Amlodipine Induced Gingival Enlargements: Non Surgical Periodontal Treatment : 2 Cases Report

Yıl 2024, Cilt: 11 Sayı: 3, 351 - 355, 23.12.2024

İrem Çolak , Demet Efe , Nurcan Buduneli

https://doi.org/10.15311/selcukdentj.1432957

Öz

Gingival enlargements; arise due to various reasons such as microbial dental plaque accumulation, trauma, systemic diseases, genetic predisposition, and drug use. One of the medication groups causing drug induced gingival enlargements is the calcium channel blockers commonly used for the treatment of cardiovascular problems such as hypertension, angina pectoris, and cardiac arrhythmia, including amlodipine derivatives. Drug induced gingival enlargements can be controlled by practices such as eliminating local factors, improving oral hygiene, periodontal treatment, and medication modification. This report presents the clinical periodontal findings after initial and non surgical periodontal treatment in two patients who presented to the clinic with complaints of gingival enlargement and had been using amlodipine for a long time.

Anahtar Kelimeler

Amlodipine, Calcium Channel Blockers, Drug İnduced Gingival Enlargements, Hypertension

Amlodipin Kullanımına Bağlı Diş Eti Büyümelerinin Cerrahisiz Periodontal Tedavisi: 2 Olgu Sunumu

Öz

Diş eti büyümeleri; mikrobiyal dental plak birikimi, travma, sistemik hastalıklar, genetik yatkınlık ve ilaç kullanımı gibi çeşitli nedenlerle ortaya çıkmaktadır. İlaca bağlı diş eti büyümelerine neden olan ilaç gruplarından biri de hipertansiyon, anjina pektoris ve kardiyak aritmi gibi kardiyovasküler problemlerin tedavisi için sıklıkla kullanılan kalsiyum kanal blokörü olan amlodipin türevleridir. Amlodipinin kısa süreli ve düşük dozda kullanımının bile diş etlerinde meydana getirdiği büyümeler plak kontrolünün sağlanamaması ve kötü estetik gibi olumsuz etkiler oluşturabilir. Lokal etkenlerin ortadan kaldırılması, ağız bakımının iyileştirilmesi, periodontal tedavi ve ilaç değişikliği gibi uygulamalar ile ilaca bağlı diş eti büyümeleri kontrol altına alınabilmektedir. Bu raporda, diş eti büyümesi şikayetiyle kliniğe başvuran ve uzun süredir amlodipin kullanmakta olan iki hastada başlangıç ve cerrahisiz periodontal tedavi sonrası klinik periodontal bulgular sunulmaktadır.

Anahtar Kelimeler

Amlodipin, Hipertansiyon, Kalsiyum Kanal Blokörü, İlaca bağlı diş eti büyümesi

Kaynakça

• 1. Kazancıoğlu H, Erişen M, Demirtaş N, Türkmen A, Gülsüm A. Diş eti büyümesi meydana getiren ilaçlar ve tedavileri. Journal of Istanbul Universty Faculty Dentistry. 2013;47:66-72.
• 2. Informational Paper: Drug-Associated Gingival Enlargement. Journal of Periodontology 2004;75(10):1424s1431.
• 3. Seymour, R.A (2006). Effects of medications on the periodontal tissues in health and disease. Periodontology 2000, Vol.40,120-129.
• 4. Ramon Y, Behar S, Kishon Y, Engelberg IS. Gingival hyperplasia caused by nifedipine--a preliminary report. International Journal Cardiology. 1984;5:195-206.
• 5. Fu, Earl, et al. "Nifedipine‐induced gingival overgrowth in rats: Brief review and experimental study." Journal of periodontology 69.7 (1998): 765-771.
• 6. Seymour RA, Ellis JS, Thomason JM, Monkman S, Idle JR. Amlodipine-induced gingival overgrowth. Journal of Clinical Periodontology. 1994; 21:281-3.
• 7. Meraw SJ, Sheridan PJ. Medically induced gingival hyperlasia. Mayo Clinic Proceeding 1996;73: 1196-1199.
• 8. Grover V, Kapoor A,Marya CM. Amlodipine Induced Gingival Hyperplasia. Journal of Oral Health and Community Dentistry 2007;1:19-22.
• 9. Deveci KC, Çalışır M, Tanık A, Erdem MB. Antihypertensive drug-induced gingival hyper- plasia: a case report. Aydın Dental Journal. 2021;7:77-84.
• 10. Livada R, Shiloah J. Calcium Channel Blocker-induced Gingival Enlargement. Journal of Human Hypertension, 2014;28:10–14.
• 11. Ayanoglou C, Lesty C. Cyclosporin A-induced gingival overgrowth in the rat: a histological, ultrastructural and histomorp- hometric evaluation. Journal of Periodontal Research 1999;34:7-15.
• 12. Trackman PC, Kantarci A. Molecular and clinical aspects of drug-induced gingival overgrowth. Journal of Dental Research, 2015;94(4):540–546.
• 13. Biswas S, Saha A, Das AK, Nair V, Biswas D. Anti-hypertensive drug induced gingival enlargement - a casereport. Jornal of Disease ang Global Health, 2017;10(1): 7-11.
• 14. Gaur S, Agnihotri R. Is dental plaque the only etiological factor in Amlodipine induced gingival overgrowth? A systematic review of evidence. Journal of Clinical Experimental and Dentistry 2018 Jun 1;10(6):e610-e619.
• 15. Arunachalam LT, Rao S. Immunolocalization of Bcl-2 oncoprotein in amlodipine-induced gingival overgrowth. Indian Journal of Dental Research, 2013;24(2): 255-260.
• 16. Seymour RA, Ellis JS, Thomason JM. Risk factors for drug-induced gingival overgrowth. Journal of Clinical Periodontology, 2000;27(4): 217-223.
• 17. Livada R, Shiloah J. Calcium channel blocker-induced gingival enlargement. Journal of Human Hypertension, 2014;28(1): 10-14.
• 18. Hallmon WW, Rossmann JA. The role of drugs in the pathogenesis of gingival overgrowth. A collective review of current concepts. Periodontology 2000, 1999;21: 176-196.
• 19. Kose, KN; Yilmaz, S1; Noyan, U2; Kuru, B3; Yildirim, HS; Agrali, OB; Ozener, HO; Kuru, L. The Gingival Crevicular Fluid Levels of Growth Factors in Patients with Amlodipine-Induced Gingival Overgrowth: A Pilot Study. Nigerian Journal of Clinical Practice April 2020;23(4):p 561-567,
• 20. Jorgensen MG. Prevalence of amlodipine-related gingival hyperplasia. Journal of Periodontology 1997;68(7):676-8.
• 21. Nery EB, Edson RG, Lee KK, Pruthi VK, Watson J. Prevalence of nifedipine-induced gingival hyperplasia. Journal of Periodontology 1995;66: 572-578.
• 22. Lafzi A, Farahani RMZ, Shoja MAM. Amlodipine- induced gingival hyperplasia. Medicina Oral Patologia Oral y Cirugia Bucal 2006;11:E480-2.
• 23. EllisJS, SeymourRA, SteeleJG, RobertsonP, ButlerTJ, Thomason JM. Prevalence of gingival overgrowth induced by calcium channel blockers: a community-based study. Journal of Periodontology. 1999;70(1):63s7
• 24. Triveni MG, Rudrakshi C, Mehta DS. Amlodipine induced gingival overgrowth. Journal of Indian Society Periodontology. 2009;13:160–163.
• 25. Sucu M, Yuce M, Davatoglu V. Amlodipine induced massive gingival hypertrophy. Canadian Family Physician. 2011;57:436–437.
• 26. Bharti V, Bansal C. Drug-induced gingival overgrowth: The nemesis of gingiva unravelled. Journal of Indian Society Periodontology, 2013;17:182-7.