Treating patients with drug-induced gingival overgrowth (original) (raw)

Drug induced gingival overgrowth: a rare case report

Journal of clinical and diagnostic research : JCDR, 2015

Gingival overgrowth is well documented side effect associated with three major classes of drugs viz, anticonvulsants, calcium channel blockers, and immunosuppressants. Despite our greater understanding of pathogenesis of Drug induced Gingival Overgrowth (DIGO), its treatment still remains a challenge for the periodontists and treatment is still largely limited to maintenance of improved level of oral hygiene and surgical removal of overgrown tissue. Dental Surgeons need to discuss this issue with their medical colleagues and to practice care while prescribing the drugs associated with gingival overgrowth. The aim of present article is to report a rare case where even after extraction of all teeth; the enlargement did not subsided for one month.

Refining the Mechanism of Drug-Influenced Gingival Enlargement and Its Management

Cureus

Drug-influenced gingival enlargement (DIGE) or overgrowth manifests as abnormal enlargement of the gingiva due to an adverse effect of certain drug reactions in patients treated with anticonvulsants, immunosuppressants, or calcium channel blockers (CCBs). As the gingival enlargement became significant, it may interfere with the normal oral hygiene measures, aesthetics, as well as masticatory functions of the patients. The exact mechanism of how this undesirable condition develops is yet unknown, and complicated, with non-inflammatory and inflammatory pathways involved. This review illuminates these putative pathways of DIGE and highlights various treatment approaches based on existing research and current observations.

Gingival Overgrowth as Adverse Drug Reaction of Calcium Channel Blockers: A Review

Background: Gingival overgrowth is an Adverse Drug Reaction (ADR) frequently encountered in the dihydropyridine (DHP) group of Calcium Channel Blockers, especially nifedipine and amlodipine. Various factors are thought to play a role as risk factors including sociodemographic, genetic, pharmacokinetics, and oral hygiene. Results : Based on the result of article peel obtained 4 articles included in this literature review. Conclusion: The wide prevalence variability is thought to occur due to differences in genetics, population characteristics, and the criteria used. Sociodemographic factors (age, gender) did not have a significant effect on GO, while oral hygiene factors and drug pharmacokinetic variables still gave mixed results, thus further research is still needed.

Drug-Induced Changes in the Gingival Tissue

Journal of Interdisciplinary Medicine

Introduction Drug-induced gingivitis is caused by the administration of certain drugs such as hydantoin, calcium blockers, beta-blockers, cyclosporine, and oral contraceptives. The aim of this study was to evaluate the modifications linked to drug-induced gingivitis such as changes in color, volume, and consistency, and the clinical signs of periodontal disease. Materials and methods The study was based on a questionnaire made up of 14 questions, formulated using colloquial language to increase addressability. Results The most frequently used drugs were beta-blockers (37%), calcium channel blockers (33%), followed by anticonvulsants (18%), oral contraceptives (8%) and cyclosporine (4%). Color changes occurred in 81% of anticonvulsant treatments and 57% of oral contraceptives. Increases in the gingival volume were higher with anticonvulsants (73%) followed by cyclosporine (67%). Gingival consistency was higher with anticonvulsant treatments (90%), followed by calcium channel blockers...

Prevalence and clinical aspects of drug-induced gingival enlargement

Biomedical Research - India, 2009

Drug-induced gingival enlargement is an iatrogenic condition which is usually not preventable. Certain factors like thorough tooth brushing, proper oral hygiene measures, regular dental flossing and professional care of oral cavity are helpful. Surgical excision of the gingival overgrowth is a treatment of choice but non-surgical methods should be adopted first. More research is needed to investigate measures that can prevent or reduce gingival overgrowth or prevent recurrence. A thorough review of literature reveals that inadequate data exist pertaining to prevalence and treatment options available for iatrogenic gingival hyperplasia. Studies with large number of samples, with statistical analysis, are required to make the data more scientific. Preventive measures have limited value and require regular assessment of patients. Hyperplasia does occur after surgical intervention but percentage of recurrence is not available. Hyperplasia can be managed to a certain extent by withdrawing or changing the medication. However, surgical intervention remains the mainstay of treatment. This paper reviews various aspects of prevalence, pathogenesis and treatment options available to manage drug-induced gingival hyperplasia.

The pathogenesis of drug-induced gingival overgrowth

Journal of Clinical Periodontology, 1996

Gingival overgrowth is a well-documented unwanted effect, associated with phenytoin, cyclosporin. and the calcium channel blockers. The palhogenesis of drug-induced gingival overgrowth is uncertain, and there appears to be no unifying hypothesis that links together the 3 commonly implicated drugs. In this review, we consider a multifactorial model which expands on the interaction between drug and/or metabolite, with the gingiva! fibroblasts. Factors which impact upon this model include age. genetic predisposition, pharmacokinetic variables, plaque-induced inflammatory and immunological changes and activation of growth factors. Of these, genetic factors which give rise to fibroblast heterogeneity, gingival inflammation, and pharmacokinetic variables appear lo be significant in the expression of gingival overgrowth, A more thorough understanding of the pathogenesis of this unwanted effect will hopefully elucidate appropriate mechanisms for its control.

Drug-induced Gingival Enlargement and Treatment Modalities

Journal of Ege University School of Dentistry, 2017

Antikonvülsanlar, kalsiyum kanal blokerleri ve immünosupresanlar dişeti büyümesine neden olan temel ilaç gruplarındandır. İlaca bağlı dişeti büyümelerinin nasıl meydana geldiği tam olarak bilinmese de yaş, genetik ve ilaçların farmakokinetik özellikleri gibi birçok faktörün dişeti büyümesi patogenezinde rol oynayabildiği bildirilmiştir. Bireyin genetik özelliklerine bağlı olarak, ilacın dişeti üzerine etkisi değişebilmektedir. Bu makale, ilaca bağlı dişeti büyümelerinin prevalansı, risk faktörleri, patogenezi ve tedavi yöntemleri ile ilgili bir derlemedir. Anahtar Kelimeler: ilaca bağlı dişeti büyümeleri, antikolvülsan, kalsiyum kanal blokeri, immünosupresan ABSTRACT Anticonvulsants, calcium channel blockers and immunosuppressants are the main drug groups that may lead to gingival enlargement. Although the underlying mechanism of drug-induced gingival enlargement is uncertain, it has been reported several factors such as age, genetics and pharmacokinetic properties of the drugs can play role in pathogenesis of gingival enlargement. The effect of drug on gingiva can vary depending on the genetic characteristics of individuals. This article is about the prevalence, risk factors, pathogenesis, and clinical management of drug-induced gingival enlargement.

Treatment Methods Conditioned by the Gravity of Drug-Induced Gingival Hyperplasias

Revista de Chimie

The first drug discovered to be involved in the development of gingival hyperplasia is phenytoin, which is indicated in the treatment of epileptic patients. The other drugs are calcium channel blockers with vasodilating effect. The most important one is Nifedipine, while Ciclosporin A, which is used as an immunosuppressant in the prevention of transplant rejection, causes gingival hyperplasia as a secondary effect. Gingival hyperplasia can reach an impressive volume, completely covering the dental crown and affecting the masticatory and physiognomic functions. The elucidation of the mechanism, by which drug-induced gingival hyperplasia occurs, favoring factors and the choice of conservative or surgical treatment methods, emphasizing the prophylactic treatment. The study batch was subject to intraoral and extraoral clinical examinations and the data were included in the dental treatment sheet of each patient, 11 patients aged over 60 years, who came to the Clinic ... in the period 20...