Drug-induced gingival overgrowth and its tentative pharmacotherapy

Matsumoto, Hiroko; Takeuchi, Reiri; Ono, Makiko; Akimoto, Yoshiaki; Kobayashi, Naomi; Fujii, Akira

doi:10.1016/j.jdsr.2009.09.001

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…The presence of a higher drug concentration in the serum will eventually lead to its detection in the gingival crevicular fluid, which may have an adverse effect on the existing inflammatory tissue. This may cause an upregulation of levels of several cytokines, including fibroblast growth factor 2, transforming growth factor-β1, interleukin-6 (IL-6), IL-1B, and platelet-derived growth-factor-β, which may lead to an increase in fibroblasts, contributing to DIGE [ 11 ]. As the cellular inflammatory events take place, there will be migration of mast cells and proliferation of fibroblasts, which eventually causes an increase in extracellular matrix synthesis and a decrease in degradation activity.…”

Section: Discussionmentioning

confidence: 99%

Oral Rehabilitation of a Patient With Generalized Inflammatory Gingival Overgrowth Exacerbated by Felodipine: A Case Report

Jamil¹,

AL-Rawas²,

Ghani³

et al. 2022

Cureus

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Gingival enlargement may manifest as a side effect of medications (calcium channel blockers, anticonvulsants, or immunosuppressants) and may be associated with inflammation, malignancy, or genetic inheritance. This condition has a significant impact on a patient’s quality of life and affects their oral health status. This case report describes the management of a 68-year-old gentleman who presented with generalized gingival enlargement and chronic periapical abscess originating from tooth 34, which served as an abutment for a fixed partial prosthesis. The patient's medical history revealed that felodipine, an antihypertensive medication, was prescribed to him. A comprehensive treatment plan was developed to improve the patient’s quality of life.

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Section: Discussionmentioning

confidence: 99%

Oral Rehabilitation of a Patient With Generalized Inflammatory Gingival Overgrowth Exacerbated by Felodipine: A Case Report

Jamil¹,

AL-Rawas²,

Ghani³

et al. 2022

Cureus

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“…These processes may create a vicious cycle to promote the pathogenesis of DIGO. Mechanistically, the CCB-induced fluctuation in intra- and extra-cellular calcium levels is mediated via inflammatory signaling (30). It has been reported that a high intracellular free Ca 2+ concentration potentiates the activity of growth factors and cell cycle regulators, and thus, promotes cell proliferation and collagen synthesis (30).…”

Section: Discussionmentioning

confidence: 99%

Felodipine‑associated gingival overgrowth in a type 2 diabetic patient: A case report and literature review

Sun

Wang

et al. 2019

Exp Ther Med

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Gingival overgrowth (GO) includes gingival enlargement and hyperplasia and may be induced by certain drugs, including calcium channel blockers (CCBs), particularly first-generation CCBs. However, to date, only few cases of GO induced by second- or third-generation CCBs have been reported. The present study reports on a case of a 48-year-old diabetic male who was admitted to the First Hospital of Jilin University (Changchun, China) due to poor blood glucose control. This patient was diagnosed with GO. Review of the patient's medical history revealed diagnoses of type 2 diabetes and hypertension, as well as the use of felodipine, a second-generation CCB, to control hypertension. The hypertensive drugs were replaced and the new drugs helped the patient control his blood glucose levels. Additionally, the patient was instructed on methods he could use to improve his oral hygiene, including rinsing of the teeth following each meal and increasing the frequency of tooth brushing per day. After 3 months, the clinical symptoms of GO were relieved. The relevant literature was also reviewed to gain an improved understanding of the correlation between GO and CCBs, as well as diabetes and poor oral hygiene.

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“…The response of gingival fibroblasts to calcium channel blockers has been investigated and mainly attributed to several mechanisms including high intracellular free Ca 2+ concentration which results in cellular responses that affects growth factors, cell cycle regulators, cell proliferation, DNA, and collagen synthesis as well as intracellular cell talk [ 25 ]. Several therapeutic treatments were investigated in order to deplete the intracellular storage of Ca 2+ including Tenidap and showed a degree of success on human cultured gingival fibroblasts [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Gingival Enlargement Induced by Felodipine Resolves with a Conventional Periodontal Treatment and Drug Modification

Khzam¹,

Bailey²,

Yie³

et al. 2016

Case Reports in Dentistry

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We present a case of a 47-year-old male who suffered from GE around his lower anterior teeth as soon as he started treatment with Felodipine 400 mg. We show that oral hygiene measures, antibiotics, and conventional periodontal treatment (scaling and root planing SRP) were all not sufficient to resolve the drug induced GE, which will persist and/or recur provided that systemic effect of the offending medication is still present. The condition immediately resolved after switching to a different medication. The mechanism of GE is complex and not fully understood yet. It is mainly due to overexpression of a number of growth factors due to high concentrations of calcium ions (Ca2+). This affects fibroblasts proliferation and DNA synthesis and leads to a heavy chronic inflammatory cell infiltrate. Our case was managed according to the suggested protocols in previous case studies. The unique features in our case were the immediate onset of the adverse effect after starting the medication and the absence of any underlying medical condition apart from high blood pressure. Improving the oral hygiene together with SRP and cessation of the medication resolves drug induced GE.

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Drug-induced gingival overgrowth and its tentative pharmacotherapy

Cited by 3 publications

References 27 publications

Oral Rehabilitation of a Patient With Generalized Inflammatory Gingival Overgrowth Exacerbated by Felodipine: A Case Report

Oral Rehabilitation of a Patient With Generalized Inflammatory Gingival Overgrowth Exacerbated by Felodipine: A Case Report

Felodipine‑associated gingival overgrowth in a type 2 diabetic patient: A case report and literature review

Gingival Enlargement Induced by Felodipine Resolves with a Conventional Periodontal Treatment and Drug Modification

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