ABSTRACT
Objective To explore the clinical therapy for cyclosporine A(CsA)-induced gingival overgrowth (GO) and the pathological changes in gingival overgrowth tissues.Methods Nine cases of CsA-induced GO after renal transplantation were subjected to periodontal non-surgical treatment and surgical treatment.Under light and electron microscopy,the pathological changes in CO tissues were observed.Results The bleeding index(BI) and the plaque index(PLI) of patients were declined after periodontal treatment.GO recurred in 2 patients 6 months later and happened to recur in all 9 patients 12 months later(GOD≤1).At 18th month after transplantation,an obvioUS GO(GOD≥2)occurred in one patient,and re-operation was done to cut hyperplastic gingiva.At 48th month during the observation period,GO existed continuously but no more than 2 in GOD.There were 3 other patients who had their GO(GOD≥2)at 24th month after peridental treatment and re-operation was carried out to remove the hyperplasic gingivaL Under a light microscope,epithelial pegs constituted of basal cells and prickle cells elongated and presented as cancellation structure;spinus layer thickened:hyperkeratosis or parakeratosis occurred in cuticular layer where inflammatory cells infiltrated:collagen increased in proper layer.Under the transmission electron microscopy,the volume of fibroblasts in hyperplastic gingival tissues was increased,rough endoplansmic reticula in the intracytoplasm were abundant and expanded slightly,and there were a few of the apoptotic fibroblasts in the early stage.Conclusion BI and PLl were declined in patients taking CyA for a long-term who were subjected to periodontal and surgical treatments.GO recurred in some patients.The proliferation and differentiation of fibroblasts was not observed in hyperplastic gingival tissues.
ABSTRACT
To treat large facial defect (more than 6 cm x 4 cm in diameter) or a wound with bone exposure to atmosphere by less-traumatic, easier-healing reconstruction method, a pedicle flap including facial, neck, posterior auricle and occipital skin flap was designed and transferred, one by one, to repair facial defect as well as other flap donor sites, but occipital skin flap was only used to cover posterior auricle area. After 2-3 years follow-up, well-healed skin flaps with good color, elasticity and sensation were observed in all 16 patients. It is concluded that this method is effective and practical.
Subject(s)
Carcinoma, Basal Cell/surgery , Cicatrix/surgery , Face , Neck , Orbital Neoplasms/surgery , Parotid Neoplasms/surgery , Plastic Surgery Procedures/methods , Scalp , Surgical FlapsABSTRACT
To treat large facial defect (more than 6 cm x 4 cm in diameter) or a wound with bone exposure to atmosphere by less-traumatic, easier-healing reconstruction method, a pedicle flap including facial, neck, posterior auricle and occipital skin flap was designed and transferred, one by one, to repair facial defect as well as other flap donor sites, but occipital skin flap was only used to cover posterior auricle area. After 2-3 years follow-up, well-healed skin flaps with good color, elasticity and sensation were observed in all 16 patients. It is concluded that this method is effective and practical.