[Systemic antibiotic therapy in chronic periodontitis in adults. II. Rational use of minocycline].
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Biomedical subjects
Publications and source records attributed to E Vaia.
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Dental decay and periodontal disease are pathologies which are closely related to environmental factors. The study analyses the various etiopathological elements which influence the onset of these diseases and the different methods of prophylaxis which reduce their incidence.
After a description of advantages and disadvantages of traditional surgical techniques for the correction of gingival retractions, a new surgical techniques is indicated: the subepithelial connective tissue graft. The latter technique is assessed and described in detail and its relative efficacy in comparison with the traditional techniques is emphasized.
Gingival overgrowth is defined as hyperplasia of gingival tissue due to local, systemic or drug-related causes. To see if the incidence and severity of this side-effect are related to cyclosporine A (CyA) dosage and/or blood levels BCyA), we analysed data from 24 renal transplanted outpatients, grouped as follows: controls (C, n = 3): patients on immunosuppressive therapy other than CyA; group 1 (G1, n = 10): patients with BCyA steadily 300 ng/mL (RIA); group 2 (G2, n = 11): patients with BCyA steadily between 301 and 650 ng/mL. BCyA averaged 290 +/- 21 in G1 and 481 +/- 100 in G2 (p less than 0.001): mean cyclosporine A dosage (mg/kg/die) was not significantly different: 4.1 +/- 1.4 in G1 and 4.97 +/- 2.4 in G2. However, six patients in G2 also received calcium antagonists known to increase CyA blood levels (diltiazem and nicardipine) for clinical purposes or deliberately to increase CyA bioavailability. Mean time from transplant was (in months) 19 +/- 11 in G1, 16 +/- 15 in G2 and 62 +/- 24 in C (G1 vs G2: NS; C vs G1 and 2: p less than 0.001). Mean GFR (mL/min) was 75 +/- 22 in C, 65 +/- 18 in G1 and 53 +/- 19 in G2 (NS). Dental hygiene, as assessed by scoring (0-3: absent, mild, moderate and severe) the bacterial plaque, was similar in all groups. Gingival overgrowth, was similarly scored (0-3) and was absent in C and in 20% of G1, mild in 40% of G1 and 33% of G2, moderate in 40% of G1 and 33% of G2 and severe in 0% of G1 and 33% of G2 (G1 vs G2: p less than 0.05). Our data suggest that the severity of gingival overgrowth in transplanted patients with similar oral hygiene is mainly related to CyA blood levels.