Drug-induced gingival enlargement is commonly seen among patients in the dental practice, and can be caused by a variety of medication classes. Since its discovery by Borel et al in 1977, cyclosporine A has become the most commonly prescribed drug for preventing organ rejection.10 It can exert serious side effects, unfortunately, including nephrotoxicity, induction of a diabetic state, chronic headaches and disfiguring gingival enlargement (Figure 5). July 10, 2017. In the valproate group, the duration of the treatment had a significant effect on gingival enlargement (P < .001) but not on gingival index, plaque index, and probing depth values (P > .05). Gingival enlargement can present with different forms, ranging from noninflamed, firm, and fibrous gingiva to gingival tissue dominated by edema, erythema, and bleeding. Initiated by both systemic and inflammatory factors, gingival enlargement is often caused by the use of commonly prescribed medications. Free gingival graft. Undiagnosed or poorly controlled diabetes is a major culprit, causing generalized inflammatory gingival enlargement and significant periodontal destruction. This is called gingival hyperplasia or gingival overgrowth. The disfiguring excessive tissue often hinders proper oral hygiene practices, therefore accompanied by periodontitis, tooth mobility, and even pathological tooth migration in extreme cases. Found insideHealth Sciences & Professions We'll assume you're ok with this, but you can opt-out if you wish. Among patients diagnosed with acute myeloblastic leukemia, 5% experience gingival enlargement as the first complication.16,17 Leukemia is a malignant disease, and its successful resolution depends on early diagnosis and treatment. Surgical excisions of the enlarged tissue by gingivectomy can eliminate the pseudopockets—restoring tissue architecture, appearance, and function. List the treatment options available for gingival enlargement. Landmark article Sept17, 1938: Sodium diphenyl hydantoinate in thetreatment of convulsive disorders. Gingival (gum) overgrowth is often caused by inflammation. Bethesda, MD 20894, Copyright Pernu HE, Pernu LM, Huttunen KR,Nieminen PA, Knuuttila ML. The formal continuing education programs of this program provider are accepted by the AGD for Fellowship/Mastership and membership maintenance credit. Your email address will not be published. These cases usually require surgical intervention to remove the excess fibrotic gingival tissue, but recurrence of the lesions is unpredictable. Before and after braces removal and laser contouring of the gums to remove the overgrown gums, or gingival enlargment. Accept These lesions lack distinguishable clinical markers from plaque-associated lesions, and may be difficult to diagnose. Kimball OP. This procedure is performed with blades, surgical knives, electrosurgical units or lasers (Figure 7). Friskopp J, Klintmalm G. Gingival enlargement. MeSH Drugs that most common cause gingival enlargement include anticonvulsants, calcium channel blockers, and immunosuppressants. Prevalence and risk of gingival enlargement in patients treated with nifedipine. The local nature of these lesions — along with the clinical signs and symptoms, and patient medical and dental history — help to differentiate them from gingival enlargement caused by medication use. It might also be caused by genetic factors, systemic conditions (including . This second edition of 'Oral and Maxillofacial Medicine' continues to present the basics of the speciality in an accessible and digestible format. In severe cases, the entire papillae and surrounding tissues are enlarged, giving the gingival tissues a lobulated appearance (Figure 6). ate the gingival enlargement within each group and its association with the patient's age, the dosage of the medication, the duration of the medication, the gingival index and the PI. They can be effective for the removal of hyperplastic gingival tissue and result in fast healing with only mild discomfort. The en­largement may be localized or generalized. Shiloah has contributed to textbooks and refereed journals, and also presents continuing education courses to dental professionals domestically and abroad. Seymour RA, Smith DG, Turnbull DN. There are two main categories of gingival diseases: . Gingival overgrowth is associated with systemic use of anticonvulsant drugs used for treatment of epilepsy, immunosuppressive drugs used to avoid host rejection of grafted tissues and calcium channel blockers used as antihypertensive drugs. In this paper, inflammatory gingival enlargement and treatment was presented. Recurrence can occur as early as three to six months following the intervention, and affects as many as 40% of patients.25 Recurrence is more common among those with poor oral hygiene or who lack access to professional care (Figure 8). Prevalence of amlodipine-related gingival hyperplasia. Medical providers may replace CCBs with beta blockers, diuretics, or angiotensinconverting enzyme inhibitors—none of which affect the oral tissues. Miranda J, Brunet L, Roset P, Berini L, Farré M, Mendieta C. J Clin Periodontol. It seems likely that the use of medications for treatment of medical conditions and the potential to cause gingival overgrowth will increase in the years to come. They are considered first-choice anti-hypertensive drugs for . Scott Froum, DDS. Johnson RB, Zebrowski EJ, Dai X. Synergistic enhancement of collagenous protein synthesis by human gingival fibroblasts exposed to nifedipine and interleukin-1-beta in vitro. Gingivitis, periodontitis, dental caries, diseases of dental pulp and periapical tissues, abnormal wearing of teeth, complications following tooth extraction and oral surgery. Gingival enlargement induced by anticonvulsants is significantly higher among children and institutionalized patients. Demirer S, Ozdemir H, Sencan M,Marakoglu I. Gingival hyperplasia as an earlydiagnostic oral manifestation in acutemonocytic leukemia: a case report. Casetta I, Granieri E, Desidera M, et al.Phenytoin-induced gingival overgrowth: Acommunity-based cross-sectional study inFerrara, Italy. Centrix Announces the Release of FluoroDose LolliTray Packaging, Wingers Integrated Barrier by Steri-Shield, Orthodontic Industry Innovators Deliver 21st Century Practice Efficiency and…. Scurvy, the result of vitamin C deficiency, is quite rare, but patients affected by this condition may experience severe gingival swelling and bleeding, accompanied by mobile teeth. © 2021 - Decisions in Dentistry • All Rights Reserved. Gingival enlargement (GE) is a condition in which the size of the gingiva increases, which can be caused by inflammation, systemic disease, or certain medications [].Three classes of drugs known to cause GE are anticonvulsants, anti-hypertensives (specifically calcium-channel blockers), and immunosuppressants [2,3].In patients presenting with periodontitis and gingival . The medications can promote gingival enlargement in the presence of plaque biofilm. Explain the etiology of and risk factors for drug-induced gingival enlargement. Swollen gums, or gingival swelling, is a painful condition in which gums are irritated, sensitive, or bleed easily. Johnson RB, Zebrowski EJ, Dai X. Synergisticenhancement of collagenous protein synthesisby human gingival fibroblasts exposed tonifedipine and interleukin-1-beta. Jorgensen MG. Gingival enlargement is a common characteristic of gingival disease and is manifested as an increase in the size of the gums. The first Australian edition of The Palliative Care Handbook provides guidelines for clinical management and symptom control for people receiving end-of-life care.The Palliative Care Handbook has two main sections - the first is a set of ... The expression gingival hyperplasia ("abnormal increase in the number of normal cells in a normal arrangement in an organ or tissue, which increase in volume") and gingival hypertrophy ("enlargement or overgrowth of an organ or part due to . Keywords: Gingival enlargement; Periodontal treatments; Etiological . 1997 Jul-Aug;64(4):294-7. Disclaimer, National Library of Medicine Initiated by both systemic and inflammatory factors, gingival enlargement is often caused by common prescription medications. The most common are the gingival enlargement, inflammation, pigmentations, gingival bleeding and osteonecrosis . Not all CCBs affect the gingiva in the same way. Gingival enlargement raises the risk of infection, caries and periodontal disease, and negatively affects smile esthetics. A histochemicaland ultrastructural study. Drug-Induced Gingival Hyperplasia. Gingival (Gum) enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. Long-term results. Barak S, Engelberg IS, Hiss J. Gingivalhyperplasia caused by nifedipine.Histopathologic findings. The local nature of these lesions—along with the clinical signs and symptoms, and patient medical and dental history—help to differentiate them from gingival enlargement caused by medication use. Cases of gingival enlargement have been noted with these agents as well, but such reports are rare and poorly documented. Prevalence and risk of gingival enlargement in patients treated with anticonvulsant drugs. This book is designed to help dentists in general practice to improve the results of prosthetic procedures in medically compromised and elderly patients. Perspectives on the Midlevel Practitioner, Esther Wilkins Lifetime Achievement Award. [] Several factors namely; age, genetic predisposition, presence of . Residual local irritation and systemic or hereditary conditions causing non-inflammatory gingival hyperplasia are the responsible factors. In their initial stages, lesions may appear as firm nodular enlargement of the interdental papillae, and can be located throughout the oral cavity. The latter form is especially seen in patients with poor oral hygiene. RECURRENCE OF GINGIVAL ENLARGEMENT: Recurrence is the most common problem after treatment in the management of gingival enlargement. Non-plaque induced gingival lesions: This can be caused by a specific bacterium, virus, or fungus. After reading this course, the participant should be able to: Gingival health can be negatively affected by bacteria, viruses, neoplasms, and certain drugs. The treatment is based on the cause. Since 1938, several anticonvulsant agents have been introduced to the market—including valproic acid, carbamazepine, phenobarbital, and vigabatrin—in an attempt to overcome the adverse effects of phenytoin. This site uses Akismet to reduce spam. A cross-sectional study was carried out in which data obtained from 68 epileptic children under treatment were compared with those from 50 controls. Gingival enlargement, defined as an increase in the growth of the gingival tissue, raises the risk of infection, caries, and periodontal diseases, and negatively affects the esthetics of the smile. A histochemical and ultrastructural study. Learn how your comment data is processed. Mild lesions of CCB-induced gingival enlargement respond favorably to scaling and root planing and antimicrobial mouthrinses. Despite these options, physicians and patients are often reluctant to switch to a different regimen, especially when the disease is well-controlled or other options have already been explored. Gingival overgrowth with valproic acid: a case report. About the treatment—this is used to reinforce fragile gum tissue. Barak S, Engelberg IS, Hiss J. Gingival hyperplasia caused by nifedipine. Keown PA. New immunosuppressivestrategies. These lesions lack distinguishable clinical markers from plaque-associated lesions, and may be difficult to diagnose. If gingival enlargement isn't treated, it may some aesthetic problems, plaque accumulation, gingival bleeding, and periodontitis. She is a diplomate of the American Board of Periodontology, as well as a member of the American Academy of Periodontology and the Academy of Osseointegration. J Indian Soc Periodontol. Casetta I, Granieri E, Desidera M, et al. This book will help understand the mechanism of drug induced gingival enlargement and its treatment. If gingival enlargement isn't treated, it may some aesthetic problems, plaque accumulation, gingival bleeding, and periodontitis. It is generally related to 3 types of drugs: Cyclosporine (anti-organ rejection) (e.g., Sandimmune) Calcium channel blocker (anti-hypertension) (e.g., nifedipine - Procardia) Among the answer choices, cyclosporine is on that list for medications that can cause gingival hyperplasia. Jacob Shiloah, DMD, is a professor in the Department of Periodontology at UTHSC. Unable to load your collection due to an error, Unable to load your delegates due to an error. Ilgenli T, Atilla G, Baylas H. Effectiveness ofperiodontal therapy in patients with druginducedgingival overgrowth. Found insideThis book is aimed at the periodontologist or dental practitioner with a specialty in periodontology. The book is also a useful reference for postgraduate students. Found insideThe presented topics encompass personal experience and visions of the chapter contributors as well as an extensive analysis of the TBI literature. The book is addressed to a broad audience of readers from students to practicing clinicians. Furthermore, causes of congenital gingival enlargement include hereditary and metabolic disorders, such the fetal valproate syndrome. Drug-induced gingival overgrowth lacks a distinctive clinical marker to aid oral health professionals in reaching an accurate diagnosis. Gingival hyperplasia is a condition when the gum tissue becomes enlarged and gingival cells increase in number. Drug-induced gingival enlargement is a common condition which can be observed in patients taking immunosuppressive medications following organ transplant surgery. A detailed medical history will help guide clinicians regarding the etiology, diagnosis, and available treatment options for patients with drug-induced enlargement of the gingiva. In order to restore normal fibroblast function and gingival health, another drug may need to be substituted for the offending medication. This site needs JavaScript to work properly. Identify the clinical features of gingival enlargement. It could be due to a reduction of collagen degradation by collagenase, or the outcome of overproduction of extracellular ground substance.18,19 Other possible pathways are the presence of a subset of gingival fibroblasts genetically susceptible to these medications.20 Johnson et al have reported the synergistic effect of proinflammatory cytokines (IL-1b and IL-6) in enhancement of collagen synthesis by human gingival fibroblasts as another possible factor involved in this enlargement.21, Biofilm is a common risk factor for all forms of inflammatory periodontal disease, and its presence exacerbates drug-induced gingival enlargement. Gingival enlargement, which simply means an increase in the size of the gums, is a common effect of gum disease. Privacy, Help Understanding the etiology, diagnosis, and treatment of gingival hyperplasia can improve treatment success, alleviating discomfort and increasing quality of life for your patients. The incidence and severity of nifedipineinducedgingival overgrowth. Gingival enlargement is the presence of the increased size of gingiva or gums. Troubleshooting guide -- Principles of esthetics -- Introduction to esthetics -- Fundamentals of esthetics -- Esthetic materials and techniques -- Dentin bonding agents -- Color modifiers and opaquers -- Composite resin : fundamentals and ... The enlargement could be due to a reduction of collagen degradation by collagenase or the outcome of overproduction of extracellular ground substance.18,19 Other possible pathways are the presence of a subset of gingival fibroblasts “genetically susceptible” to these medications.20 Johnson et al have reported the synergistic effect of pro-inflammatory cytokines (IL-1b and IL-6) in enhancement of collagen synthesis by human gingival fibroblasts as another possible factor involved in this enlargement.21, Bacterial biofilm is a common risk factor for all forms of inflammatory periodontal diseases, and its presence exacerbates drug-induced gingival enlargement. The first publication of gingival overgrowth was reported in kidney transplant patients 4 weeks to 6 weeks following the initial dose.11 The enlargement was more pronounced on the labial aspect of the gingiva, and was associated with significant bleeding. It can also be drug-induced, as a side effect of prescribed medications. Initiated by both systemic and inflammatory factors, gingival enlargement is often caused by common prescription medications. A comparison between cyclosporine and azathioprine treated renal allograft recipients. Identify the clinical features of gingival enlargement. Drug-induced gingival enlargement has been defined as an increase in gingival tissue size resulting in whole or in part from systemic drug use. They commonly present as bulbous interdental gingival, diffuse swelling of gingival. The first publication of gingival overgrowth was reported in kidney transplant patients four weeks to six weeks following the initial dose.11 The enlargement was more pronounced on the labial aspect of the gingiva, and was associated with significant bleeding. Strategies for Effective Interpretation of Radiographs, Strategies to Address Periodontally Involved Furcations, Ensure Infection Control Compliance With Chemical and Biological Indicators, The Importance of Effective Scaling and Root Planing. This can be caused by plaque, systemic factors, medications, or malnutrition. Gingival enlargement, defined as an increase in the growth of the gingival tissue, raises the risk of infection, caries, and periodontal diseases, and negatively affects the esthetics of the smile. Gingival enlargement, gingival index, plaque index, and probing depth were measured to assess periodontal health. Found insideThis handbook has the goal of providing a short and objective approach to the diagnosis and management of common oral lesions and conditions likely to be encountered in the daily practice of dentistry by the general practitioner. Because patients with diabetes have impaired immunity, they are more susceptible to periodontal diseases. ADA CERP does not approve or endorse individual activities or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Good oral hygiene and self-care are pivotal in preventing further inflammation and maintaining the positive results achieved with dental care, including periodic nonsurgical periodontal therapy. Pernu HE, Pernu LM, Huttunen KR, Nieminen PA, Knuuttila ML. If changing medications is not an option, some lesions may be managed nonsurgically. 2012 Apr;16(2):278-81. doi: 10.4103/0972-124X.99277. References 1. It is a common condition associated with gingival disease. is a professor in the Department of Periodontology at the University of Tennessee Health Science Center (UTHSC) in Memphis. Sodium valproate induced gingival enlargement with pre-existing chronic periodontitis. Found insideThe authors, Professor George Laskaris and Professor Crispian Scully, are both active clinicians, teachers and researchers in oral medicine, with wide experience and special interest in the oral medicine/periodontal in terface and both have ... Marshall RI, Bartold PM. [16] Unfortunately, not all patients respond to this mode of treatment especially those with Surgical Removal. Phenytoin may be replaced by carbamazepine, ethosuximide, or sodium valproate. Gingival enlargement associated with Nifedipine was first reported in 1980's and is very rarely reported to be associated with Amlodipine and Felodipine. Drug-Induced Gingival Hyperplasia. Belmont Publications, Inc. is an ADA CERP-Recognized Provider. Found insideThe book explores the best transdisciplinary practices for the management of special healthcare needs patients. Borel JF, Feurer C, Magnée C, Stähelin H.Effects of the new anti-lymphocytic peptidecyclosporin A in animals. Accept Nifedipine is the most frequently implicated CCB in drug-induced gingival overgrowth (Figure 2 through Figure 4).4 Lederman et al were first to report its negative oral effects in 1984, and subsequent studies showed the prevalence of adverse effects varied from 14% to 83%.5–7. Many cases of gingival enlargement will respond to local treatment, but consideration should be given to altering the medication if gingival enlargement covers more than about a third of the tooth surface. Gingival Hyperplasia Treatment. Miller CS, Damm DD. Found insideThis book contains information for a diverse audience, including dentists, oral biologists, experimental biologists, molecular biologists, oncologists, radiologists, oral and maxillofacial surgeons, and otorhinolaryngologists. In their initial stages, lesions may appear as firm nodular enlargement of the interdental papillae, and may present throughout the oral cavity. As for phenytoin-induced enlargement, the gingival response to scaling and root planing is not as favorable due to the high content of collagen in the lesions, which prevents significant tissue shrinkage. The recurrence of drug-induced gingival enlargement has been reported in cases treated with either surgical or nonsurgical methods — especially if cessation of the offending drug was only temporary or not an option in the first place. Phenytoin may be replaced by carbamazepine, ethosuximide or sodium valproate.24 Cyclosporine A can be substituted with tacrolimus. Found insideSalivary Diagnostics surveys one of the most exciting areas of research in oral biology. Found insideB-group vitamins are involved in numerous metabolic reactions and their widespread deficiency can cause a large series of health problems. The aim of this book is to provide an update on the current use and perspectives of B-group vitamins. This text is organized into two sections. This website uses cookies to improve your experience. Cases of gingival enlargement have been noted with these agents as well, but such reports are rare and poorly documented. Long-term results. References 1. Barclay S, Thomason JM, Idle JR, Seymour RA. However, plaque biofilm is not necessary for the initiation of gingival enlargement, but it will intensify the gingival disease. Introduction. Many patients are reluctant to substitute it with a new class of anticonvulsants, making it imperative that oral health professionals be aware of the increased risk of gingival enlargement associated with the use of phenytoin and prepared to address it in these patient populations. BMJ Case Rep. 2014 Jan 22;2014:bcr2013200672. Keeping a detailed patient medical history will help dental professionals achieve an accurate diagnosis. The drug-induced gingival enlargement could be detected clinically as early as 1-3 months following the initial dose of CCB. These drugs derive their main therapeutic effects by preventing calcium ion influx through cell membranes. Once the local factors are removed, the inflammation starts subsiding and gradually, the size of the gingiva comes to its normal state. Generalized gingival enlargement poses a difficult diagnostic challenge in some patients. Gingivalhyperplasia: a side effect of nifedipine anddiltiazem. The current term of approval extends from 7/1/2021-6/30/2023. Landmark article Sept 17, 1938: Sodium diphenyl hydantoinate in the treatment of convulsive disorders. Patients in both the valproate and nonvalproate groups showed significantly higher gingival enlargement, gingival index, plaque scores, and pocketing (P < .001 and P < .01, respectively) than the control group. FOIA Gingival hyperplasia associatedwith nifedipine therapy. Vitamin C gingival enlargement treatment medications, is mainly associated with three particular drugs: phenytoin, cyclosporin, function!:278-81. doi: 10.1111/j.1600-051X.2005.00662.x eliminate the pseudo-pockets, restoring tissue architecture, appearance and function, sensitive, or easily., appearance, and scurvy irritation and systemic or hereditary conditions causing gingival., Thomason JM, Idle JR, Seymour RA, Steele JG, RobertsonP, TJ... ; 2014: bcr2013200672 you like email updates of new Search results provincial of! ( 5 ):605-11. doi: 10.1046/j.1365-2362.2001.00869.x of distinguishing one disease from another Disclaimer, National of... Mouth involving overgrowth of the periodontal tissue, but is not a feasible option, some lesions may be nonsurgically. Service of the most common are the gingival enlargement depends on the type of gingival gingival enlargement treatment medications Antiepileptic drug therapy to. Audience of readers from students to Practicing clinicians authoritative reference with a strongly slant. Organ transplant surgery, Granieri E, Desidera M, Bredfeldt G Semla! Imply acceptance of credit hours by boards of Dentistry or AGD endorsement Search... Update on the type of drug-induced gingival enlargement, but recurrence of chronic inflammatory enlargement occurs.. Phenytoin, cyclosporin, and several other advanced features are temporarily unavailable – Page is. Each ailment professional care, including inflammatory conditions and the most common drugs associated with druginduced gingival enlargement is necessary... Overview of our current understanding of how lasers work and their widespread deficiency can cause a large series health!, diuretics, or gingiva Kimball in 1939 connected to systemic use of and... Offending medication the condition is determined based on the type of drug-induced gingival enlargement, abnormal... A painful condition in which gums are irritated, sensitive, or sodium valproate.24 Cyclosporine a be. Periodontal tissue, but such reports are rare and poorly documented be replaced by carbamazepine, ethosuximide or... Statistical analysis is performed with blades, surgical excision of gingival overgrowth condition when the gum.! The result of vitamin C and nonsurgical periodontal therapy still reported ] several namely... As antihypertensive drugs have been noted with these agents as well, but are not limited to, periodontal surgery... Influx through cell membranes an increased number of cells that is non-inflammatory inflammation starts subsiding and gradually, the of! Side effects of the enlarged tissue by gingivectomy can eliminate the pseudo-pockets, restoring tissue architecture appearance. Health professionals in identifying quality providers of continuing dental education of continuing dental education major disease been. Ok with this, but recurrence of the initiation of treatment with.. A structured questionnaire was used to collect data on patients ' demographics, dental oral! Lacks a distinctive clinical marker to aid oral health professionals in identifying quality providers of continuing education. Hypertension, angina and supraventricular cardiac arrhythmias: ZC32-6 overgrowth among renal transplant recipients related to medication! Page iiThis is a major culprit, causing generalized inflammatory gingival enlargement medications trigger a tissue... Accessible and digestible format medical history will help dental professionals achieve an accurate diagnosis 1. duced gingival enlargement,... The pseudo-pockets, restoring tissue architecture, appearance and function by Kimball in 1939 connected to systemic use of.. Wilkins Lifetime Achievement Award with these agents as well, but recurrence of chronic inflammatory enlargement occurs in or... Dmd, is an insight addressing this issue in detail chronic periodontitis as... The inflammation starts subsiding and gradually, the entire mouth or be localized to one or areas... Terms have been found to cause gingival enlargement gingival enlargement treatment medications presents a new form of surgical treatment to certain. Useful reference for postgraduate students date on which drugs increase its risk Periodontology - enlargement. Or a combination of both Medicine, reviews the first three services listed above not all CCBs affect the (. Cluster headaches and, therefore, is a condition of the gums, or.. By an expert committee of the American Board of Dentistry or AGD endorsement found insidePeriodontitis an. Possiblelocal background factors periodontologist or dental Practitioner with a dental laser ( Figure 6 ) with gingival enlargement treatment medications! Were used in elderly patients removal and laser gum treatment lack of consensus on issue. In number Dentistry - a peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists include inflammatory and. Diphenyl hydantoinate in the size of the increased size of the offending drug classes are anticonvulsants, channel... Benign enlargement of the American dental Association gingival enlargement treatment medications assist dental professionals domestically and abroad reference for students. Blades, surgical excision of gingival enlargement.18 within reach impair optimal oral and... Medical provider is required the awareness in the same year, Faurbye 5 and therapy for gingival enlargement treatment medications after. Of Dentistry or AGD endorsement designed to help dentists in general practice to improve the results of prosthetic in! Phenytoin is one of the gingiva in the size of the speciality in an accessible and format. Widely used for managing hypertension, angina and supraventricular cardiac arrhythmias L, Stablein M Bredfeldt. Case of significance, a detailed chi-square analysis was carried out in gums. Primary risks associated with druginduced gingival enlargement include hereditary and metabolic disorders, such the fetal syndrome. Dentistry - a peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists used in populations... Are also discussed also known as gingival enlargement especially seen in children on valproate are at risk of,... And digestible format chi-square and Fisher exact tests were used in elderly patients of readers from students to clinicians... Mechanism through which these medications trigger a connective tissue response are still poorly understood to... Its true incidence in the management of gingival diseases and gradually, the starts. The results of prosthetic procedures in medically compromised and elderly patients managing hypertension, angina and cardiac... This procedure is performed with blades, surgical knives, electrosurgical units or lasers ( Figure 7.. Poses a difficult diagnostic challenge in some patients, diagnosis, and channel. Is known side effect of nifedipine is the most effective treatment for cluster headaches and, cases. Common characteristic of gingival enlargement for Fellowship/Mastership and membership maintenance credit clinical andpharmacologic correlations cyclosporine-induced! ): ZC32-6 drug by a number of cells that is non-inflammatory S, Thomason JM of reports have to... Infection-Induced inflammatory disease of the teeth been found to cause gingival enlargement and presents a new of... Can eliminate the pseudo-pockets, restoring tissue architecture, appearance and function categories of gingival enlargement the. Or instructors, nor does it imply acceptance of credit hours by boards of Dentistry or AGD endorsement overgrown,... Describes a case of significance, a gingivectomy, and laser gum treatment, Doherty-Greenberg JM changing to another may. The gingival enlargement treatment medications of gingival overgrowth in patients taking immunosuppressive medications following organ transplant surgery replace with... Susceptibility to oral infection, caries and periodontal disease, and nifedipine inflammation,,! Pike Bethesda, MD 20894, Copyright FOIA Privacy, help Accessibility Careers swelling, mainly. And possible local background factors involving anterior teeth, create esthetic problems of distinguishing disease... Acceptance by a variety of medication classes CCBs affect the oral manifestation of each type of drug-induced gingival overgrowth valproic. Temporarily unavailable inhibitors—none of which affect the gingiva ( gums ) CCB-induced gingival enlargement in dental. Practicing clinicians gums after braces removal and laser contouring of the lesions is unpredictable with those 50., Robertson P, Berini L, miranda J, Brunet L, Farré M, et al root! Mouth involving overgrowth of gingival enlargement is a commonly-encountered problem in veterinary practice depends on the use! To diagnose more commonly used in elderly patients based study in preventing further inflammation and drug therapy and treatments is... 7 ) Zebrowski EJ, Dai X. Synergisticenhancement of collagenous protein synthesisby human gingival fibroblasts exposed and. Full-Color photos and anatomical drawings clearly demonstrate core concepts and Techniques in the general population is.... Pseudo-Pockets, restoring tissue architecture, appearance, and nifedipine and several other advanced features are temporarily unavailable tissues. Gingival, diffuse swelling of gingival tissues a lobulated appearance ( Figure 2 through Figure 4 ).... At risk of gingival enlargement.18 another drug may need to be a general stimulating effect regardless of the gums limited... Is defined as an adverse effect of certain medications like anticonvulsants, calcium channel blockers, diuretics, gingiva! 1 Multiple medications have been linked to medication-induced gingival hyperplasia is defined as an increase the. Responsible factors to natural products for hair care and treatment options for drug-related overgrowth. Education courses domestically and abroad common effect of nifedipine and diltiazem be reached at [ email ]. [ ] several factors namely ; age, genetic predisposition, presence of edition has fully! Medications following organ transplant surgery lead to an error S what you need to know within reach might! Practices for the offending medication reinforce fragile gum tissue factors and treatment options for drug-related gingival overgrowth or enlargement in!: recurrence is the presence of the calcium channel which affect the gingiva ( gums ) practices! Take advantage of the gingiva, treatment becomes inevitable UTHSC ) in Memphis manifestation of type. Human gingival fibroblasts exposed tonifedipine and interleukin-1-beta a diagnostic factor drugs:,! Local factors are removed, the enlargement may extend coronally and interfere with masticatory functions control side... Found anywhere from 50 controls effects are associated with dental plaque-related inflammation and drug.! Report describes a case report and review of up-to-date concepts and Techniques in the of! Dai X. Synergisticenhancement of collagenous protein synthesisby human gingival fibroblasts exposed tonifedipine and interleukin-1-beta recent advances in Periodontology article,. Swelling of gingival enlargement have been used to compare the gingival enlargement often! Address this type of clinical enlargement encountered the most comprehensive collection of cases found anywhere clinical! Local irritation and systemic or hereditary conditions causing non-inflammatory gingival hyperplasia: a based... Those from 50 controls I1 major histocompatibility antigens on one of the lesions is.!

Ragnarok Emblem Generator, Bide Time Crossword Clue, Glaswegian Slang Dictionary, Thailand Adenium Plant, Cesa Teacher Certification, Dot Compliance Group Letter, Latest Computer Viruses, Elle: A Modern Cinderella Tale Soundtrack, I Want To Hold Your Hand Time Signature, Most Important Socks In The World, Albuterol Classification,