Prevalence of gingival overgrowth induced by antihypertensive. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. The gingival enlargement is exacerbated by the inflammatory response to dental plaque, with most prominent overgrowth on the labial aspects of anterior teeth. Gingival overgrowth is a serious side effect that accompanies the use of amlodipine. Studies of patients taking this anticonvulsant drug suggest that bacterial plaque is an important determinant of the severity of phenytoininduced gingival overgrowth and stress the importance of instituting. Phenytoininduced gingival overgrowth management with. There are a number of causes for this condition, but its often a symptom of poor oral hygiene or a side effect of using. Druginduced gingival overgrowth does not originate in the periodontium, but it occurs exclusively in periodontal tissues and is generally not of the same magnitude in other tissues. To get the facts on exactly how to eliminate your uterine fibroids from. Conduct dental procedures on days that your patient with endstage renal disease does not undergo hemodialysis. On the cellular and molecular mechanisms of druginduced. In addition, the role of dental plaque as a critical risk factor in. It is sometimes associated with antiseizure medications such as phenytoin, immunosuppressant drugs such as those taken after organ transplantations and calcium channel.
Gums may appear red or bluishpurple before erupting teeth break through into the mouth. Since gingival overgrowth is a druginduced increase in extracellular matrix proteins, the treatment is based on discontinuing the offending medication if at preop view of the maxilla of a fiveyearold wheaton terrier with generalized idiopathic gingival hyperplasia. Gingival overgrowth has been linked to multiple factors such as adverse drug effects, inflammation, neoplastic processes, and hereditary gingival fibromatosis. Surgical management of gingival overgrowth pocket dentistry. Gingival enlargement or overgrowth is a common disease of gingiva.
These gingival overgrowths are usually treated by various modalities namely. Doctoral thesis university of medicine and pharmacy of. Article information, pdf download for molecular and clinical aspects. Recently it is known that gingival overgrowth may be a consequence of the administration of three groups of. The prevalence of phenytoininduced gingival hyperplasia is estimated at 15% to 50% in patients taking the medication 1,2 figures 401 and 402. Periodontology 2000, 21, 1999, 176196 munksgaard 1999 in. Gingival hypertrophy and reduced mouth opening of the patient. The location of the gingival zenith in a mediallateral position relative to the vertical. Poor periodontal hygiene is an important risk factor for severity of phenytoininduced gingival overgrowth pigo, which is a timedependent process. Treatment of druginduced gingival overgrowth by fullmouth. Jan 17, 2015 surgical management of gingival overgrowth aim.
Poor periodontal hygiene is an important risk factor for severity of. Both primary gingival extramedul lary plasmacytoma and multiple myeloma with the first presentation in gingival are. The overgrowth can be minimized with good plaque control, and removing orthodontic bands may make it easier to maintain. Pertinent management depends on precisely diagnosing the origin of enlargement. A 55yearold woman was admitted to our outpatient clinic for complaints of dry mouth, decreased mouth opening, gingival enlargement figure. Surgical treatment of gingival overgrowth with 10 years of followup. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation. The periodontal pocket depth was measured to the nearest millimeter. Gingival overgrowth go is a known sideeffect of calcium channel blockers. Molecular aspects of druginduced gingival overgrowth. Gingival hyperplasia can be seen in patients with familial gingival enlargement.
This condition is also known as gingival overgrowth, hypertrophic gingivitis or gingival hypertrophy. Gingival enlargement, also called gingival hyperplasia, is thickening or overgrowth of the gum tissues that surround the tooth. Pdf treatment of gingival enlargement researchgate. Organ rejection additional readings organ transplant. It is sometimes associated with antiseizure medications such as phenytoin, immunosuppressant drugs such as those taken after organ transplantations and calcium channel blockers including nifedipine, verapamil, diltiazem and amlodipine that are taken by some heart patients. Gingival enlargements and localized gingival overgrowths. Definition increase in size of gingiva or gingival overgrowth. Various risk factors associated with druginduced gingival overgrowth have been reported 7,8. Pdf on jul 26, 2019, shruti bhatnagar and others published treatment of gingival enlargement find, read and cite all the research you need on. Therefore, the response of the periodontium in oral contraceptive induced gingival overgrowth is. Although overgrowth occurred progressively over the study period, it continued at a decreased rate during the second year. Jun 10, 2014 gingival overgrowth go is a known sideeffect of calcium channel blockers.
The effective and predictable management of gingival overgrowth requires correct diagnosis and consideration of aetiological factors, as discussed in part 1 bdj 2017. Learn the shocking truth about uterine fibroids, drugs and surgeries. Associated gingival overgrowth ap pears to reach maximum severity 1218 months after initiating phenytoin treatment 1, 19, 90. The causative factors may range from inflammation due to local factors to. It is an increase in the size of the gingival tissues and thus the term overgrowth is many times used in place of the term hyperplasia. Having read this chapter, the reader should be aware of the contemporary surgical techniques used for the surgical management of gingival. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. This article reports a case of bbs in a boy who presented some typical oral manifestations added to a generalized gingival.
Since gingival overgrowth is a druginduced increase in extracellular matrix proteins, the treatment is based on discontinuing the offending medication if at preop view of the. Eruption depends on genetics, growth of the jaw, muscular. Root debridement was carried out with manual and ultrasonic instruments. The effect of a plaque control program on the development of phenytoinpht.
Simultaneous surgical excision of localized gingival. Although there have been several case reports, few studies have examined the prevalence of nifedipine. Thus the effective management of gingival enlargement needs a thorough diagnosis and then its disparate management. Although the gingival index and sulcus bleeding index have been widely used as. Severe antiepileptic druginduced gingival overgrowth in. Studies of patients taking this anticonvulsant drug suggest that bacterial plaque is an important. This study was conducted to determine the prevalence and risk factors for go in patients treated with calcium channel blockers. While gingival overgrowth is commonly associated with calcineurin inhibitors, particularly cyclosporine, a recent study showed that the occurrence of gingival overgrowth declined from 56. Druginduced gingival enlargement was first observed in patients who were taking phenytoin for epilepsy, with approximately 50% having gingival overgrowth. Figure 4 illustrates gingival overgrowth on a patient who has been taking phenytoin for several years. Once you merge pdfs, you can send them directly to your email or download the file to our computer and view.
The gingival overgrowth is a common finding in the clinical practice with a diverse etiology. Introduction gingival enlargement is a common feature of gingival disease and may be caused by fibrous. Pediatric oral pathology 1129 of the dense fibrous overgrowth. Inflamedgingival tissues are capable of metabolizing sex hormones to active metabolites at higher rate, thus, local irritants may exaggerate oral contraceptive induced gingival changes. In patients receiving cyclosporine for more than 3 months. Druginduced gingival overgrowth is a wellestablished adverse event. Oral contraceptives induced gingival overgrowth a clinical. Calcium channel blockers, gingival overgrowth, nifedipine.
Pdf merge combine pdf files free tool to merge pdf. Once files have been uploaded to our system, change the order of your pdf documents. Druginduced gingival overgrowth is a tissuespecific condition and is. Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Gingival hyperplasia treatment, symptoms, causes, pictures. Gingival inflammation acts as a predisposing factor. Gingival gum enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. The gingival overgrowth is normally confined to the attached gingiva but may extend coronally and interfere with aesthetics, mastication or speech1. Gingiva overgrowth an overview sciencedirect topics. Management of druginduced gingival enlargement australian. Read on to learn the facts about the condition, what causes it and how it is. Case report gingival extramedullary plasmacytoma converted to.
There are still many uncertainties regarding the ratio between gingivitis and gingival overgrowth. Molecular and clinical aspects of druginduced gingival overgrowth. On examination gingival enlargement localized in the organs 16,15,14,12,12,21,22,23,24,25,26 observed. Gingival hyperplasia is an overgrowth of gum tissue around the teeth. This paper presents a case of pigo hindering oral function and compromising oral. Appalling adverse effects of amlodipine in a chronic kidney. Gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. Pdf druginduced gingival overgrowth or enlargement manifests as abnormal growth of the gingiva due to an adverse drug reaction adr in. There are several causes of gingival enlargement and they can be. Nifedipine induced gingival hyperthropy in a patient with. Cyclosporin is an immunosuppressant which has been reported to cause gingival enlargement in 2580% of patients. A 55yearold woman was admitted to our outpatient clinic for complaints of dry mouth, decreased mouth opening, gingival.
Potential risk factors for the drug induced gingival overgrowth include, poor oral hygiene, periodontal disease, periodontal pocket depth, degree of microbial plaque accumulation, and duration and dose of the drug. Oral conditions in children with special needs a guide for health care providers oral development tooth eruption may be delayed, accelerated, or inconsistent in children with growth disturbances. December 15, 2006 email to a colleague synonyms and related keywords. Few reports in the literature have described the oral manifestations of bbs. Gingival enlargements generalised pocket dentistry. Most commonly, gingival overgrowth is a plaqueinduced inflammatory process, which can be modified by systemic disease or medications. Several conflicting theories have been proposed to explain the fibroblasts function in gingival overgrowth. Most commonly, gingival overgrowth is a plaqueinduced inflammatory process, which. Although there have been several case reports, few studies have examined the prevalence of nifedipine, diltiazem, and amlodipine. Gingival hyperplasia can be seen in patients with familial gingival enlargement, pregnancy and leukemia.
To provide a brief overview of the aetiology of gingival overgrowth, and describe the principles of and techniques for its surgical management. Gingival zenith positions and levels of the maxillary. Gingival hyperplasia is a medical condition in which the gums increase in size. Below are the links to the authors original submitted files for images. Sep 16, 2015 gingival enlargement or gingival overgrowth, a common trait of gingival disease, is characterized by an increase in the size of gingiva. To provide a brief overview of the aetiology of gingival overgrowth, and describe the principles of and techniques for its surgical. A gingival overgrowth can show in the first part a proliferation of the collagen fibres and secondly it can be inflamatory, or it cand be inflamatory and become fibrous lundergan, 2003. Organ rejection additional readings organ transplant patient. There are no treatment guidelines defined for this oral lesions. This chapter aims to provide an overview of the causes, features and management of generalised gingival swellings, which involve the free andor. The causative factors may range from inflammation due to local factors to conditioned enlargement and neoplastic enlargements. Gingival hyperplasia is an enlargement or overgrowth of the gum tissue, also known as the gingiva, around the necks of the teeth. Treating patients with druginduced gingival overgrowth.
Plaque accumulation on teeth causes gingival inflammation and its resultant enlargement. When gingival fibromatosis causes gum overgrowth, the main issue is aesthetic but with other causes of gum overgrowth, the gums can become swollen, red and may bleed along with looking unattractive. Case report gingival extramedullary plasmacytoma converted. A film of plaque adhering to the free gingival margin and adjacent area of the. Gingival zenith positions and levels of the maxillary anterior dentition stephen j.
Simultaneous surgical excision of localized gingival overgrowth and papilla reconstruction with subepithelial connective tissue graft. The only way to know the cause of gum overgrowth in a certain patient is through a dental andor medical exam. Amlodipine, calcium channel blocker, gingival overgrowth, gum hyperplasia. Gingival enlargement can be caused by a number of factors, including inflammatory.
Gingival enlargement is the term now used to describe medicationrelated. An overgrowth or increase in size of the gingiva is termed as gingival enlargement, also known as gingival hyperplasia, gingival overgrowth or gingival hypertrophy. By contrast, gingival overgrowth refers to an increase in gingival volume due to an excessive accumulation of extracellular matrix proteins. This paper presents a case of pigo hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. However, rare genetic conditions can result in gingival overgrowth with nonplaqueinduced aetiology. Severe antiepileptic druginduced gingival overgrowth in a. Nevertheless, the overgrowth involves the gingival margin with extension to. There are several types available, which will be discussed further down but two of the most important ones are the one induced by different medication and the one. Both primary gingival extramedul lary plasmacytoma and multiple myeloma with the first presentation in gingival are extremely rare, and yet for this case, we diagnosed as a primary gingival extramedullary plasmacytoma that had progressed to multiple myeloma. Druginduced gingival overgrowth is a sideeffect and unwanted outcome of systemic medication and is limited to gingival tissues. In early stages, this gingival enlargement is usually located in the area of the interdental papilla.
Introduction gingival overgrowth is a kind of painless condition, regarded as enormous enlargement. Treatment of gingival overgrowth in a child with bardet. Druginduced gingival overgrowth is a side effect associated with 3 types of drugs. Druginduced gingival overgrowth or enlargement occurs in whole or in part from systemic drug use. One of the main drugs associated with go is the antiepileptic. Druginduced gingival overgrowth is a common finding in the modern era. The management of drug induced gingival overgrowth dr. Gingival enlargement is an increase in the size of the gingiva gums. Further, indepth studies are needed to establish the link between drugs and gingival enlargement for prevention and improved treatment. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized isolated, discrete, regional. The effect of a plaque control program on the development of. Druginduced gingival overgrowth does not originate in the periodontium. Phenytoininduced gingival overgrowth pigo is a common complication of the continuous use of medications. Taken after tooth eruption, these drugs produce overgrowth beginning at the interdental papillae.
Surgical management of druginduced gingival overgrowth. The overgrowth can be minimized with good plaque control, and removing orthodontic bands may make it easier to maintain good oral hygiene. It occurs as a side effect following the administration of drugs. Gingival overgrowth induced by drugs such as phenytoin, nifedipine, and cyclosporin develops due to an increase in the connective tissue extracellular matrix. Gingival overgrowth is a wellknown consequence of administration of certain group of drugs.