非牙周病性龈病损
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摘要
牙龈是众多全身系统性疾病的首发及好发部位,多数患者因牙周病损就诊,却忽略了全身系统性疾病的诊断和治疗。作为牙周病学专科医生应有全局观念,针对患者出现的牙周病损,既要做到对症治疗,也要做到对因治疗,纠正引起牙周病损的全身系统性因素,使牙周病损得以彻底解决。本文将全身系统性疾病所伴发的非牙周病性龈病损,按照常见的"增生、出血、溃疡/糜烂"三大临床表征作一综述。
Gingiva is the first predilection site in many systemic diseases. A large number of patients whose chief complaint was periodontal lesions visit periodontists initially, thereby neglecting the diagnosis and treatment of systemic diseases. Periodontists must have comprehensive views for patients with periodontal lesions. It is necessary to achieve both symptomatic and etiological treatments to correct the periodontal lesions caused by systemic factors. Some systemic diseases associated with non-periodontal gingival lesions are reviewed in accordance with the common three clinical features "hyperplasia, bleeding, and ulceration/erosion".
Gingiva is the first predilection site in many systemic diseases. A large number of patients whose chief complaint was periodontal lesions visit periodontists initially, thereby neglecting the diagnosis and treatment of systemic diseases. Periodontists must have comprehensive views for patients with periodontal lesions. It is necessary to achieve both symptomatic and etiological treatments to correct the periodontal lesions caused by systemic factors. Some systemic diseases associated with non-periodontal gingival lesions are reviewed in accordance with the common three clinical features "hyperplasia, bleeding, and ulceration/erosion".
引文
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[3]Jin SH,Park G,Ko Y,et al.Myeloid sarcoma of the gingiva with myelodysplastic syndrome:a case report[J].Medicine(Baltimore),2016,95(24):e3897.
[4]Neiman RS,Barcos M,Berard C,et al.Granulocytic sarcoma:a clinicopathologic study of 61 biopsied cases[J].Cancer,1981,48(6):1426-1437.
[5]Antic D,Elezovic I,Milic N,et al.Is there a“gold”standard treatment for patients with isolated myeloid sarcoma[J].Biomed Pharmacother,2013,67(1):72-77.
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[34]Stasi R,Evangelista ML,Stipa E,et al.Idiopathic thrombocytopenic purpura:current concepts in pathophysiology and management[J].Thromb Haemost,2008,99(1):4-13.
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[36]侯明,彭军.应重视成人特发性血小板减少性紫癜诊治中的问题[J].中华血液学杂志,2007,28(3):145-146.Hou M,Peng J.Attention should be paid to the diagnosis and treatment of idiopathic thrombocytopenic purpura in adults[J].Chin J Hematol,2007,28(3):145-146.
[37]Li R,Byers K,Walvekar RR.Gingival hypertrophy:a solitary manifestation of scurvy[J].Am J Otolaryngol,2008,29(6):426-428.
[38]Bendick C,Mey S.Haematomas and gingival bleeding[J].Lancet,2012,379(9834):2400.
[39]Omori K,Hanayama Y,Naruishi K,et al.Gingival overgrowth caused by vitamin C deficiency associated with metabolic syndrome and severe periodontal infection:a case report[J].Clin Case Rep,2014,2(6):286-295.
[40]Fain O.Musculoskeletal manifestations of scurvy[J].Joint Bone Spine,2005,72(2):124-128.
[41]陈少如.以牙龈出血为首发症状的鼠药中毒1例[J].实用口腔医学杂志,2015,31(1):76.Chen SR.Gingival bleeding as the first symptom of raticide:a case report[J].J Pract Stomatol,2015,31(1):76.
[42]Manche?o Franch A,GavaldáEsteve C,Sarrión Pérez MG.Oral manifestations and dental management of patient with leukocyte alterations[J].J Clin Exp Dent,2011,3(1):53-59.
[43]Diz-Dios P,Ocampo-Hermida A,Fernandez-Feijoo J.Quantitative and functional neutrophil deficiencies[J].Med Oral,2002,7(3):206-221.
[44]刘永红,刘振丽,张志勇.重型先天性中性粒细胞缺乏症伴牙周损害一例[J].中华口腔医学杂志,2017,52(6):379-380.Liu YH,Liu ZL,Zhang ZY.Severe congenital neutropenia with periodontal disease:a case report[J].Chin J Stomatol,2017,52(6):379-380.
[45]Becker ST,Wiltfang J,Springer IN,et al.Lifethreatening bite injury of the lower lip after use of metamizole[J].Oral Maxillofac Surg,2008,12(1):39-41.
[46]石晶,鲍结煊,郝梅.粒细胞缺乏症首发口腔黏膜症状1例报道及分析[J].口腔医学,2014,34(6):461-463.Shi J,Bao JX,Hao M.Symptoms of oral mucous membrane:the first symptoms of agranulocytosis[J].Stomatology,2014,34(6):461-463.
[47]江红,臧国庆.肺外结核[J].中华全科医学,2012,10(1):103-104.Jiang H,Zang GQ.Extrapulmonary tuberculosis[J].Chin J General Pract,2012,10(1):103-104.
[48]Jain P,Jain I.Oral manifestations of tuberculosis:step towards early diagnosis[J].J Clin Diagn Res,2014,8(12):ZE18-ZE21.
[49]王恒琨,巩艳玲,刘同军,等.口腔颌面部结核132例临床分析[J].中国基层医药,2011,18(3):333-334.Wang HK,Gong YL,Liu TJ,et al.Clinical characteristics of tuberculosis in oral and maxillofacial region[J].Chin J Prim Med Pharm,2011,18(3):333-334.
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[2]Agrawal AA.Gingival enlargements:differential diagnosis and review of literature[J].World J Clin Cases,2015,3(9):779-788.
[3]Jin SH,Park G,Ko Y,et al.Myeloid sarcoma of the gingiva with myelodysplastic syndrome:a case report[J].Medicine(Baltimore),2016,95(24):e3897.
[4]Neiman RS,Barcos M,Berard C,et al.Granulocytic sarcoma:a clinicopathologic study of 61 biopsied cases[J].Cancer,1981,48(6):1426-1437.
[5]Antic D,Elezovic I,Milic N,et al.Is there a“gold”standard treatment for patients with isolated myeloid sarcoma[J].Biomed Pharmacother,2013,67(1):72-77.
[6]Dineshkumar T,Suresh V,Ramya R,et al.Primary intraoral granulocytic sarcoma:a rare case presenting as generalized gingival enlargement[J].J Oral Maxillofac Pathol,2016,20(3):523-526.
[7]乌玉红,吕威,王瑞梅.牙龈髓细胞肉瘤1例[J].华西口腔医学杂志,2015,33(1):107-108.Wu YH,LüW,Wang RM.Myeloid sarcoma occurring in the gingiva:a case report[J].West Chin JStomatol,2015,33(1):107-108.
[8]Antmen B,Haytac MC,Sasmaz I,et al.Granulocytic sarcoma of gingiva:an unusual case with aleukemic presentation[J].J Periodontol,2003,74(10):1514-1519.
[9]Byrd JC,Edenfield WJ,Shields DJ,et al.Extramedullary myeloid cell tumors in acute nonlymphocytic leukemia:a clinical review[J].J Clin Oncol,1995,13(7):1800-1816.
[10]Richards A,Costelloe MA,Eveson JW,et al.Oral mucosal non-Hodgkin’s lymphoma-a dangerous mimic[J].Oral Oncol,2000,36(6):556-558.
[11]Wilson TG,Wright JM.Non-Hodgkin’s lymphoma of the gingiva:review of the literature.Report of a case[J].J Periodontol,1986,57(3):155-158.
[12]Beral V,Peterman T,Berkelman R,et al.AIDS-associated non-Hodgkin lymphoma[J].Lancet,1991,337(8745):805-809.
[13]Manjunatha BS,Gowramma R,Nagarajappa D,et al.Extranodal non-Hodgkin’s lymphoma presenting as gingival mass[J].J Indian Soc Periodontol,2011,15(4):418-420.
[14]Patankar S,Venkatraman P,Sridharan G,et al.Burkitt’s lymphoma of maxillary gingiva:a case report[J].World J Clin Cases,2015,3(12):1011-1016.
[15]Basavaraj KF,Ramalingam K,Sarkar A,et al.Primary non-Hodgkin’s lymphoma of gingiva in a28-year-old HIV-positive patient[J].J Nat Sci Biol Med,2012,3(2):189-191.
[16]Corti M,MinuéG,Campitelli A,et al.An aggressive plasmablastic lymphoma of the oral cavity as primary manifestation of acquired immunodeficiency syndrome:case report and literature review[J].Int Arch Otorhinolaryngol,2015,19(4):354-358.
[17]陈谦明.口腔黏膜病学[M].4版.北京:人民卫生出版社,2015:132-140,185-191.Chen QM.Oral mucous diseases[M].4th ed.Beijing:People’s Medical Publishing House,2015:132-140,185-191.
[18]Padmavathi B,Sharma S,Astekar M,et al.Oral Crohn’s disease[J].J Oral Maxillofac Pathol,2014,18(Suppl 1):S139-S142.
[19]Joshi C,Shukla P.Plasma cell gingivitis[J].J Indian Soc Periodontol,2015,19(2):221-223.
[20]Liu X,Cui Y,Li Y,et al.Using inpatient data to estimate the prevalence of Wegener’s granulomatosis in China[J].Intractable Rare Dis Res,2016,5(1):31-35.
[21]Stewart C,Cohen D,Bhattacharyya I,et al.Oral manifestations of Wegener’s granulomatosis:a report of three cases and a literature review[J].J Am Dent Assoc,2007,138(3):338-348.
[22]Aravena V,Beltrán V,Cantín M,et al.Gingival hyperplasia being the first sign of Wegener’s granulomatosis[J].Int J Clin Exp Med,2014,7(8):2373-2376.
[23]曾小峰.重视韦格纳肉芽肿病的诊断与治疗[J].中华风湿病学杂志,2003,7(10):587-589.Zeng XF.Attaching importacnce to the diagnosis and treatment of Wegener’s granulomatosis[J].Chin JRheumatol,2003,7(10):587-589.
[24]蔡晓燕,董光富,张晓,等.韦格纳肉芽肿13例临床分析[J].广东医学,2010,31(6):756-758.Cai XY,Dong GF,Zhang X,et al.Clinical analysis of 13 cases of Wegener’s granulomatosis[J].Guangdong Med J,2010,31(6):756-758.
[25]王宁,冯雅靖,王宝华,等.1990年与2013年中国人群白血病疾病负担分析[J].中华流行病学杂志,2016,37(6):783-787.Wang N,Feng YJ,Wang BH,et al.Disease burden of leukemia in the Chinese population,in 1990 and2013[J].Chin J Epidemiol,2016,37(6):783-787.
[26]葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:12-13,578-589.Ge JB,Xu YJ.Internal medicine[M].8th ed.Beijing:People’s Medical Publishing House,2013:12-13,578-589.
[27]付朝泓,李艳,童永清,等.初发白血病患者血常规和临床症状的关系分析[J].医学综述,2015,21(18):3405-3407.Fu CH,Li Y,Tong YQ,et al.Correlation analysis between blood routine examination results and clinical symptoms in the incipient leukemia patients[J].Med Recapitul,2015,21(18):3405-3407.
[28]Lynch MA,Ship II.Oral manifestations of leukemia:a postdiagnostic study[J].J Am Dent Assoc,1967,75(5):1139-1144.
[29]Demirer S,Ozdemir H,Sencan M,et al.Gingival hyperplasia as an early diagnostic oral manifestation in acute monocytic leukemia:a case report[J].Eur JDent,2007,1(2):111-114.
[30]Cooper CL,Loewen R,Shore T.Gingival hyperplasia complicating acute myelomonocytic leukemia[J].JCan Dent Assoc,2000,66(2):78-79.
[31]Terrell DR,Beebe LA,Vesely SK,et al.The incidence of immune thrombocytopenic purpura in children and adults:a critical review of published reports[J].Am J Hematol,2010,85(3):174-180.
[32]Bennett D,Hodgson ME,Shukla A,et al.Prevalence of diagnosed adult immune thrombocytopenia in the United Kingdom[J].Adv Ther,2011,28(12):1096-1104.
[33]Kayal L,Jayachandran S,Singh K.Idiopathic thrombocytopenic purpura[J].Contemp Clin Dent,2014,5(3):410-414.
[34]Stasi R,Evangelista ML,Stipa E,et al.Idiopathic thrombocytopenic purpura:current concepts in pathophysiology and management[J].Thromb Haemost,2008,99(1):4-13.
[35]Bal MV,Koyuncuoglu CZ,Saygun I.Immune thrombocytopenic purpura presenting as unprovoked gingival hemorrhage:a case report[J].Open Dent J,2014,8:164-167.
[36]侯明,彭军.应重视成人特发性血小板减少性紫癜诊治中的问题[J].中华血液学杂志,2007,28(3):145-146.Hou M,Peng J.Attention should be paid to the diagnosis and treatment of idiopathic thrombocytopenic purpura in adults[J].Chin J Hematol,2007,28(3):145-146.
[37]Li R,Byers K,Walvekar RR.Gingival hypertrophy:a solitary manifestation of scurvy[J].Am J Otolaryngol,2008,29(6):426-428.
[38]Bendick C,Mey S.Haematomas and gingival bleeding[J].Lancet,2012,379(9834):2400.
[39]Omori K,Hanayama Y,Naruishi K,et al.Gingival overgrowth caused by vitamin C deficiency associated with metabolic syndrome and severe periodontal infection:a case report[J].Clin Case Rep,2014,2(6):286-295.
[40]Fain O.Musculoskeletal manifestations of scurvy[J].Joint Bone Spine,2005,72(2):124-128.
[41]陈少如.以牙龈出血为首发症状的鼠药中毒1例[J].实用口腔医学杂志,2015,31(1):76.Chen SR.Gingival bleeding as the first symptom of raticide:a case report[J].J Pract Stomatol,2015,31(1):76.
[42]Manche?o Franch A,GavaldáEsteve C,Sarrión Pérez MG.Oral manifestations and dental management of patient with leukocyte alterations[J].J Clin Exp Dent,2011,3(1):53-59.
[43]Diz-Dios P,Ocampo-Hermida A,Fernandez-Feijoo J.Quantitative and functional neutrophil deficiencies[J].Med Oral,2002,7(3):206-221.
[44]刘永红,刘振丽,张志勇.重型先天性中性粒细胞缺乏症伴牙周损害一例[J].中华口腔医学杂志,2017,52(6):379-380.Liu YH,Liu ZL,Zhang ZY.Severe congenital neutropenia with periodontal disease:a case report[J].Chin J Stomatol,2017,52(6):379-380.
[45]Becker ST,Wiltfang J,Springer IN,et al.Lifethreatening bite injury of the lower lip after use of metamizole[J].Oral Maxillofac Surg,2008,12(1):39-41.
[46]石晶,鲍结煊,郝梅.粒细胞缺乏症首发口腔黏膜症状1例报道及分析[J].口腔医学,2014,34(6):461-463.Shi J,Bao JX,Hao M.Symptoms of oral mucous membrane:the first symptoms of agranulocytosis[J].Stomatology,2014,34(6):461-463.
[47]江红,臧国庆.肺外结核[J].中华全科医学,2012,10(1):103-104.Jiang H,Zang GQ.Extrapulmonary tuberculosis[J].Chin J General Pract,2012,10(1):103-104.
[48]Jain P,Jain I.Oral manifestations of tuberculosis:step towards early diagnosis[J].J Clin Diagn Res,2014,8(12):ZE18-ZE21.
[49]王恒琨,巩艳玲,刘同军,等.口腔颌面部结核132例临床分析[J].中国基层医药,2011,18(3):333-334.Wang HK,Gong YL,Liu TJ,et al.Clinical characteristics of tuberculosis in oral and maxillofacial region[J].Chin J Prim Med Pharm,2011,18(3):333-334.
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