scholarly journals Localised Gingival Overgrowth in Patient taking Amlodipine

2020 ◽  
Vol 4 (2) ◽  
pp. 96-99
Author(s):  
Arjun Hari Rijal ◽  
Bhageshwar Dhami ◽  
Nashib Pandey ◽  
Deepa Aryal ◽  
Kamana Neupane
Keyword(s):  
Side Effects ◽  
Male Patient ◽  
Treatment Modalities ◽  
Third Generation ◽  
Middle Aged ◽  
Drug Induced ◽  
Aged Patients ◽  
Gingival Overgrowth ◽  
Drug Substitution ◽  
Gingival Enlargement

 Gingival enlargement is an increase in the size of gingiva. It is one of the side effects of systemic administration of antihypertensives, anticonvulsants, and immunosuppressants. Amlodipine, a new third-generation dihydropyridine, very useful in middle-aged to older aged patients for various cardiovascular conditions can cause gingival enlargement. Treatment modalities for drug induced gingival enlargement include removal of local irritating factors, meticulous plaque removal and drug substitution after consultation with a physician. This article reports an amlodipine induced gingival enlargement and its treatment in a 40 years old hypertensive male patient.

scholarly journals Oral Contraceptives Induced Gingival Overgrowth – A Clinical Case Report

2017 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Anushi Mahajan ◽  
Ritesh Sood
Keyword(s):  
Oral Contraceptives ◽  
Oral Hygiene ◽  
Periodontal Therapy ◽  
Response To Therapy ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Periodontal Tissues ◽  
Hygiene Measures ◽  
Nonsurgical Periodontal Therapy ◽  
Gingival Enlargement

Aim: The purpose of this article is to report a case of drug induced gingival enlargement due to oral contraceptives, managed by nonsurgical periodontal therapy. Background: Drug-induced gingival overgrowth remains the most widespread unwanted effect of systemic medication on the periodontal tissues. Hormones are specific regulatory molecules that modulate a host of body functions. Oral contraceptives that contain estrogen and/or progesterone are associated with gingival enlargement. Report: A 32-year-old female presented with a complaint of swelling of the gingiva with spontaneous bleeding in the mandibular anterior region for a period of two years. The health history documented the use of contraceptives for two years, and a clinical examination revealed the existence of poor oral hygiene and enlarged painful gingival tissues that bled when touched. Summary: Females on oral contraceptives can be considered as a “risk group” for periodontal diseases. Not all females on oral contraceptives respond in similar way. Plaque control is the most important procedure in periodontal therapy. Although the initial picture presented the possibility of surgical intervention, the clinical problems were resolved with non-surgical treatment. Another factor contributing to response to therapy is patient compliance. The patient followed home care instructions well and was effective in personal oral hygiene measures. Keywords: Gingival enlargement, Sex hormones, Oral contraceptives.

scholarly journals Benign Cystic Mesothelioma: A Rare Cause for Scrotal Swelling

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
A. Aber ◽  
A. Tahir ◽  
V. Arumuham ◽  
G. Smith ◽  
S. Almpanis
Keyword(s):  
Male Patient ◽  
Unusual Case ◽  
Rare Occurrence ◽  
Middle Aged ◽  
Tunica Vaginalis ◽  
Aged Patients ◽  
Scrotal Swelling ◽  
Cystic Mesothelioma

Benign cystic mesothelioma of the tunica vaginalis is a rare occurrence. It usually presents with painless gradual swelling in the scrotum. These types of benign mesotheliomas typically occur in the peritoneum and usually affect young to middle-aged patients. We present in this case an unusual case of benign cystic mesothelioma of the tunica vaginalis in a 77-year-old male patient.

scholarly journals An Update on the Mechanisms of Phenytoin Induced Gingival Overgrowth

2019 ◽  
Vol 13 (1) ◽  
pp. 430-435 ◽  
Author(s):  
Fathima Fazrina Farook ◽  
Mohamed Nuzaim M. Nizam ◽  
Abdulsalam Alshammari
Keyword(s):  
Web Of Science ◽  
Molecular Level ◽  
Gingival Hyperplasia ◽  
Pathophysiological Mechanism ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Gingival Enlargement ◽  
High Prevalence ◽  
Central Database ◽  
Inflammatory Changes

Background: Phenytoin induced gingival overgrowth, a side effect with multifactorial aetiology, is characterized by an increase in the volume of extracellular tissues, particularly collagenous components, with varying degrees of inflammation. Objective: The aim of this paper is to review the available literature regarding the pathophysiological mechanisms of phenytoin induced gingival overgrowth. Methods: A thorough literature search of the PubMed/ Embase/ Web of science/ Cochrane central database was conducted to identify the mechanisms involved in the process of phenytoin-induced gingival overgrowth using the following keywords: Phenytoin; Anticonvulsant; Gingival Overgrowth; Gingival Enlargement, Gingival Hyperplasia; Drug Induced Gingival Enlargement; Drug Induced Gingival Overgrowth Results: According to the available evidence, several mechanisms have been proposed addressing the pathophysiological mechanism of phenytoin induced gingival overgrowth both at a cellular and molecular level. Evidence suggests that the inflammatory changes in the gingival tissues orchestrate the interaction between phenytoin and fibroblasts particularly resulting in an increase in the extracellular matrix content. Conclusion: However, the mechanism of production of inflammatory mediators is not fully understood. This, together with the high prevalence of Phenytoin induced gingival overgrowth, warrants further research in this area in order to develop treatment and preventive strategies for the management of this condition.

scholarly journals On the Cellular and Molecular Mechanisms of Drug-Induced Gingival Overgrowth

2017 ◽  
Vol 11 (1) ◽  
pp. 420-435 ◽  
Author(s):  
Albert Ramírez-Rámiz ◽  
Lluís Brunet-LLobet ◽  
Eduard Lahor-Soler ◽  
Jaume Miranda-Rius
Keyword(s):  
Extracellular Matrix ◽  
Molecular Mechanisms ◽  
Phenotypic Variability ◽  
Membrane Receptors ◽  
Gingival Tissue ◽  
Inflammatory Factor ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Pubmed Database ◽  
Gingival Enlargement

Introduction: Gingival overgrowth has been linked to multiple factors such as adverse drug effects, inflammation, neoplastic processes, and hereditary gingival fibromatosis. Drug-induced gingival overgrowth is a well-established adverse event. In early stages, this gingival enlargement is usually located in the area of the interdental papilla. Histologically, there is an increase in the different components of the extracellular matrix. Objective: The aim of this manuscript is to describe and analyze the different cellular and molecular agents involved in the pathogenesis of Drug-induced gingival overgrowth. Method: A literature search of the MEDLINE/PubMed database was conducted to identify the mechanisms involved in the process of drug-induced gingival overgrowth, with the assistance of a research librarian. We present several causal hypotheses and discuss the advances in the understanding of the mechanisms that trigger this gingival alteration. Results: In vitro studies have revealed phenotypic cellular changes in keratinocytes and fibroblasts and an increase of the extracellular matrix with collagen and glycosaminoglycans. Drug-induced gingival overgrowth confirms the key role of collagenase and integrins, membrane receptors present in the fibroblasts, due to their involvement in the catabolism of collagen. The three drug categories implicated: calcineuron inhibitors (immunosuppressant drugs), calcium channel blocking agents and anticonvulsant drugs appear to present a multifactorial pathogenesis with a common molecular action: the blockage of the cell membrane in the Ca2+/Na+ ion flow. The alteration of the uptake of cellular folic acid, which depends on the regulated channels of active cationic transport and on passive diffusion, results in a dysfunctional degradation of the connective tissue. Certain intermediate molecules such as cytokines and prostaglandins play a role in this pathological mechanism. The concomitant inflammatory factor encourages the appearance of fibroblasts, which leads to gingival fibrosis. Susceptibility to gingival overgrowth in some fibroblast subpopulations is due to phenotypic variability and genetic polymorphism, as shown by the increase in the synthesis of molecules related to the response of the gingival tissue to inducing drugs. The authors present a diagram depicting various mechanisms involved in the pathogenesis of drug-induced gingival overgrowth. Conclusion: Individual predisposition, tissue inflammation, and molecular changes in response to the inducing drug favor the clinical manifestation of gingival overgrowth.

scholarly journals Biology of Drug-Induced Gingival Hyperplasia: In Vitro Study of the Effect of Nifedipine on Human Fibroblasts

2021 ◽  
Vol 11 (7) ◽  
pp. 3287
Author(s):  
Dorina Lauritano ◽  
Giulia Moreo ◽  
Fedora Della Vella ◽  
Annalisa Palmieri ◽  
Francesco Carinci ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Real Time ◽  
Human Fibroblasts ◽  
Control Group ◽  
Gingival Hyperplasia ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Drug Concentrations ◽  
Gingival Enlargement ◽  
E Cadherin

Background: It has been proven that the antihypertensive agent nifedipine can cause gingival overgrowth as a side effect. The aim of this study was to analyze the effects of pharmacological treatment with nifedipine on human gingival fibroblasts activity, investigating the possible pathogenetic mechanisms that lead to the onset of gingival enlargement. Methods: The expression profile of 57 genes belonging to the “Extracellular Matrix and Adhesion Molecules” pathway, fibroblasts’ viability at different drug concentrations, and E-cadherin levels in treated fibroblasts were assessed using real-time Polymerase Chain Reaction, PrestoBlue™ cell viability test, and an enzyme-linked immunoassay (ELISA), respectively. Results: Metalloproteinase 24 and 8 (MMP24, MMP8) showed significant upregulation in treated cells with respect to the control group, and cell adhesion gene CDH1 (E-cadherin) levels were recorded as increased in treated fibroblasts using both real-time PCR and ELISA. Downregulation was observed for transmembrane receptors ITGA6 and ITGB4, the basement membrane constituent LAMA1 and LAMB1, and the extracellular matrix protease MMP11, MMP16, and MMP26. Conclusions: The obtained data suggested that the pathogenesis of nifedipine-induced gingival overgrowth is characterized by an excessive accumulation of collagen due to the inhibition of collagen intracellular and extracellular degradation pathways.

scholarly journals Gingival overgrowth and associated factors in a population of Nigerian hypertensives

2021 ◽  
Vol 12 (3) ◽  
pp. 164-174
Author(s):  
Soroye Modupeoluwa Omotunde ◽  
Sorunke Modupeore Ekua
Keyword(s):  
Oral Hygiene ◽  
Associated Factors ◽  
Statistical Significance ◽  
Gingival Tissue ◽  
Age Group ◽  
Gingival Inflammation ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Hygiene Measures ◽  
Gingival Enlargement

Background: Gingival overgrowth may be idiopathic or secondary. Drug Induced Gingival Overgrowth (DIGO) occurs within 3 months of treatment and is more prevalent in younger age group with predilection for the anterior gingival tissue and usually not associated with attachment loss or tooth mobility unless there is an existing periodontal disease. Methodology: 170 hypertensive patients were recruited for the study; 85 calcium channel blocker (CCB) and 85 non-CCB users. Interviewer-administered questionnaires was used to obtain socio-demographic information as well as medical and drug history. GO was assessed using New Clinical Index for DIGO and data was analyzed with SPSS version 21 (Armonk, NY: IBM Corp). Continuous and nominal variables were described with means, standard deviations and frequencies. Statistical significance was set at P < 0.05. Results: Amlodipine was the most commonly used CCB. The prevalence of DIGO in CCB and non-CCB was the same (49.5%). Gingival enlargement was found equally among both sexes in the CCB and non-CCB groups. A third of the participants with GO were 70 years and above while those without were majorly in the fifth and sixth decade of life. Two-third of those with DIGO had fair oral hygiene status, two-fifth had gingival bleeding and three-fifth had mild gingival inflammation. Those without DIGO in both groups had a slight female predominance and majorly good oral hygiene. Associated factors with DIGO were female sex, 60-69 age group, 10mg drug dosage, been on medication less than 10 years, mild gingival inflammation and generalized gingivitis. Conclusion: There was no difference in the prevalence of DIGO between BBC and non-BBC users. However, there was mild gingival inflammation in all participants with DIGO and amlodipine users were three times more at risk of developing DIGO than nifedipine users. Thus, it is imperative to advise the hypertensives on the importance of maintaining adequate oral hygiene measures and incorporate periodontal care in their management so as to ameliorate the side effects of their medication.

scholarly journals Estimation of Bcl-2 and Ki-67 in Gingival Epithelium of Epileptic Patients

2020 ◽  
Vol 7 (3) ◽  
pp. 53-58
Author(s):  
Mohamed Helmy Salama ◽  
Abdelraheem R. Algendy ◽  
Saleem Shaikh
Keyword(s):  
Side Effects ◽  
Proliferative Activity ◽  
Gingival Tissue ◽  
Oral Epithelium ◽  
Drug Induced ◽  
Ki 67 ◽  
Gingival Overgrowth ◽  
Oral Side ◽  
Epileptic Patients ◽  
Gingival Epithelium

Abstract   Introduction: Gingival overgrowth is one of several oral side effects of phenytoin, a potent antiepileptic drug.  Several mechanisms have been elucidated to understand the pathogenesis of drug induced gingival overgrowth. The frequency of gingival overgrowth associated with chronic phenytoin therapy remains controversial. and the possible subclinical effects of this drug on the gingival epithelium should be investigated histopathologically and immunohistochemically. Purpose of the study: To investigate the Bcl-2 for apoptosis rate and Ki-67 for the epithelial proliferative activity in epileptic patients. Materials and methods: Twenty four samples of gingival tissue from epileptic patients treated with phenytoin and in eight samples of gingival tissue from healthy patients who didn’t use phenytoin (control) were evaluated for Bcl-2 and Ki-67 immunohistochemically. Results: The results revealed moreproliferative activity of the overlying epithelium and an increased pattern of Bcl-2 and Ki-67 in phenytoin users compared to controls. Conclusion: These results concluded that the increased epithelial thickness observed in phenytoin induced gingival overgrowth is associated with increased apoptotic rate and mitotic activity , especially in the oral epithelium.   Keywords: Gingival overgrowth, Bcl-2, Ki-67, Phenytoin.

scholarly journals Cyclosporine A and amlodipine induced gingival overgrowth in a kidney transplant recipient: case presentation with literature review

2019 ◽  
Vol 12 (5) ◽  
pp. e229587 ◽  
Author(s):  
Tarun Nanda ◽  
Baljeet Singh ◽  
Parul Sharma ◽  
Karandeep Singh Arora
Keyword(s):  
Calcium Channel ◽  
Kidney Transplant ◽  
Cyclosporine A ◽  
Calcium Channel Blockers ◽  
Kidney Transplant Recipient ◽  
Kidney Transplant Patient ◽  
Channel Blockers ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Gingival Enlargement

Drug-induced gingival overgrowth is a condition caused by side effects of treatment with one of three types of drugs: phenytoin (used in epilepsy treatment), cyclosporine A (used in transplantology after allogenic organ transplants) and calcium channel blockers (used in the treatment of hypertension). Gingival overgrowth leads to inflammation within the gums and periodontium and can amplify the existing periodontal disease leading to tooth loss. Patients who have undergone kidney transplant are given immunosuppressants to prevent transplant rejection and mostly it is accompanied with calcium channel blockers to treat hypertension associated with kidney transplant. This article reports a case of recent gingival enlargement associated with cyclosporine A and amlodipine given to a kidney transplant patient from the past 11 years.

scholarly journals A clinico-histopathological report on low dose of amlodipine: A third-generation calcium channel blocker-induced gingival overgrowth

2021 ◽  
Vol 7 (3) ◽  
pp. 182-185
Author(s):  
Vinayaka Ambujakshi Manjunatha ◽  
Gayathri Gunjiganur Vemanaradhya ◽  
Triveni Mavinakote Gowda
Keyword(s):  
Arterial Hypertension ◽  
Calcium Channel ◽  
Mechanism Of Action ◽  
Low Dose ◽  
Channel Blocker ◽  
Vital Role ◽  
Third Generation ◽  
Drug Induced ◽  
Gingival Overgrowth ◽  
Histopathological Report

This clinical & histopathological report describes the clinical features, mechanism of action on drugs causing drug-induced gingival overgrowth (DIGO), diagnosis and management of patients with arterial hypertension with the regular usage of amlodipine drug. The report also highlights the importance of an involvement of cardiologist and his/her vital role in the management of amlodipine-induced gingival overgrowth.

scholarly journals Agrandamiento gingival inducido por medicamentos. Reporte de un caso clínico / Drug-Induced Gingival Overgrowth. A Clinical Case Report

2018 ◽  
Vol 36 (77) ◽  
Author(s):  
Laura Vanessa Cañas Díaz ◽  
María Isabel Pardo Silva ◽  
Silie Soad Arboleda Salaimán
Keyword(s):  
Oral Hygiene ◽  
Treatment Plan ◽  
Treatment Protocol ◽  
Plaque Index ◽  
Channel Blockers ◽  
San Jose ◽  
Drug Induced ◽  
Support Design ◽  
Gingival Overgrowth ◽  
Gingival Enlargement

RESUMEN. Antecedentes: el agrandamiento gingival inducido por medicamentos es una condición clínica frecuente en pacientes que ingieren anticonvulsivantes, inmunosupresores y bloqueadores de los canales de calcio. La prevalencia de agrandamiento gingival inducido por medicamentos es de 3 - 20 % en comparación con otras condiciones gingivales inflamatorias. Todos estos medicamentos producen lesiones clínicas y características histológicas indistinguibles unas de otras, que llegan a comprometer la función y la estética de los pacientes afectados. Propósito: Describir el manejo terapéutico integral y el seguimiento a 12 meses de una paciente con agrandamiento gingival inducido por tacrolimus y amlodipino. Descripción del caso: Paciente de 22 años con discapacidad mental limítrofe, receptora de trasplante renal fue remitida al servicio de Odontología del Hospital Infantil Universitario de San José (Bogotá, Colombia) por presentar agrandamiento gingival. El examen clínico mostró un índice de placa de O’Leary del 84,3 %, inflamación generalizada y bolsas gingivales de 4 a 6 mm. El protocolo de tratamiento periodontal fue revisado por el equipo de trasplante renal e incluyó: trabajo con la familia para red de apoyo, diseño de un programa personalizado de higiene oral, gingivectomía y mantenimientos periodontales periódicos. Esta estrategia terapéutica permitió reducir el índice de placa y lograr un resultado clínico favorable. Conclusión: La condición sistémica y psicológica de la paciente determinó desarrollar un plan de tratamiento ajustado a sus necesidades. Pacientes susceptibles deben ser instruidos sobre la importancia de tener unas prácticas adecuadas de higiene oral y ameritan ser incluidos en un programa de mantenimiento periodontal.ABSTRACT. Background: drug-influenced gingival enlargement, is a frequent clinical condition in patients who ingest anticonvulsant, immunosuppressant and calcium channel blockers. The prevalence of gingival overgrowth due to prescribed medications ranges from 3% to 20% in comparison to other gingival inflammatory conditions. These drugs produce clinical lesions and histological characteristics that are indistinguishable from one another, which compromise the function and aesthetics of the affected patients. Purpose: To describe the total therapeutic management and the clinical follow up at 12-months from a patient with gingival enlargement induced by tacrolimus and amlodipine. Case description: A 22-year-old patient with borderline mental disability who received a kidney transplant was referred to San Jose Hospital - Medical Dental Unit (Bogotá, Colombia) presenting gingival enlargement. The clinical examination revealed an O'Leary plaque index of 84.3%, generalized inflammation, and gingival pockets of 4 to 6 mm. The periodontal treatment protocol was reviewed by the transplant team and included: family engagement to create a network for support, design of a personalized program for oral hygiene, gingivectomy and periodic periodontal maintenance. This therapeutic strategy allowed to reduce the plaque index and achieve favorable clinical result.  Conclusion: The systemic and psychological condition of the patient established the development of a treatment plan adjusted to her needs. Susceptible patients need to be instructed about the importance of adequate oral hygiene practices and should be included in a maintenance periodontal program.

Sign in / Sign up

Export Citation Format

Share Document