Nonsurgical Management of Amlodipine Induced Gingival Enlargement – A Case Report

Nitesh kumar Sharma^1, and Roopa D.A.¹

¹Department of periodontics and oral implantology, Rama dental college hospital & research centre, Kanpur

Cite this paper:
Nitesh kumar Sharma and Roopa D.A.. Nonsurgical Management of Amlodipine Induced Gingival Enlargement – A Case Report. International Journal of Dental Sciences and Research. 2014; 2(6):137-140. doi: 10.12691/ijdsr-2-6-4

Abstract

Antihypertensive drugs in the calcium channel blocker group are extensively used in elderly patients. Gingival enlargement associated with Nifedipine was first reported in 1980’s and is very rarely reported to be associated with Amlodipine and Felodipine. The mechanism through which these medications trigger a connective tissue response are still poorly understood. The most effective treatment of drug induced gingival overgrowth is withdrawl or substitution of medication combined with meticulous oral hygiene, plaque control, and removal of local irritants. When these measures fails to resolve the enlargement, surgical intervention is recommended. This case reports a rare case of Amlodipine induced gingival enlargement. The patient was successfully managed by drug substitution and nonsurgical periodontal terapy.

Keywords:
Nonsurgical therapy Amlodipine Calcium cannel blocker drug induced gingival enlargement

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Rees TD, Levine RA. Systemic drugs as a risk factor periodontal disease initiation and progression. Compdend contin Educ Dent 1995; 16: 20-42.
[2]	Seymour R.A, Ellis J.S, Thomason J.M, Monkman S, Idle J.R (1994) “Amlodipine induced gingival overgrowth” J. Clin. Periodontal, 21: 281-283. Amlodipine Induced Gingival Hyperplasia.
[3]	Seymour R.A (1991) “Calcium channel blockers and gingival enlargements” Br. Dent. J. 170: 376-379.
[4]	Ellis J.S, Seymour R A, Monkman S.C, Idle J R (1992) “Gingival sequestration of nifedipine induced gingival overgrowth.” Lancet, 39: 1382-1383.
[5]	Meraw SJ, Sheridan PJ. Medically induced gingival hyperlasia. Mayo Clin Proc 1996; 73: 1196-1199.
[6]	Hallmon WW, Rossmann JA. The role of drugs in the pathogensis of gingival overgrowth. A collective review of current concepts. Periodontol 2000 1999; 21: 176-196.
[7]	Marshall RI, Bartold PM. A clinical review of drud-induced gingival overgrowth. Oral Surg Oral Med Oral Pathol 1993; 76: 543-548.
[8]	Hassel TM, Hefti AF. Drug-induced gingival overgrowth: Old problem, new problem. Criti Rev Oral Biol Med 1991; 2: 103-137.
[9]	Hassel TM, Page RC, Narayanan AS, Cooper CG. Diphenylhydantion (Dilantin) gingival hyperplasia; Drug-induced abnormality of connective tissue. Proc Natl Acad Sci (USA) 1976; 73: 2909-2912.
[10]	Sinha-Morton R, Dongri-Bagtzoglou AI. Regulation cyclosporine A. J Periodontol 1998; 69: 899-910.
[11]	Johnson RB, Zebrowski EJ, Dai X. Synergistic enhancement of collegenous protein synthesis by human gingival fibroblasts exposed to nifedipine and interleukin-1-beta in vitro. J Oral Pathol Med 2000; 29: 8-12.
[12]	Williamson MS, Miller EK, Plemons J, Rees T, lacopino AM. Cyclosporine A upregulates interleukin-6 gene expression in human gingiva: Possible mechanism for gingival overgrowth. J Periodontol 1994; 11: 552-560.
[13]	Hassel TM. Evidence for production of an inactive collagenase by fibroblasts from phenytion-enlarged human gingiva. J oral Pathol 1982; 11: 310-317.
[14]	Hall EE. Prevention and treatment consideration in patients with drug-induced gingival enlargement. Curr Opin Periodontol 1997: 4: 59-63.
[15]	Boraz RA. A dental protocol for the pediatric cardiac transplant patient. ASDC J Dent Child 1986; 53: 382-385.
[16]	Khocth A, Schneider LC. Periodontal management of gingival overgrowth in the heart transplant patient: A case report. J Periodontal 1997; 68; 1140-1146.
[17]	Somacarrera ML, Lucas M, Scully C, Barrios C. Effectiveness of periodontal treatments on cyclosporine induced gingival overgrowth in transplant patients. Br. Dent J 1997; 183:89-94. Amlodipine Induced Gingival Hyperplasia.