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Laura Vanessa Cañas Díaz

María Isabel Pardo Silva

Silie Soad Arboleda Salaimán

Abstract

RESUMEN. Antecedentes: el agrandamiento gingival inducido por medicamentos es una condición clínica frecuente en pacientes que ingieren anticonvulsivantes, inmunosupresores y bloqueadores de los canales de calcio. La prevalencia de agrandamiento gingival inducido por medicamentos es de 3 - 20 % en comparación con otras condiciones gingivales inflamatorias. Todos estos medicamentos producen lesiones clínicas y características histológicas indistinguibles unas de otras, que llegan a comprometer la función y la estética de los pacientes afectados. Propósito: Describir el manejo terapéutico integral y el seguimiento a 12 meses de una paciente con agrandamiento gingival inducido por tacrolimus y amlodipino. Descripción del caso: Paciente de 22 años con discapacidad mental limítrofe, receptora de trasplante renal fue remitida al servicio de Odontología del Hospital Infantil Universitario de San José (Bogotá, Colombia) por presentar agrandamiento gingival. El examen clínico mostró un índice de placa de O’Leary del 84,3 %, inflamación generalizada y bolsas gingivales de 4 a 6 mm. El protocolo de tratamiento periodontal fue revisado por el equipo de trasplante renal e incluyó: trabajo con la familia para red de apoyo, diseño de un programa personalizado de higiene oral, gingivectomía y mantenimientos periodontales periódicos. Esta estrategia terapéutica permitió reducir el índice de placa y lograr un resultado clínico favorable. Conclusión: La condición sistémica y psicológica de la paciente determinó desarrollar un plan de tratamiento ajustado a sus necesidades. Pacientes susceptibles deben ser instruidos sobre la importancia de tener unas prácticas adecuadas de higiene oral y ameritan ser incluidos en un programa de mantenimiento periodontal.ABSTRACT. Background: drug-influenced gingival enlargement, is a frequent clinical condition in patients who ingest anticonvulsant, immunosuppressant and calcium channel blockers. The prevalence of gingival overgrowth due to prescribed medications ranges from 3% to 20% in comparison to other gingival inflammatory conditions. These drugs produce clinical lesions and histological characteristics that are indistinguishable from one another, which compromise the function and aesthetics of the affected patients. Purpose: To describe the total therapeutic management and the clinical follow up at 12-months from a patient with gingival enlargement induced by tacrolimus and amlodipine. Case description: A 22-year-old patient with borderline mental disability who received a kidney transplant was referred to San Jose Hospital - Medical Dental Unit (Bogotá, Colombia) presenting gingival enlargement. The clinical examination revealed an O'Leary plaque index of 84.3%, generalized inflammation, and gingival pockets of 4 to 6 mm. The periodontal treatment protocol was reviewed by the transplant team and included: family engagement to create a network for support, design of a personalized program for oral hygiene, gingivectomy and periodic periodontal maintenance. This therapeutic strategy allowed to reduce the plaque index and achieve favorable clinical result.  Conclusion: The systemic and psychological condition of the patient established the development of a treatment plan adjusted to her needs. Susceptible patients need to be instructed about the importance of adequate oral hygiene practices and should be included in a maintenance periodontal program.

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References
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How to Cite
Cañas Díaz, L., Pardo Silva, M., & Arboleda Salaimán, S. (2018). Agrandamiento gingival inducido por medicamentos. Reporte de un caso clínico / Drug-Induced Gingival Overgrowth. A Clinical Case Report. Universitas Odontologica, 36(77). https://doi.org/10.11144/Javeriana.uo36-77.agim
Section
Clinical Practice
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