scholarly journals Nonsurgical Management of Nifedipine Induced Gingival Overgrowth

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
George Sam ◽  
Staly Chakkalakkal Sebastian
Keyword(s):  
Case Report ◽  
Oral Hygiene ◽  
Medical Community ◽  
Unwanted Effect ◽  
Gingival Inflammation ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Nonsurgical Management ◽  
Gingival Enlargement ◽  
Oral Hygiene Practice

Drug-induced gingival overgrowth is frequently associated with three particular drugs: phenytoin, cyclosporin, and nifedipine. As gingival enlargement develops, it affects the normal oral hygiene practice and may interfere with masticatory functions. The awareness in the medical community about this possible side effect of nifedipine is less when compared to the effects of phenytoin and cyclosporin. The frequency of gingival enlargement associated with chronic nifedipine therapy remains controversial. Within the group of patients that develop this unwanted effect, there appears to be variability in the extent and severity of the gingival changes. Although gingival inflammation is considered a primary requisite in their development, few cases with minimal or no plaque induced gingival inflammation have also been reported. A case report of gingival overgrowth induced by nifedipine in a patient with good oral hygiene and its nonsurgical management with drug substitution is discussed in this case report.

scholarly journals Periodontal Management of Cyclosporin A-Induced Gingival Overgrowth: A Nonsurgical Approach

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Rayhana Malek ◽  
Bouchra El Houari ◽  
Jamila Kissa
Keyword(s):  
Case Report ◽  
Cyclosporin A ◽  
Drug Withdrawal ◽  
Unwanted Effect ◽  
Gingival Overgrowth ◽  
Nonsurgical Management ◽  
Supportive Periodontal Therapy ◽  
Gingival Enlargement

Gingival overgrowth is a major and frequent unwanted effect accompanying the chronic usage of antihypertensive, anticonvulsant, and immunosuppressant drugs. The expression and the severity of this tissue-specific condition are influenced by a variety of factors, mainly drug and periodontal variables. Such increased volume of gingiva may compromise normal oral functions, aesthetics in addition to the patients’ ability to practice optimal oral hygiene. The management of gingival overgrowth includes nonsurgical approach, surgical approach, or both of them for severe cases of gingival overgrowth as well as drug withdrawal. This case report illustrates a successful nonsurgical management of a 21-year-old patient with cyclosporin A-induced gingival overgrowth who experienced a total regression of the gingival enlargement without any surgical procedure or drug substitution. And it highlights therefore the key role of supportive periodontal therapy in maintaining good and stable outcomes over 2 years of follow-up.

scholarly journals Gingival overgrowth and associated factors in a population of Nigerian hypertensives

2021 ◽  
Vol 12 (3) ◽  
pp. 164-174
Author(s):  
Soroye Modupeoluwa Omotunde ◽  
Sorunke Modupeore Ekua
Keyword(s):  
Oral Hygiene ◽  
Associated Factors ◽  
Statistical Significance ◽  
Gingival Tissue ◽  
Age Group ◽  
Gingival Inflammation ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Hygiene Measures ◽  
Gingival Enlargement

Background: Gingival overgrowth may be idiopathic or secondary. Drug Induced Gingival Overgrowth (DIGO) occurs within 3 months of treatment and is more prevalent in younger age group with predilection for the anterior gingival tissue and usually not associated with attachment loss or tooth mobility unless there is an existing periodontal disease. Methodology: 170 hypertensive patients were recruited for the study; 85 calcium channel blocker (CCB) and 85 non-CCB users. Interviewer-administered questionnaires was used to obtain socio-demographic information as well as medical and drug history. GO was assessed using New Clinical Index for DIGO and data was analyzed with SPSS version 21 (Armonk, NY: IBM Corp). Continuous and nominal variables were described with means, standard deviations and frequencies. Statistical significance was set at P < 0.05. Results: Amlodipine was the most commonly used CCB. The prevalence of DIGO in CCB and non-CCB was the same (49.5%). Gingival enlargement was found equally among both sexes in the CCB and non-CCB groups. A third of the participants with GO were 70 years and above while those without were majorly in the fifth and sixth decade of life. Two-third of those with DIGO had fair oral hygiene status, two-fifth had gingival bleeding and three-fifth had mild gingival inflammation. Those without DIGO in both groups had a slight female predominance and majorly good oral hygiene. Associated factors with DIGO were female sex, 60-69 age group, 10mg drug dosage, been on medication less than 10 years, mild gingival inflammation and generalized gingivitis. Conclusion: There was no difference in the prevalence of DIGO between BBC and non-BBC users. However, there was mild gingival inflammation in all participants with DIGO and amlodipine users were three times more at risk of developing DIGO than nifedipine users. Thus, it is imperative to advise the hypertensives on the importance of maintaining adequate oral hygiene measures and incorporate periodontal care in their management so as to ameliorate the side effects of their medication.

scholarly journals Oral Contraceptives Induced Gingival Overgrowth – A Clinical Case Report

2017 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Anushi Mahajan ◽  
Ritesh Sood
Keyword(s):  
Oral Contraceptives ◽  
Oral Hygiene ◽  
Periodontal Therapy ◽  
Response To Therapy ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Periodontal Tissues ◽  
Hygiene Measures ◽  
Nonsurgical Periodontal Therapy ◽  
Gingival Enlargement

Aim: The purpose of this article is to report a case of drug induced gingival enlargement due to oral contraceptives, managed by nonsurgical periodontal therapy. Background: Drug-induced gingival overgrowth remains the most widespread unwanted effect of systemic medication on the periodontal tissues. Hormones are specific regulatory molecules that modulate a host of body functions. Oral contraceptives that contain estrogen and/or progesterone are associated with gingival enlargement. Report: A 32-year-old female presented with a complaint of swelling of the gingiva with spontaneous bleeding in the mandibular anterior region for a period of two years. The health history documented the use of contraceptives for two years, and a clinical examination revealed the existence of poor oral hygiene and enlarged painful gingival tissues that bled when touched. Summary: Females on oral contraceptives can be considered as a “risk group” for periodontal diseases. Not all females on oral contraceptives respond in similar way. Plaque control is the most important procedure in periodontal therapy. Although the initial picture presented the possibility of surgical intervention, the clinical problems were resolved with non-surgical treatment. Another factor contributing to response to therapy is patient compliance. The patient followed home care instructions well and was effective in personal oral hygiene measures. Keywords: Gingival enlargement, Sex hormones, Oral contraceptives.

scholarly journals Oral myiasis associated with drug induced gingival hyperplasia – a rare case report

2021 ◽  
Vol 27 (3) ◽  
pp. 45
Author(s):  
Rohit B. Gadda ◽  
Ankush Agrawal ◽  
Santosh Kumar SN ◽  
Tushar Manohar Rothe
Keyword(s):  
Case Report ◽  
Oral Hygiene ◽  
Rare Case ◽  
Diabetes Mellitus Patient ◽  
Complete Healing ◽  
Predisposing Factors ◽  
Gingival Hyperplasia ◽  
Drug Induced ◽  
Anterior Maxilla ◽  
Gingival Enlargement

Introduction: Myiasis (Greek: myi = fly) refers to infestation of living tissues of humans and animals by Dipterous eggs or larvae. Incidence of oral myiasis is comparatively lesser than that of cutaneous myiasis. We report a rare case of oral myiasis of anterior maxilla associated with drug induced gingival enlargement. Observation: We report a rare case of oral myiasis of anterior maxilla with amlodipine induced gingival enlargement in a sixty-two-year-old male with history of hypertension, hemiplegia and diabetes mellitus. Patient was mouth breather and presented with poor oral hygiene. Generalized gingival hyperplasia was observed. Multiple maggots were observed in the ulcerated areas on maxillary anterior alveolus. The maggots were mechanically removed with curettage after application of turpentine oil. Cleaning and debridement of the wound was done. After one month follow-up there was complete healing of the lesion. Maintenance of oral hygiene and gingivectomy as indicated was planned for this patient. Conclusion: Clinical significance of presented case is its rarity of association with drug induced gingival hyperplasia and typical presence of multiple predisposing factors. This case report provides interesting information about predisposing factors, clinical features and management of oral myiasis that could help clinicians in the diagnosis and management of this condition.

scholarly journals Agrandamiento gingival inducido por medicamentos. Reporte de un caso clínico / Drug-Induced Gingival Overgrowth. A Clinical Case Report

2018 ◽  
Vol 36 (77) ◽  
Author(s):  
Laura Vanessa Cañas Díaz ◽  
María Isabel Pardo Silva ◽  
Silie Soad Arboleda Salaimán
Keyword(s):  
Oral Hygiene ◽  
Treatment Plan ◽  
Treatment Protocol ◽  
Plaque Index ◽  
Channel Blockers ◽  
San Jose ◽  
Drug Induced ◽  
Support Design ◽  
Gingival Overgrowth ◽  
Gingival Enlargement

RESUMEN. Antecedentes: el agrandamiento gingival inducido por medicamentos es una condición clínica frecuente en pacientes que ingieren anticonvulsivantes, inmunosupresores y bloqueadores de los canales de calcio. La prevalencia de agrandamiento gingival inducido por medicamentos es de 3 - 20 % en comparación con otras condiciones gingivales inflamatorias. Todos estos medicamentos producen lesiones clínicas y características histológicas indistinguibles unas de otras, que llegan a comprometer la función y la estética de los pacientes afectados. Propósito: Describir el manejo terapéutico integral y el seguimiento a 12 meses de una paciente con agrandamiento gingival inducido por tacrolimus y amlodipino. Descripción del caso: Paciente de 22 años con discapacidad mental limítrofe, receptora de trasplante renal fue remitida al servicio de Odontología del Hospital Infantil Universitario de San José (Bogotá, Colombia) por presentar agrandamiento gingival. El examen clínico mostró un índice de placa de O’Leary del 84,3 %, inflamación generalizada y bolsas gingivales de 4 a 6 mm. El protocolo de tratamiento periodontal fue revisado por el equipo de trasplante renal e incluyó: trabajo con la familia para red de apoyo, diseño de un programa personalizado de higiene oral, gingivectomía y mantenimientos periodontales periódicos. Esta estrategia terapéutica permitió reducir el índice de placa y lograr un resultado clínico favorable. Conclusión: La condición sistémica y psicológica de la paciente determinó desarrollar un plan de tratamiento ajustado a sus necesidades. Pacientes susceptibles deben ser instruidos sobre la importancia de tener unas prácticas adecuadas de higiene oral y ameritan ser incluidos en un programa de mantenimiento periodontal.ABSTRACT. Background: drug-influenced gingival enlargement, is a frequent clinical condition in patients who ingest anticonvulsant, immunosuppressant and calcium channel blockers. The prevalence of gingival overgrowth due to prescribed medications ranges from 3% to 20% in comparison to other gingival inflammatory conditions. These drugs produce clinical lesions and histological characteristics that are indistinguishable from one another, which compromise the function and aesthetics of the affected patients. Purpose: To describe the total therapeutic management and the clinical follow up at 12-months from a patient with gingival enlargement induced by tacrolimus and amlodipine. Case description: A 22-year-old patient with borderline mental disability who received a kidney transplant was referred to San Jose Hospital - Medical Dental Unit (Bogotá, Colombia) presenting gingival enlargement. The clinical examination revealed an O'Leary plaque index of 84.3%, generalized inflammation, and gingival pockets of 4 to 6 mm. The periodontal treatment protocol was reviewed by the transplant team and included: family engagement to create a network for support, design of a personalized program for oral hygiene, gingivectomy and periodic periodontal maintenance. This therapeutic strategy allowed to reduce the plaque index and achieve favorable clinical result.  Conclusion: The systemic and psychological condition of the patient established the development of a treatment plan adjusted to her needs. Susceptible patients need to be instructed about the importance of adequate oral hygiene practices and should be included in a maintenance periodontal program.

EFFECTIVENESS OF NON-SURGICAL PERIODONTAL THERAPY ON AMLODIPINE INDUCED GINGIVAL ENLARGEMENT: A CASE REPORT

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dagar Mona ◽  
Kataria Prerna
Keyword(s):  
Case Report ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Normal State ◽  
Periodontal Therapy ◽  
Channel Blockers ◽  
Scaling And Root Planing ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Gingival Enlargement

Gingival enlargement, [sometimes abbreviated to GO (gingival overgrowth)] is an increase in the size of the gingiva. It is a common feature of gingival disease. Gingival enlargement is a well known side-effect of drugs like anticonvulsants, calcium channel blockers and immunosuppressant. A case of amlodipine induced gingival enlargement was reported and after drug substitution when the patient was treated non-surgically (scaling and root planing), the enlargement subsides to a normal state which suggested the effectiveness of non-surgical periodontal therapy in the treatment of drug induced gingival enlargement. Keywords: Anticonvulsants, Immunosuppressants, Calcium channel blockers, gingival enlargement

The multifactorial aetiology of gingival overgrowth: a case report illustrating diagnosis and management

Dental Update ◽  
2019 ◽  
Vol 46 (7) ◽  
pp. 662-671
Author(s):  
Rachael Y Jablonski ◽  
Bethany Rushworth ◽  
Kathryn A Durey
Keyword(s):  
Case Report ◽  
Renal Transplantation ◽  
Vitamin C ◽  
Oral Hygiene ◽  
Patient Engagement ◽  
Surgical Intervention ◽  
Gingival Overgrowth ◽  
Vitamin C Deficiency ◽  
Specialist Services ◽  
Detailed Assessment

Gingival overgrowth is the enlargement of gingival tissues and has various underlying aetiological factors. This case report highlights the multifactorial aetiology of gingival overgrowth for a patient who was prescribed an immunosuppressive strategy following renal transplantation, had poor levels of oral hygiene and a diet deficient in fruit and vegetables. The report highlights the importance of a detailed assessment to identify all underlying factors and demonstrates how a referral to the specialist services for gingival overgrowth led to a diagnosis of vitamin C deficiency. It also illustrates how both patient engagement and a conservative cause-related therapy can achieve a satisfactory resolution without any surgical intervention. CPD/Clinical Relevance: This case report highlights the importance of a detailed assessment to diagnose all relevant underlying aetiological factors involved in the development of gingival overgrowth. It also illustrates how both patient engagement and a conservative cause-related therapy can achieve a satisfactory resolution of gingival overgrowth without any surgical intervention.

scholarly journals Connective Tissue Metabolism and Gingival Overgrowth

2004 ◽  
Vol 15 (3) ◽  
pp. 165-175 ◽  
Author(s):  
P. C. Trackman ◽  
A. Kantarci
Keyword(s):  
Extracellular Matrix ◽  
Connective Tissue ◽  
Oral Hygiene ◽  
Tissue Specificity ◽  
Gingival Fibroblast ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Connective Tissue Metabolism ◽  
Matrix Metabolism ◽  
Systemic Health

Gingival overgrowth occurs mainly as a result of certain anti-seizure, immunosuppressive, or antihypertensive drug therapies. Excess gingival tissues impede oral function and are disfiguring. Effective oral hygiene is compromised in the presence of gingival overgrowth, and it is now recognized that this may have negative implications for the systemic health of affected patients. Recent studies indicate that cytokine balances are abnormal in drug-induced forms of gingival overgrowth. Data supporting molecular and cellular characteristics that distinguish different forms of gingival overgrowth are summarized, and aspects of gingival fibroblast extracellular matrix metabolism that are unique to gingival tissues and cells are reviewed. Abnormal cytokine balances derived principally from lymphocytes and macrophages, and unique aspects of gingival extracellular matrix metabolism, are elements of a working model presented to facilitate our gaining a better understanding of mechanisms and of the tissue specificity of gingival overgrowth.

scholarly journals Drug-Induced Gingival Overgrowth in an 8-Year-Old Girl: A Case Report

2021 ◽  
Vol 13 (3) ◽  
pp. 109-112
Author(s):  
Parviz Torkzaban ◽  
Amir Talaie
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Immunological Tolerance ◽  
Systemic Autoimmune Disease ◽  
Channel Blockers ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Gingival Overgrowth

Systemic lupus erythematosus is a systemic autoimmune disease that involves multi organs. Genetic, endocrine, immunological, and environmental factors influence the loss of immunological tolerance against self-antigens leading to the formation of pathogenic autoantibodies that cause tissue damage through multiple mechanisms. The gingival overgrowth can be caused by three factors: noninflammatory, hyperplastic reaction to the medication; chronic inflammatory hyperplasia; or a combined enlargement due to chronic inflammation and drug-induced hyperplasia. Drug-Induced Gingival Overgrowth is associated with the use of three major classes of drugs, namely anticonvulsants, calcium channel blockers, and immunosuppressants. Due to recent indications for these drugs, their use continues to grow.

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