Gingival overgrowth and associated factors in a population of Nigerian hypertensives

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.

Bibliometric Analysis of Research Trends And Characteristics of Drug-Induced Gingival Overgrowth

Objectives: Drug-induced gingival overgrowth (DIGO) is a common adverse drug reaction generally caused by the cyclosporine, phenytoin and nifedipine which belong to the category of immunosuppressant, anticonvulsant and calcium channel blocker respectively. The objective of the bibliometric analysis was to depict main citation characteristics and analyze research trend in the field of DIGO.Methods: An exhaustive search was performed in the Scopus database for the bibliometric list of DIGO in the syntax. The information related to the number of citations, drugs related to DIGO, study topic and design, authorship, year of publication, journal, contributing institution, country of origin and department was extracted.Results: A total of 399 papers on DIGO were retrieved. The total number of citations and that after removal of self-citations is 7814 and 7314, respectively. The mean number of citations is 19.6, with a range of 0 to 608. Article (76.9%) and review (19.5%) are the main paper types. A remarkable increasing trend in the number of citations is observed since 1994. Cyclosporine (45%) is the most common used drug which has close relation with DIGO, followed by nifedipine, phenytoin (both are 18%), amlodipine (7%). Review (28%) constitutes the most design in the study of DIGO. According to the top 20 keywords, the risk factors and pathogenesis of DIGO have been the hot area of research for several years.Conclusions: The bibliometric study is the first of its kind to identify the top-cited articles and their main characteristics and research trend of DIGO. Risk factors and pathogenesis is the hotspot of research in the field of DIGO. More high level of scientific evidence on DIGO, such as systematic reviews and randomized controlled trials, are encouraged to serve as good helper to reduce the incidence and severity of DIGO.

PERIPHERAL CEMENTO-OSSIFYING FIBROMA – A CASE REPORT

Peripheral cemento-ossifying fibroma is a gingival overgrowth that occurs most commonly on the gingiva. It is a slow-growing reactive lesion. It is a benign tumor that grows to a considerable size and leads to pathologic migration of the teeth at later stages. It most commonly occurs following a gingival irritation or trauma. These lesions are said to arise from the PDL fibers excision of these lesions along with the periosteum is very important to avoid recurrence. The recurrence rate of peripheral cemento-ossifying fibroma has been reported to be 8–20%, so a close postoperative follow-up is required. Here, we are presenting two case of peripheral cemento-ossifying fibroma in the mandible.

Amlodipine Induced Gum Hypertrophy – A Rare Case Report

Background: DIGO or drug-induced gingival overgrowth occurs as a side effect of certain drugs. Until now, the etiology of drug-induced gingival overgrowth is not clearly understood. Among the calcium channel blockers, nifedipine has been shown to be most frequently associated with drug-induced gingival hyperplasia. Amlodipine is a comparatively newer calcium channel blocker that witha longer duration of action and lesser side effects as compared to nifedipine. There are only certain case reports of amlodipine-induced gum hyperplasia. Case presentation: We report a case of amlodipine-induced gum hyperplasia in a 66-year-old hypertensive patient taking amlodipine at a dose of 5 mg once a day. There was significant regression of gum hypertrophy after substitution of amlodipine by Losartan. Conclusion: Amlodipine is one of the commonly prescribed antihypertensive drugs, and gingival hyperplasia is one overlooked side effect in patients taking amlodipine. Awareness of this potential side effect of amlodipine may be helpful to reduce the anxiety of patients and the cost of diagnostic procedures.