Oral Cir Bucal,2006, 11: E480-2.
2. Eggerath J, English H, Leichter JW. Drug- associated gingival enlargement: case report and review of aetiology, management and evidence- based outcomes of treatment. J N Z Soc Periodontol,2005: 7-14.
3. Kara c, Yağız H, Zihni M. Nifedipin tedavisine bağlı ortaya çıkan dişeti büyümesi (Olgu Sunumu). Atatürk Üni Diş Hek Fak Derg 2006;16(1):59-62.
4. Callaghan CJ, Bradley JA. Current status of renal transplantation. Methods Mol Biol,2006, 333: 1- 28.
5. Gourishankar S, Halloran PF. Late deterioration of organ transplants: a problem in injury and homeostasis. Curr Opin Immunol,2002, 14: 576- 83.
6. Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ, Stablein D. Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med,2000, 342: 605-12.
7. Lopez-Pintor RM, Hernandez G, de Arriba L, Morales JM, Jimenez C, de Andres A. Amlodipine and nifedipine used with cyclosporine induce different effects on gingival enlargement. Transplant Proc,2009, 41: 2351-3.
8. Seymour RA, Ellis JS, Thomason JM, Monkman S, Idle JR. Amlodipine-induced gingival overgrowth. J Clin Periodontol,1994, 21: 281-3.

9. Camargo PM CF, Takei HH. , Treatment of gingival enlargement. 11 ed.; St. Louis, Missouri, 2011; p 556-61.
10. Mattson JS, Blankenau R, Keene JJ. Use of an argon laser to treat drug-induced gingival overgrowth. The Journal of the American Dental Association,1998, 129: 78-83.
11. Loe H, Silness J. Periodontal Disease in Pregnancy. I. Prevalence and Severity. Acta Odontol Scand, 1963, 21: 533-51.
12. Silness J, Loe H. Periodontal Disease in Pregnancy. Ii. Correlation between Oral Hygiene and Periodontal Condtion. Acta Odontol Scand,1964, 22: 121-35.
13. Radwan-Oczko M, Boratynska M, Klinger M, Zietek M. Risk factors of gingival overgrowth in kidney transplant recipients treated with cyclosporine A. Ann Transplant,2003, 8: 57-62.
14. Hernandez G, Arriba L, Frias MC, de la Macorra JC, de Vicente JC, Jimenez C, de Andres A, Moreno E. Conversion from cyclosporin A to tacrolimus as a non-surgical alternative to reduce gingival enlargement: a preliminary case series. Periodontol,2003, 74: 1816-23. J
15. Ellis JS, Seymour RA, Steele JG, Robertson P, Butler TJ, Thomason JM. Prevalence of gingival overgrowth induced by calcium channel blockers: a community-based study. J Periodontol,1999, 70: 63-7.
16. Jorgensen MG. Prevalence of amlodipine-related gingival hyperplasia. J Periodontol,1997, 68: 676- 8.
17. Ellis JS, Seymour RA, Thomason JM, Monkman SC, Idle JR. Gingival sequestration of amlodipine and amlodipine-induced gingival overgrowth. Lancet, 1993, 341: 1102-3.
18. Lin YT, Yang FT. Gingival enlargement in children cyclosporine transplantation. J Periodontol,2010, 81: 1250-5.
19. Thomas DW, Newcombe RG, Osborne GR. Risk factors in the development of cyclosporine-induced gingival overgrowth. Transplantation,2000, 69: 522-6.
20. Nurmenniemi PK, Pernu HE, Laukkanen P, Knuuttila ML. Macrophage subpopulations in gingival overgrowth induced by nifedipine and immunosuppressive medication. J Periodontol, 2002, 73: 1323-30.
21. Lima RB, Benini V, Sens YA. Gingival overgrowth in renal transplant recipients: a study concerning prevalence, severity, periodontal, and predisposing factors. Transplant Proc,2008, 40: 1425-8.
22. Aimetti M, Romano F, Priotto P, Debernardi C. Non-surgical periodontal therapy of cyclosporin A gingival overgrowth in organ transplant patients. Clinical results at 12 months. Minerva Stomatol, 2005, 54: 311-9.
23. Darbar UR, Hopper C, Speight PM, Newman HN. Combined treatment approach to gingival overgrowth due to drug therapy. Periodontol,1996, 23: 941-4. J Clin
24. Kara C. Evaluation of patient perceptions of frenectomy: a comparison of Nd:YAG laser and conventional techniques. Photomed Laser Surg, 2008, 26: 147-52.
25. Pogrel MA, Yen CK, Hansen LS. A comparison of carbon dioxide laser, liquid nitrogen cryosurgery, and scalpel wounds in healing. Oral Surg Oral Med Oral Pathol,1990, 69: 269-73.
26. White JM, Goodis HE, Rose CL. Use of the pulsed Nd:YAG laser for intraoral soft tissue surgery. Lasers Surg Med,1991, 11: 455-61.