A study of the histopathology of gingival hyperplasia in mental patients receiving sodium diphenylhydantoinate

Han, Seong S.; Hwang, P.J.; Lee, O.H.

doi:10.1016/0030-4220(67)90369-6

Cited by 15 publications

(5 citation statements)

References 13 publications

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“…The present study demonstrated significantly higher Hyp levels in gingiva in both the PHT-GO+ and PHT-GO-groups than in controls. This finding supports previous histological and biochemical studies which have demonstrated increased accumulation and/or synthesis of collagen in PHT-induced gingival overgrowth [1,14,35]. Total protein levels were also significantly higher in the PHT-GO+ and PHT-GO-groups than in controls.…”

Section: Discussionsupporting

confidence: 91%

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Hydroxyproline and Total Protein Levels in Gingiva from Patients Treated with Phenytoin and Cyclosporine-A.

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et al. 1996

The Journal of Nihon University School of Dentistry

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Section: Discussionsupporting

confidence: 91%

“…Proliferation of fibroblasts [1,12,13] and increased formation of collagen fibers or extensive deposits of collagen [1,3,11,[14][15][16][17] have been observed in connective tissue. Inflammatory cells are also present in dense collagenous connective tissue [3,[8][9][10]12,14,[16][17][18].…”

Section: Introuductionmentioning

confidence: 99%

Hydroxyproline and Total Protein Levels in Gingiva from Patients Treated with Phenytoin and Cyclosporine-A.

Akalın

Bozkurt

Şengün

et al. 1996

The Journal of Nihon University School of Dentistry

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“…In addition, environmental factors are involved in disease predisposition [24,25,26]. Histological studies suggest that susceptibility is genetically determined in the cyclosporine-sensitive subpopulation of gingival fibroblasts [27]. Additional evidence supporting fibroblast heterogeneity has been provided by laboratory animal studies, showing an increase of gingival fibroblast growth and synthetic activity by cyclosporine-A [28].…”

Section: Introductionmentioning

confidence: 99%

Periodontal Microbiological Status Influences the Occurrence of Cyclosporine-A and Tacrolimus-Induced Gingival Overgrowth

et al. 2019

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Immune suppressed renal transplant patients are more prone to developing oral tissue alterations due to medications associated with a pleiotropic set of side effects involving the oral cavity. Drug-induced gingival overgrowth (DIGO) is the most commonly encountered side effect resulting from administration of calcineurin inhibitors such as cyclosporine-A (CsA), the standard first-line treatment for graft rejection prevention in transplant patients. Pathogenesis of gingival overgrowth (GO) is determined by the interrelation between medications and a pre-existing inflammatory periodontal condition, the main modifiable risk factor. Severity of gingival hyperplasia clinical manifestation is also related to calcium channel blocker association, frequently provided in addition to pharmacological therapy of transplant recipients. Specifically, nifedipine-induced enlargements have a higher prevalence rate compared to amlodipine-induced enlargements; 47.8% and 3.3% respectively. Available epidemiological data show a gender difference in prevalence, whereby males are generally more frequently affected than females. The impact of GO on the well-being of an individual is significant, often leading to complications related to masticatory function and phonation, a side effect that may necessitate switching to the tacrolimus drug that, under a similar regimen, is associated with a low incidence of gingival lesion. Early detection and management of GO is imperative to allow patients to continue life-prolonging therapy with minimal morbidity. The purpose of this study was threefold: firstly, to determine the prevalence and incidence of GO under the administration of CsA and Tacrolimus; secondly, to assess the correlation between periodontal status before and after periodontal therapy and medications on progression or recurrence of DIGO; and finally, to analyse the effect of immunosuppressant in association to the channel blocker agents on the onset and progression of gingival enlargement. We compared seventy-two renal transplant patients, including 33 patients who were receiving CsA, of which 25% were also receiving nifedipine and 9.72% also receiving amlodipine, and 39 patients who were receiving tacrolimus, of which 37.5% were also receiving nifedipine and 5.55% also receiving amlodipine, aged between 35 and 60 years. Medical and pharmacological data were recorded for all patients. Clinical periodontal examination, in order to establish the inflammatory status and degree of gingival enlargement, was performed at baseline (T0), 3 months (T1), 6 months (T2), and 9 months (T3). All patients were subjected to periodontal treatment. Statistically significant correlation between the reduction of the mean value of periodontal indices and degree of gingival hyperplasia at the three times was revealed. The prevalence of GO in patients taking cyclosporine was higher (33.3%) in comparison with those taking tacrolimus (14.7%). In accordance with previous studies, this trial highlighted the clinical significance of the pathological substrate on stimulating drug-induced gingival lesion, confirming the key role of periodontal inflammation in pathogenesis of gingival enlargement, but did not confirm the additional effect of calcium-channel blocker drugs in inducing gingival enlargement.

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“…The tissue overgrowth, which is generally referred to incorrectly as a "hyperplasia, " is made up almost completely of dense collagenous tissue with scattered chronic inflammatory cells. The resident connective tissue cells do not appear to be abnormal in morphology or number (26), and, except in quantity and architecture, the collagenous material seems normal (27,26). In these respects the dph-induced lesion resembles other forms of fibrosis.…”

Section: Resultsmentioning

confidence: 96%

Diphenylhydantoin (Dilantin) gingival hyperplasia: Drug-induced abnormality of connective tissue

1976

Proc. Natl. Acad. Sci. U.S.A.

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A study of the histopathology of gingival hyperplasia in mental patients receiving sodium diphenylhydantoinate

Cited by 15 publications

References 13 publications

Hydroxyproline and Total Protein Levels in Gingiva from Patients Treated with Phenytoin and Cyclosporine-A.

Hydroxyproline and Total Protein Levels in Gingiva from Patients Treated with Phenytoin and Cyclosporine-A.

Periodontal Microbiological Status Influences the Occurrence of Cyclosporine-A and Tacrolimus-Induced Gingival Overgrowth

Diphenylhydantoin (Dilantin) gingival hyperplasia: Drug-induced abnormality of connective tissue

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