Untypical amlodipine-induced gingival hyperplasia.

Amlodipine is a third generation dihydropyridine calcium channel blocker that is frequently used in therapy of hypertension. Among many side effects, amlodipine has been found associated with gingival overgrowth (GO) which usually occurs within the first three months of starting therapy at a dose of 10 mg/day. However, there are very few reports on amlodipine-induced gingival overgrowth (AIGO) at a lower dose (5 mg/day) and only after short term administration. A 64-year-old male patient with hypertension, who received amlodipine (5 mg/day) for four years, sought medical attention at the Department of Periodontology and Oral Medicine, Institute of Dentistry, Banja Luka, Bosnia and Herzegovina. The patient complained of masticatory problems due to extensive maxillary GO along with pain, bleeding, and foul odor. The clinical and the histological evidences were consistent with AIGO. The first line treatment consisted of the amlodipine substitution (amlodipine was replaced with enalapril, 5 mg/day) and the scaling and root planning/SRP. At one-month follow-up, drug replacement and SRP resulted in some reduction of the inflammation and significant reduction of symptoms. Further, gingivectomy/gingivoplasty helped overcome the effect of these drugs. The possibility of AIGO should be considered for a lower dose, as well as a late presentation.

Pemphigus vulgaris and laser therapy: crucial role of dentists.

INTRODUCTION: Pemphigus vulgaris is a relatively rare, chronic, autoimmune vesiculobullous disorder characterized by formation of intraepithelial vesiculae and/or bullae in the skin and mucous membrane. Systemic steroids are considered to be the standard first-line therapy for pemphigus vulgaris. However, for patients unresponsive to standard therapy, the new treatment modalities are being sought. Low-level laser therapy has been accepted as an alternative or adjunctive treatment modality for many conditions in medicine and dentistry. Therefore, this study was aimed at presenting the effects of low-level laser therapy in the treatment of pemphigus vulgaris and to emphasize the crucial role of dentists in early recognition and diagnosis of pemphigus vulgaris. MATERIAL AND METHODS: The articles published until May 2013 were obtained from the Medline/PubMed online database, using following search terms and key words: "laser therapy" and "pemphigus vulgaris", "low-level laser irradiation" and "pemphigus vulgaris", "lasers" and "pemphigus vulgaris" and "pemphigus vulgaris". RESULTS: Low-level laser therapy could result in immediate and significant analgesia and improved wound healing within the observation period and follow-up. Furthermore, a decrease in patients' discomfort as well as the absence of recurrence of the pemphigus vulgaris lesions has been claimed. CONCLUSION: Even though available literature suggests that low-level laser therapy can be efficiently used in treatment of oral pemphigus vulgaris, either independently or as a part of combined therapy approach, these results should be interpreted with caution since there are no solid evidence-based proofs to provide the guidelines for the treatment of pemphigus vulgaris with low-level laser therapy. Therefore, further long-term randomized controlled clinical studies are necessary in order to give any solid recommendations on the use of low-level laser therapy in the treatment of pemphigus vulgaris.

Periodontitis and Buerger's Disease: Recent Advances.

Buerger's disease (BD) is a relatively rare thrombotic, occlusive and non-atherosclerotic clinical syndrome of unknown etiology. In recent years, numerous epidemiological studies confirmed the strong association between chronic anaerobic periodontal infection and development of cardiovascular diseases, including BD. Therefore, the aim of this study is to clarify association between periodontal pathogens and Buerger's disease. Confirmation of presence and identification of periopathogens in patients with BD can be considered crucial in developing novel therapies for BD. Further, periodontal therapy will lead to eventual improvement of BD patients' condition.