RESUMO
Patients who undergo a renal transplant also require a pharmacological immunosuppressor therapy with cyclosporine (CsA) as well as anti-hypertensive calcium channel-blockers (CCBs); the former suppresses interferon and interleukin-2 production thus interfering with T cell cell-mediated activity, while the latter are used in order to counteract the nephrotoxicity of CsA which causes the local release, of thromboxane A2 with vascular vasoconstriction in the kidney. The use of both these drugs, particularly if used in association, leads to the onset of a clinical picture of variable entity, characterized mainly by a hypertrophy originating usually at the level of interdental papillae, and more pronounced in the anterior maxillary areas and the vestibular surfaces of the teeth, in a more or less symptomatic manner. The therapy is above all preventive, with an appropriate oral hygiene program, both professionally as well as at home, and with the use of substitutive drugs that do not present such side effects.
Assuntos
Bloqueadores dos Canais de Cálcio/efeitos adversos , Ciclosporina/efeitos adversos , Hipertrofia Gengival/induzido quimicamente , Doença Enxerto-Hospedeiro/prevenção & controle , Imunossupressores/efeitos adversos , Transplante de Rim , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Bloqueadores dos Canais de Cálcio/administração & dosagem , Bloqueadores dos Canais de Cálcio/farmacologia , Bloqueadores dos Canais de Cálcio/uso terapêutico , Ciclosporina/administração & dosagem , Ciclosporina/farmacologia , Ciclosporina/uso terapêutico , Interações Medicamentosas , Hipertrofia Gengival/prevenção & controle , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/farmacologia , Imunossupressores/uso terapêutico , Nefropatias/prevenção & controle , Higiene Bucal , Tromboxano A2/metabolismo , Vasoconstrição/efeitos dos fármacosRESUMO
AIM: Tha aim of this paper is to assess the effects in vivo of the Nd: Yag laser on gingival microflora in patients periodontally at risk. METHODS: An investigation has been carried out on 5 patients suffering from serious periodontal disease, with a sub-gingival check-up a week after the treatment. The selected patients presented either a relapse after the raising of a traditional flap, or showed acute phenomena and were, therefore, treated with a laser with the propedeutic intention of surgery; or they refused traditional surgical therapy or presented systematic pathologies that could not be included in the appropriate protocol. Pockets were chosen that had a probe depth of between 5-8 mm, an optic fibre probe was pushed as far as possible into the probe depth, for about 1 minute per site, 5 times, at 30 second intervals. The samples, taken in order to calculate bacteria colonies, were carried out before using the laser, immediately after and, again, 1 week later. RESULTS: All the sites showed a slight reduction in the quantity of colonies forming immediately after the Nd:Yag laser application, while a week later, only if clinical inflammation appeared to be resolved, the bacteria forming colonies seemed to be reduced. CONCLUSION: From this study it can be concluded that the use of the Nd:Yad laser represents, in mild and average periodontitis, a therapeutic aid to scaling and root planing and, in the same way, in serious periodontitis for traditional surgical therapy.
Assuntos
Terapia a Laser , Bolsa Periodontal/microbiologia , Bolsa Periodontal/radioterapia , HumanosRESUMO
Human viruses play a fundamental role in the pathogenesis of periodontal disease due to their intrinsec capacity to interfere with immune system of the host. Herpesvirus maybe involved in the onset or progress of a number of periodontal diseases while HIV seems to be related to the linear gingival erythema (LGE) and necrotizing ulcerative periodontitis (NUP).