The role of drugs in the pathogenesis of gingival overgrowth. A collective review of current concepts

Hallmon, William W.; Rossmann, Jeffrey A.

doi:10.1111/j.1600-0757.1999.tb00175.x

Cited by 120 publications

(135 citation statements)

References 135 publications

Supporting

Mentioning

128

Contrasting

Unclassified

Order By: Relevance

“…This result may be explained by the use of novel immunosuppression protocols, whose effects seem to be dose-dependent and reversible with lower doses, 13,14 although several studies have failed to confirm this association. 15,16 By adjusting the CsA dosage for each patient, 17 current protocols ensure that CsA dosages are lower than those administered when the drug was first introduced in the market.…”

Section: Discussionmentioning

confidence: 94%

Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

et al. 2011

View full text Add to dashboard Cite

Gingival overgrowth (GO) is a frequent finding in patients treated with cyclosporine (CsA). This study investigated the prevalence and severity of GO in patients who received kidney transplant and CsA therapy, as well as associations with pharmacological and clinical factors. This cross-sectional study included 63 kidney transplant recipients who were treated with CsA in a university hospital. Demographic, pharmacological, and periodontal data were collected. The primary variable was GO. Independent sample t-and chi-square tests were used to compare means in groups with versus without GO. The response rate was 86.3%. Overall, 40% of patients had some degree of GO. Eleven individuals presented GO scores > 10%, and 5 individuals reached 30%. The mean GO percentage was low (6.79 ± 15.83). Patients that were concurrently under nifedipine treatment showed a non-significant trend toward a greater prevalence of GO. Mean CsA dosage and serum levels were 3.20 ± 0.94 mg/kg/d and 156.12 ± 162.75 ng/mL, respectively. There were no statistically significant differences between patients with versus without GO nor between the groups receiving nifedipine, no drug, or verapamil. The GO prevalence and severity rates were lower than those reported in previous studies and seemed to be independent of drug interactions.

show abstract

Section: Discussionmentioning

confidence: 94%

Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Dişsiz bölgelerde büyüme gözlenmez; ancak dental implantların etrafında nifedipinle ilişkili dişeti büyümesi rapor edilmiştir. 8 Bu vakada da alt çenede alveolar kret üzerindeki dişsiz bölgelerde büyüme olmaması, plağa bağlı enflamasyonun gingival bağ dokusunda ilaca bağlı büyümeyi tetiklediği görüşünü desteklemektedir. Amlodipin, gingival hiperplazinin potansiyel etiyolojik nedenlerinden biri olarak sıklıkla rapor edilmiştir.…”

Section: 7 Heijl Veunclassified

Kalsi̇yum Kanal Blokörü (Amlodi̇pi̇n) Kullanimina Bağli Di̇şeti̇ Büyümesi̇:5 Yil Taki̇pli̇ Vaka Raporu

Kurgan¹,

Önder²,

Tayman³

et al. 2016

Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

View full text Add to dashboard Cite

ÖZHipertansiyon, anjina pektoris ve kardiyak aritmi gibi kardiyovasküler problemlerin tedavisi için sıklıkla kullanılan ilaçlardan olan kalsiyum kanal blokörlerinin, yan etki olarak dişeti büyümesine neden oldukları bilinmektedir. Kalsiyum kanal blokörü olan amlodipin, hipertansiyon tedavisinde antihipertansif bir ilaç olarak kullanılmaktadır. Yapılan birçok çalışmada, amlodipinin de diğer kalsiyum kanal blokörleri gibi dişeti büyümesini tetiklediği gösterilmiştir. Bu vakada amlodipin kullanımına bağlı gelişen dişeti büyümesinin ağız içi klinik özellikleri ve tedavi protokolleri sunulmuştur. Hipertansiyon tedavisi için 3 yıldır amlodipin kullanan 77 yaşındaki kadın hasta, üst çenesinde estetik ve fonksiyonel problemlere neden olan aşırı dişeti büyümesi şikâyeti ile kliniğimize başvurmuştur. Tedavisinde; kazıma ve kök yüzey düzlemesi işlemi, ilacın değiştirilmesi, cerrahi eksizyon ve klinik sonucun idame ve destekleyici tedavisi yapılmıştır. İlaca bağlı dişeti büyümelerinin tedavisi, ilacı kesme ya da başka bir ilaçla değiştirme ve dikkatli bir şekilde mekanik ve kimyasal olarak plak kontrolü ile risk faktörlerinin azaltılmasını içerir. Oral hijyeni ve fonksiyonu etkilemesi veya kozmetik nedenlerle, aşırı dişeti büyümesi görülen şiddetli vakalar eksize edilmelidir. Diş hekimlerinin kalsiyum kanal blokörü kullanan bireylerde dişeti büyümesi riski açısından dikkatli olmaları ve iyi plak kontrolü yapabilmeleri için hastalarını eğitmeleri önemlidir. Anahtar kelimeler: Dişeti büyümesi, kalsiyum kanal blokörü, hipertansiyon, amlodipin ABSTRACT Calcium channel blockers are among the most widely used drugs in the treatment of cardiovascular problems such as hypertension, angina pectoris and cardiac arrhythmia. These drugs cause gingival overgrowth as a side effect. Amlodipine is one of the calcium channel blocker, which is used to treat hypertension. Many studies have been shown that, amlodipine triggers gingival growth as other calcium channel blockers. In this case, the clinical features and developing treatment protocols of gingival enlargement due to use of amlodipine have been presented. A 77-years-old female patient who has used amlodipine for 3 years for hypertension referred to our clinic with the complain of maxillary massive gingival overgrowth causing functional and esthetic problems. The treatment aspect included scaling and root planning (SCRP), substitution of the drug, the surgical excision and the maintenance and supportive therapy resulting in excellent clinical outcome. Treatment of drug-induced gingival overgrowth includes cessation or replacement of the drug and decreasing other risk factors with meticulous mechanical and chemical plaque control. Excision of excessive gingival tissue should be reserved for severe cases that affect oral hygiene or functionality, or can be performed for cosmetic reasons. It is important that dentists are aware that individuals taking calcium channel blockers need to demonstrate excellent plaque control to reduce their risk of developing gingival overgrowth.

show abstract

“…Se asocia desde factores locales, como la presencia de biofilm bacteriano, hasta factores sistémicos y una predisposición genética. Se ha descrito que el metabolito OL-17 de la ciclosporina podría interactuar con cierta subpoblación fenotípicamente distinta del fibroblasto gingival, desencadenando en el aumento de la síntesis de proteínas y proliferación celular 11 . Estudios in vitro en fibroblastos humanos han ratificado una variedad de respuestas celulares individuales en su proliferación 11 .…”

unclassified

“…Se ha descrito que el metabolito OL-17 de la ciclosporina podría interactuar con cierta subpoblación fenotípicamente distinta del fibroblasto gingival, desencadenando en el aumento de la síntesis de proteínas y proliferación celular 11 . Estudios in vitro en fibroblastos humanos han ratificado una variedad de respuestas celulares individuales en su proliferación 11 . Esta heterogeneidad fibroblástica también afecta la actividad sobre los tejidos de las colagenasas y metaloproteinasas.…”

unclassified

“…Esta heterogeneidad fibroblástica también afecta la actividad sobre los tejidos de las colagenasas y metaloproteinasas. Otra posible causa de la variabilidad de respuestas ante los pacientes expuestos a la ciclosporina A sería la expresión de cierto antíge-no linfocitario humano (HLA-DR1), el cual presentaría un rol protector ante el desencadenamiento de agrandamientos gingivales, a diferencia del HLA-DR2, el cual aumentaría el riesgo de desencadenar dicha entidad patológica 11 . En el tejido conectivo in vitro la ciclosporina A provocaría un aumento de la matriz, glicoaminoglicanos no sulfatados y en la síntesis colágena, pero no en la síntesis de ADN, con un aumento en el nivel de procolágeno tipo I 11 .…”

unclassified

See 1 more Smart Citation

Hiperplasia gingival por ciclosporina: A propósito de un caso

Bahamondes

Godoy

2007

Rev. méd. Chile

View full text Add to dashboard Cite

Gingival enlargement can be an adverse effect of ciclosporine A and nifedipine use. It has a high relapse rate if the drugs are not discontinued.There is a genetic predisposition to the development of this condition and dental biofilm can also play a role. We report a 64 years old male who received a renal allograft and was treated with cyclosporine and nifedipine. He required six surgical interventions for generalized gingival enlargement. After the sixth relapse, the patient was subjected to a periodontal treatment to eliminate the dental biofilm, which decreased the rate of recurrence of gingival enlargement (Rev Méd Chile 2007; 135: 370-74 M uchas de las enfermedades sistémicas y de las terapias farmacológicas indicadas en ellas, tienen repercusiones en la cavidad oral. Es así como algunos fármacos como anticonvulsivantes (fenitoína), inmunosupresores (ciclosporina A) y bloqueadores de canales de calcio (nifedipino, verapamil, diltiazem y valproato sódico) se vinculan a la aparición de agrandamientos gingivales. Algunos autores recomiendan cambiar el término hiperplasia por el de agrandamiento gingival, ya que el incremento en el tamaño del tejido es debido a un aumento en su estroma y no al número de sus células constituyentes 1 , término que ocuparemos para este trabajo. Se define como agrandamiento gingival al aumento exagerado y desfigurante del volumen de la encía, asociándose su aparición principalmente a fármacos 2,3 .Se describe que 30% de los pacientes que toman ciclosporina A desarrollan agrandamiento gingival, con una alta tasa de recidiva, aumentando su prevalencia al doble al encontrarse junto a nifedipino 4 , no poseyendo una etiología única, sino una serie de factores asociados 5,6 . Si bien es aceptada su relación directa con fármacos y el factor genético, entre otros, el rol del biofilm bacteriano (placa dental) ha sido controvertido [5][6][7][8][9] .La ciclosporina A es un potente inmunosupresor del grupo de inhibidores de la calcineurina, junto al tacrolimo, que actúa principalmente sobre el linfocito T por el bloqueo de la interleuquina 2. Indirectamente, altera la función monocitaria por la supresión de una variedad de linfoquinas del

show abstract

The role of drugs in the pathogenesis of gingival overgrowth. A collective review of current concepts

Cited by 120 publications

References 135 publications

Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

Kalsi̇yum Kanal Blokörü (Amlodi̇pi̇n) Kullanimina Bağli Di̇şeti̇ Büyümesi̇:5 Yil Taki̇pli̇ Vaka Raporu

Hiperplasia gingival por ciclosporina: A propósito de un caso

Contact Info

Product

Resources

About