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ISSN : 0376-4672
잇몸의 국소 증식은 치과 임상에서 비교적 흔하게 접할 수 있는 병소이다. 이러한 병변은 매우 다양한 양상으로 나타나며 임상 소견만으로 이들 병소를 감별하는 것은 어려울 수 있으므로, 임상가에 있어서 가장 큰 문제는 정확한 진단을 내려 적절한 치료 방법을 찾는 것이다. 잇몸의 증식은 전신질환(systemic disease), 약물, 국소적인 의원성 요소(local iatrogenic factor)나 치태/치석과 연관이 있다. 잇몸의 국소적증식 병소는 진성 종양성 병소라기보다는 반응성 증식병소인 경우가 많아 조직생검에서 분석된 예의 90%이상을 차지한다. 이 경우 감별 진단으로 화농성육아종(pyogenic granuloma), 치은종(epulis),주변성 골화 섬유종(peripheral ossifyingfibroma), 주변성 거대세포 육아종(peripheralgiant cell tumor) 등을 포함하여야 한다 . 이들 반응성 병소는 단독 병소로 발생하는 경우가 많으며, 치태, 치석, 잘 맞지 않는 보철물 등의 국소적자극 인자(local irritant)와 연관되어 생기는 경우가많다. 드물게는 치성 종양, 낭종, 악성 종양 등의병소가 잇몸에 나타나는 경우도 있다. 본 논문에서는구강에서 흔하게 나타날 수 있는 잇몸의 국소 증식 질환을 소개하고, 감별 진단과 치료법에 대해 설명하고자 한다.
Localized gingival enlargement is a common finding and tends to be reactive hyperplasia. Gingival reactive lesions are usually asymptomatic and respond to conservative treatment. However, a small entity of localized gingival enlargement is distinct from non-neoplastic growth, including developmental and neoplastic lesions. Since their clinical characteristics are similar with other lesions of gingiva, it can cause diagnostic dilemma, and is recommended to submit biopsy and confirm pathologic diagnosis. Their incidence of recurrence are different, therefore method of treatment should vary depending on the diagnosis. This review explains identification and treatment of localized gingival lesions.
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