Poor oral hygiene enhances gingival overgrowth caused by calcineurin inhibitors

Reali, Laura; Zuliani, E; Gabutti, Luca; Schönholzer, Carlo; Marone, Claudio

doi:10.1111/j.1365-2710.2008.01000.x

Cited by 28 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The bacterial dental biofilm level is strongly associated with gingival and periodontal disease and its control has an important role in the control and prevention of DIGO (5,6). Nevertheless, even in the presence of the high biofilm levels and CPI shown in this study, there was a lack of evidence of any association of these factors with DIGO, as demonstrated by other studies (11,25).…”

Section: Discussionmentioning

confidence: 43%

“…It is more conspicuous in the buccal than in the lingual gingiva and less severe in the maxilla than in the mandible (4,5). DIGO may lead to esthetic and/or functional alterations, impairing occlusion, mastication and speech (2,6). It also impairs dental hygiene, resulting in a higher susceptibility to caries and periodontal diseases (6).…”

Section: Introductionmentioning

confidence: 99%

“…DIGO may lead to esthetic and/or functional alterations, impairing occlusion, mastication and speech (2,6). It also impairs dental hygiene, resulting in a higher susceptibility to caries and periodontal diseases (6). The prevalence of this DIGO is widely variable (2), but large controlled studies have revealed a percentage of 50% for phenytoin users, and 6 to 83% for nifedipine users (2,7).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiological analysis of nifedipine and phenytoin-induced gingival overgrowth in users of the Primary Health Care System

Fonseca

Júnior²,

Gonçalves

et al. 2010

Rev. odonto ciênc. (Online)

View full text Add to dashboard Cite

Purposes: The aim of this study was to evaluate the prevalence of drug-induced gingival overgrowth (DIGO) in Brazilian users of nifedipine and/or phenytoin and to determine the presence of predisposing/modifying factors.Methods: Demographic, pharmacological, and periodontal data were obtained from 100 users of the Brazilian Primary Health Care System in Diamantina, Jequitinhonha Valley, Minas Gerais state, Brazil, who were taking nifedipine and/or phenytoin. Clinical evaluations including gingival overgrowth analysis were carried out by a single calibrated examiner. Bivariate analysis (Chi-square test or Student's t-test) were used to identify demographic, periodontal and drugrelated significant factors associated with gingival overgrowth severity. Multivariate analysis (Poisson regression) was used to assess confounding factors.Results: The prevalence of DIGO was high (86%), but its severity was predominately mild. The prevalence of DIGO was significantly higher in phenytoin users than in nifedipine users (P=0.01). There was no association between DIGO and demographic, pharmacological or periodontal variables.Conclusion: The high occurrence of DIGO among users of nifedipine and phenytoin emphasizes the importance of the dentist as part of the public health team to provide the prevention, early diagnostic, and control of this alteration.Key words: Nifedipine; phenytoin; gingival overgrowth; primary health care ResumoObjetivo: Avaliar a prevalência dos aumentos gengivais medicamentosos em usuários brasileiros de nifedipina e fenitoína e determinar a presença de fatores preditores/modificadores. Metodologia: Dados demográficos, farmacológicos e periodontais foram obtidos de 100 pacientes usuários da Atenção Primária no Vale do Jequitinhonha que usavam nifedipina e/ou fenitoína. Avaliações clínicas, incluindo a análise do aumento gengival, foram feitas por um avaliador calibrado. Análises bivariadas (teste do qui-quadrado ou teste t de Student) foram usadas para identificar fatores demográficos, periodontais e medicamentosos que apresentassem associação com a severidade do aumento gengival. Foi utilizada análise multivariada (regressão de Poisson) para estimar a razão de prevalência e intervalo de 95% de confiança para identificar os fatores de risco associados ao desenvolvimento do AG.Resultados: A prevalência do aumento gengival foi elevada (86%), mas a gravidade mais comumente observada foi a leve. A prevalência foi maior em usuários de fenitoína do que de nifedipina (P=0.01). Não houve associação entre aumento gengival e as variáveis demográficas, farmacológicas e periodontais.Conclusão: A alta prevalência do aumento gengival medicamentoso entre os usuários de nifedipina e fenitoína enfatiza a importância do cirurgião dentista no diagnóstico, prevenção e controle dessa alteração.

show abstract

Section: Discussionmentioning

confidence: 43%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiological analysis of nifedipine and phenytoin-induced gingival overgrowth in users of the Primary Health Care System

Fonseca

Júnior²,

Gonçalves

et al. 2010

Rev. odonto ciênc. (Online)

View full text Add to dashboard Cite

show abstract

“…Hence, it is important that children and parents should be aware of the need to brush their teeth after taking each dose of medicine, to take medicines at meal times rather than between meals, and to avoid taking medicines before going to bed and the need for fluoride application. [131622]…”

Section: Discussionmentioning

confidence: 99%

Oral health concerns with sweetened medicaments: Pediatricians′ acuity

Nirmala

Popuri

Chilamakuri

et al. 2015

J Int Soc Prevent Communit Dent

View full text Add to dashboard Cite

Background:Administration of sweetened medicaments poses many oral health related problems in children due to the lack of awareness among the pediatricians regarding their ill effects.Purpose:To assess pediatricians’ awareness and attitudes toward the use of liquid pediatric medicines and their relationship with dental caries and erosion.Materials and Methods:A cross-sectional descriptive study was conducted among the pediatricians residing in Nellore city. Data were obtained from 55 pediatricians using questionnaires.Results:Among the respondents, 95.6% prescribed liquid medicaments, 51.1% expressed that they may be associated with dental effects, 60% were not aware regarding the sweetness of medicaments, whereas majority of them (77.8%) opined that children complained regarding the taste, 73.3% stated that sugar substitutes were used as sweetening agents, 70.9% believed that they were not acidic, 68.9% did not recommend brushing after intake of medicines, 90% failed to deliver oral health instructions, and 54.5% believed that lack of oral hygiene was a contributing factor for development of dental caries.Conclusion:Majority of the respondents prescribed liquid medicaments and were unaware regarding the sweetening agents and acidity, which cause ill effects on the dental hard tissues. Most of them neither recommended nor delivered oral hygiene instructions (OHI) after prescribing sweetened liquid medicaments. Hence, OHI should be delivered to enhance the oral health related quality of life in children.

show abstract

“…However, the incidence increases with concomitant use of calcium channel blockers and in those with poor oral hygiene. 2 As single agents, calcium channel blockers have also rarely been reported to induce gingival overgrowth. 1 Proper oral hygiene can help prevent progression, but will not reverse gingival overgrowth.…”

mentioning

confidence: 99%

Drug-induced gingival overgrowth after renal transplantation

2017

View full text Add to dashboard Cite

A 23-year-old male with a history of posterior urethral valves complicated by chronic kidney disease requiring renal transplantation at age 19 was incidentally found to have extensive gingival overgrowth on physical examination ( Figs. 1 and 2). The gingival overgrowth developed several months after the patient's transplant and progressively worsened. His medications had included mycophenolate mofetil, tacrolimus, and amlodipine since his renal transplant 4 years prior.Medications other than anticonvulsants and cyclosporine can cause gingival overgrowth. 1 This patient's gingival overgrowth was attributed to the combination of amlodipine and tacrolimus. Limited studies have demonstrated low rates of gingival overgrowth with tacrolimus, 1 with prevalence ranging from 0% to 29%. However, the incidence increases with concomitant use of calcium channel blockers and in those with poor oral hygiene. 2 As single agents, calcium channel blockers have also rarely been reported to induce gingival overgrowth. 1Proper oral hygiene can help prevent progression, but will not reverse gingival overgrowth. Treatment options include discontinuation of causative medications and gingivectomy, although recurrence rates with this procedure are as high as 40%.

show abstract

Poor oral hygiene enhances gingival overgrowth caused by calcineurin inhibitors

Abstract: Intensive motivation of patients to maintain good oral hygiene is necessary to reduce the incidence of gingival hyperplasia.

Cited by 28 publications

References 20 publications

Epidemiological analysis of nifedipine and phenytoin-induced gingival overgrowth in users of the Primary Health Care System

Epidemiological analysis of nifedipine and phenytoin-induced gingival overgrowth in users of the Primary Health Care System

Oral health concerns with sweetened medicaments: Pediatricians′ acuity

Drug-induced gingival overgrowth after renal transplantation

Contact Info

Product

Resources

About