口腔疾病防治 ›› 2022, Vol. 30 ›› Issue (6): 438-442.DOI: 10.12016/j.issn.2096-1456.2022.06.009

• 综述 • 上一篇    下一篇

牙龈色素沉着诊疗研究进展

宋思行(), 赵蕾, 肖诗梦()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院牙周病科,四川 成都(610041)
  • 收稿日期:2021-07-09 修回日期:2022-02-09 出版日期:2022-06-20 发布日期:2022-04-15
  • 通讯作者: 肖诗梦
  • 作者简介:宋思行,住院医师,学士,Email: sxsongsx@163.com
  • 基金资助:
    国家自然科学基金项目(81970944)

Research progress on diagnosis and treatment of gingival pigmentation

SONG Sixing(), ZHAO Lei, XIAO Shimeng()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Periodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2021-07-09 Revised:2022-02-09 Online:2022-06-20 Published:2022-04-15
  • Contact: XIAO Shimeng
  • Supported by:
    grants from National Natural Science Foundation of China(81970944)

摘要:

牙龈色素沉着(gingival pigmentation,GP)表现为牙龈出现黑色或棕褐色等深色色素沉着斑,多由黑色素细胞分泌的黑色素颗粒沉积于牙龈上皮引起,其影响因素分为外源性和内源性两大类,外源性因素包括重金属、纹身、吸烟或药物的使用,而内源性因素则与某些疾病有关。对GP进行临床分级有助于对治疗的必要性及预后进行合理评估,Dummett-Gupta口腔色素沉着指数是目前常用的分级方式,而将病因与临床表现结合起来形成的新的评级方式则可更为全面地描述患者情况。临床中需详细询问病史、完善检查以鉴别生理性GP与病理状态所致的GP。激光治疗是目前治疗效果较好、患者接受度较高且较为舒适便捷的治疗方式,包括半导体激光、Er:YAG激光、Nd:YAG激光等。本文就GP的形成因素、临床表现、治疗方法做一综述,以期为GP的临床诊治提供思路。

关键词: 牙龈, 色素沉着, 牙龈色素沉着指数, 黑色素, 激光, Nd: YAG激光, 半导体激光, Er: YAG激光, CO2激光

Abstract:

Gingival pigmentation(GP) manifests as dark pigmentation spots, such as black or brown spots, in the gums. It is mostly caused by the deposition of melanin particles secreted by melanocytes on the gingival epithelium. The influencing factors may be divided into two categories, exogenous and endogenous. Exogenous factors include heavy metals, tattoos, smoking or drug use, and endogenous factors are related to certain diseases. The clinical grading of GP helps make a reasonable assessment of the necessity of treatment and prognosis. The Dummett-Gupta oral pigmentation index is a commonly used grading method, and the new grading method formed by combining the etiology and clinical manifestations described the patient’s situation more comprehensively. It is necessary to ask for a detailed medical history, complete examination, and correctly differentiate between physiological GP and GP caused by pathological state. Laser treatment is the currenttreatment with a better treatment effect and higher patient acceptance, and it is more comfortable and convenient, including diode laser, Er: YAG laser, and Nd: YAG laser, etc. This article summarizes the formation factors, clinical manifestations and treatment methods of GP to provide ideas for the clinical diagnosis and treatment of GP.

Key words: gingiva, pigmentation, gingival pigmentation index, melanin, lasers, Nd: YAG laser, diode laser, Er: YAG laser, CO2 laser

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