Treatment of druginduced gingival enlargement with er. Gingival enlargement is the term now used to describe medicationrelated gingival overgrowth or gingival hyperplasia, a common reactionary. Regardl ess of its cause, gingival enlar gement can cause problems in controlling pl aque, chewing, teething, speech. Gingival enlargement is one of the frequent features of gingival diseases.
Druginduced gingival hyperplasia clinical presentation. Gingival enlargement simply means that there is an increase in the size of your gingivalgums. Druginduced gingival overgrowth remains the most widespread unwanted effect of systemic medication on the periodontal tissues. Regardl ess of its cause, gingival enlar gement can cause problems in controlling pl aque, chewing, teething, speech and aesthetics 1. Enlargements associated with systemic diseases periodontal. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. Among calcium channel blockers, nifedipine causes gingival hyperplasia in about 10% of patients, whereas the incidence of amlodipine, a third generation calcium channel blocker, induced gingival hyperplasia is very limited. As with medicationinduced gingival enlargement, effective oral hygiene measures will. Dec 23, 2014 gingival enlargement also known as gingival hyperplasia, gingival hypertrophy, gingival overgrowth, hypertrophic gingivitis which is caused with the increase in the size of gingiva is called as gingival enlargement. Management of drug induced gingival enlargement barbara anne taylor, department of periodontics, united dental hospital of sydney, sydney synopsis healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
There are very few reports of amlodipine induced gingival enlargement at a dose of 5 mg. Gingival enlargement an overview sciencedirect topics. It is the degree of enlargement and the tendency to develop massive recurrence in the presence of relatively scant plaque deposits that distinguish pubertal gingival enlargement from uncomplicated chronic. Chapter 6 nonplaque induced periodontal diseases i. Phenytoin induced gingival overgrowth pigo is a common complication of the continuous use of medications. Brunet l, miranda j, farre m, berini l, mendieta c 1996 gingival enlargement induced by drugs.
What is the most likely diagnosis if patient has htn. A patients diagnosis and treatment rely on proper classification of gingival diseases. Preexisting gingival inflammation induced by dental plaque seems to be a favorable. The case was resolved with use of non surgical periodontal therapy. Mar 26, 2019 several causes of gingival hyperplasia are known, and the most recognized is drug induced gingival enlargement. Oct 26, 2012 gingival enlargement, an abnormal growth of the periodontal tissue, is mainly associated with dental plaque related inflammation and drug therapy. Pregnancy induced gingival enlargementa case report t. Also, adequate plaque control may aid in preventing or retarding the recurrence of gingival surgically treated cases. Gingival enlargement may cause discomfort, interfere with speech or chewing, result in halitosis and unilateral gingival enlargement a case report kalburge j v, metgud rashmi abstract a 14 year old female patient suffered from unusual unilateral gingival enlargement on left.
Silverstain et al 1995 nifidepine induced gingival enlargements has been reported around dental implants yoon angela et al in 2006 myeloid sarcoma occurring concurrently with drug induced gingival enlargement frederic duffau in 2007 gingival enlargement originating from medication and tooth migration 48. Furthermore, causes of congenital gingival enlargement include hereditary and metabolic disorders, such the fetal valproate syndrome. The purpose of this article is to report a case of drug induced gingival enlargement due to oral contraceptives, managed by nonsurgical periodontal therapy. According to the medical literature, there are five different types of gingival hyperplasia. Gingival biopsies one per person were harvested from 22 renal transplant recipients 8 men and 14 women. Although gingival overgrowth has been traditionally recognised as an adverse effect of. Jan 14, 2014 silverstain et al 1995 nifidepine induced gingival enlargements has been reported around dental implants yoon angela et al in 2006 myeloid sarcoma occurring concurrently with drug induced gingival enlargement frederic duffau in 2007 gingival enlargement originating from medication and tooth migration 48. There are very few reports of amlodipineinduced gingival enlargement at a dose of 5 mg. Druginduced gingival overgrowth or enlargement manifests as abnormal growth of the gingiva due to an adverse drug reaction adr in patients treated with anticonvulsants, immunosuppressants, and calcium channel blockers. Cyclosporineinduced gingival enlargement is more vascularized than phenytoin enlargement figures 1610 and 1611. Gingival enlargement produces aesthetic changes, pain, gingival bleeding and periodontal disorders.
Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Among the cause for drug induced ge, phenytoin is the most common agent. Jan 15, 2015 the treatment of gingival enlargement is based on an understanding of the cause and underlying pathologic changes of this condition see chapter 16. Druginduced enlargement is associated with a patients genetic predisposition, and the presence of existing plaque or gingival inflammation. Unusual clinical presentation of generalized gingival enlargementa report of 3 cases. Nonplaque induced gingival lesions npigl encompass a group of pathologies that are not primarily caused by plaque and usually do not disappear after plaque removal, even when the severity of. Gingival enlargement during puberty has all the clinical features generally associated with chronic inflammatory gingival disease. Surgical approach to drug induced gingival enlargement in renal transplant patients case report christina popova, antoaneta mlachkova department of periodontology, faculty of dental medicine, medical university sofia, bulgaria journal of imab annual proceeding scientific papers 2007, vol. Several cause of gingival enlargement is known, and the most recognized is drug induced gingival enlargement. Drug induced gingival overgrowth remains the most widespread unwanted effect of systemic medication on the periodontal tissues. Propranolol induced gingival hyperplasia with nager syndrome. A rare case report of amlodipineinduced gingival enlargement.
Phenytoininduced gingival overgrowth management with. Introduction gingival enlargement is a common feature of gingival disease and may be caused by fibrous overgrowth or gingival inflammation or a combination of two. The most fibrotic druginduced lesions develop in response to therapy with phenytoin, the least fibrotic. The classification presented below is from development of a classification system for periodontal diseases and conditions by gc armitage, dds 1999 and is used by the american academy of periodontology aap. Gingival enlargements are of special concern to the patient and the dentist because they pose problems that involve plaque control, function including mastication, tooth eruption, and speech, and aesthetics. Unusual clinical presentation of generalized gingival.
Drug induced gingival overgrowth digo statpearls ncbi. Tissue enlargement may progress to the point that the tissue obscures the teeth and may interfere with occlusion enlargement tissue appear firm fibrotic, pale pink and resilient, has little tendency to bleed, and has lobed surface appearance enlargement usually through out the. Pdf drug induced gingival enlargement researchgate. Gingival enlargement and its treatment authorstream. Signs and symptoms related to gingival enlargement are seen within 24 mo of initiation of drug intake. Gingivitis classification is useful for diagnosis, prognosis and treatment planning. One of the main drugs associated with go is the antiepileptic. The surgical treatment is the definitive therapy of the druginduced gingival overgrowth, although the recurrence is frequent even with well. Hormone induced gingival enlargement intelligent dental. There are many anticonvulsants, immunosuppressants and calcium channel blockers that may lead to gingival enlargement in varied presentations table table1 1 and figure figure7. Treatment of gingival overgrowth is based on cause of gums enlargement and underlying pathological change which has occurred.
Patient selection and collection of gingival tissues. Gingival enlargement induced by drugs springerlink. Update on gingival overgrowth by cyclosporine a in renal transplants. Gingival enlargement is an increase in the size of the gingiva gums. Management of druginduced gingival enlargement australian. Amlodepine induced gingival enlargement presen tation of a. Management of druginduced gingival enlargement barbara anne taylor, department of periodontics, united dental hospital of sydney, sydney synopsis healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. Health, general anticonvulsants health aspects chronic myeloid leukemia case studies gingivitis care and treatment causes of diagnosis gum diseases nifedipine complications and side.
As with medication induced gingival enlargement, effective oral hygiene measures will reduce the risk of developing gingival enlargement. To get the facts on exactly how to eliminate your uterine fibroids from the root 100% naturally and permanently and achieve lasting freedom from pcos related symptoms without spending your hardearned money on drugs and over the counters. Unusual clinical presentation of generalized gingival enlargement a report of 3 cases. What are 5 common features between all drug induced gingival enlargement. Treatment of gums enlargement, treatment of gingival. Pregnancy induced gingival enlargementa case report. Treatment of gingival enlargement pocket dentistry. Clocheret k, dekeyser c, carels c, willems g 2003 idiopathic gingival hyperplasia and orthodontic treatment. Gingival overgrowth go is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressant, and calcium channel blockers. Drug induced gingival enlargement was first observed in patients who were taking phenytoin for epilepsy, with approximately 50% having gingival overgrowth. Gingival overgrowth is a side effect of certain medications. Phenytoin is an anticonvulsant which is seen to cause gingival enlargement in human patients with a reported incidence of 50%. Amlodepine induced gingival enlargement med oral patol oral cir. Several causes of gingival hyperplasia are known, and the most recognized is druginduced gingival enlargement.
Healthy gums are pale pink or pigmented, and wrap tightly around the neck of the teeth. Gingival hyperplasia treatment, symptoms, causes, pictures. This is why there are specialists who prefer not to use either of these two terms but rather choose gingival enlargement as the final diagnosis. Druginduced gingival enlargement was first observed in patients who were taking phenytoin for epilepsy, with approximately 50% having gingival overgrowth. Propranololinduced gingival hyperplasia with nager syndrome. These results are consistent with a significant role of oestrogen during primate pregnancy in the fig. Dental scaling, root planning, periodontal surgery or gingivectomy that is removal of excess gingival tissue is done for treatment of gums enlargement. Although gingival overgrowth has been traditionally. Gingival enlargement is an unwanted adverse effect of some drugs such as. Gingival enlargement or hypertrophy are the two other terms used to describe the condition. Cyclosporine induced gingival hyperplasia in 28 yearold male renal transplanted patient disscusion cyclosorin a csa is a powerful immunosuprssant widely used for prevention of transplant rejection as well as for management of a number of autoimmune conditions such as rheumatoid arthritis 7 cya is usually administered orally. The simplified taxonomy of gingival conditions includes. Go is characterized by the accumulation of extracellular matrix in gingival connective tissues, particularly collagenous components, with varying degrees of inflammation.
Tissue enlargement may progress to the point that the tissue obscures the teeth and may interfere with occlusion enlargement tissue appear firm fibrotic, pale pink and resilient, has little tendency to bleed, and has lobed surface appearance enlargement usually through out the mouth and appear more pronounced in the. Gingival enlargement associated with systemic conditions usually resolves when the underlying condition is treated or in the case of pregnancy, delivery of the child. There are several reasons why your gums are enlarged. Gingival overgrowth go comprises any clinical condition in which an increase in the size of the gingiva is observed. Gingival hyperplasia is a disease in which the gum tissues overgrow abnormally. Since gingival overgrowth is a drug induced 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. This chapter aims to provide an overview of less common conditions that may present as gingival lesions and which do not have plaque as the primary aetiological agent. Phenytoininduced gingival overgrowth pigo is a common complication of the continuous use of medications.
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. 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. Felodipineinduced calcium channel blocker felodipineinduced calcium channel blocker druginduced gingival hyperplasia differential diagnosis. Gingival enlargement definition of gingival enlargement by.
It exhibits slow and painless progression and can be exacerbated by hormonal causes or use of drugs. Learn the shocking truth about uterine fibroids, drugs and surgeries. Dental plaqueinduced gingival diseases classification of gingival diseases is a significant part of an intraoral examination. The present article studies the case of a patient afflicted with gingival enlargement and gingival lesions induced by bacterial plaque. The treatment of gingival enlargement is based on an understanding of the cause and underlying pathologic changes of this condition see chapter 16. Gingival enlargement and its treatment authorstream presentation. Gingival enlargement resolution by means of nonsurgical. Gingival hyperplasia hypertrophy is a rather common. I treatment of druginduced gingival enlargement with er. The aim of the present paper is to summarize current knowledge regarding aetiology, pathogenesis and management of gingival overgrowth induced by.
Its true incidence in the general population is unknown. Dental scaling, root planning, periodontal surgery or gingivectomy that is removal of excess gingival tissue is. Systemic and clinical treatment of gingival hyperplasia. Analysis of proliferative activity in oral gingival. The nonplaque induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. Cyclosporineinduced gingival hyperplasia in 28 yearold male renal transplanted patient disscusion cyclosorin a csa is a powerful immunosuprssant widely used for prevention of transplant rejection as well as for management of a number of autoimmune conditions such as rheumatoid arthritis 7 cya is usually administered orally.
Health, general anticonvulsants health aspects chronic myeloid leukemia case studies gingivitis care and treatment causes of diagnosis gum. The possible potential therapeutic targets for drug induced. Gingival enlargement, an abnormal growth of the periodontal tissue, is mainly associated with dental plaquerelated inflammation and drug therapy. Oral contraceptives induced gingival overgrowth a clinical. Gingival enlargement also known as gingival hyperplasia, gingival hypertrophy, gingival overgrowth, hypertrophic gingivitis which is caused with the increase in the size of gingiva is called as gingival enlargement. As gingival enlargement develops, it affects the normal oral hygiene practice and may interfere with masticatory functions. Cyclosporin is an immunosuppressant which has been reported to cause gingival enlargement in 2580% of patients. Individualized treatment plan for gingival enlargement. Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. A rare adverse drug reaction syed ahmed raheel 1, omar bashar kujan 1, bassel tarakji 1, dilshad umar 2, salah ibrahim 2. Such enlargement can be caused by a multitude of stimuli and stands as a singular complaint in the dental office. Unusual clinical presentation of generalised gingival. Gingival enlargement ge is an abnormal growth of the periodontal tissue. Most likely, this may be related to the age of the population, the nature of the disease, and poor oral hygiene.