Información del artículo
Abstract
Drug induced gingival enlargement (DIGE) is characterized by a gingival enlargementwhich can reach just one area or involve several areas, mainly anterior regions of maxilla and mandible. The cyclosporine, phenytoin and nifedipine are the mainly drugs related with DIGE. Several risk factors are involved, as bacterial plaque. The pathogenesis is controversial, but most of the studies agree with the participation of genetic susceptibility, growth factors and fibroblasts. The prevention approaches in patients under this therapy programme are essential, and also the early diagnosis and follow-up, to minimize the adverse consequences and reduce the prevalence and severity of gingival enlargement.
Key-words:
Drug induced gingival overgrowth
Drug induced gingival enlargement
Gingival diseases
Drugs
Resumo
O aumento de volume gengival induzido por fármacos (AVGIF) caracteriza-se pelo aumento de volume da gengiva que pode ser limitada a uma área ou envolver várias regiões, principalmente nas zonas anteriores da maxila e da mandíbula. A ciclosporina, a fenitoína e a nifedipina são os fármacos principais relacionados com o AVGIF. Vários factores de risco estão envolvidos, tais como a placa bacteriana. A patogénese é controversa, mas a maioria dos estudos é concordante com a participação da susceptibilidade genética, factores de crescimento e fibroblastos. Os regimes preventivos em pacientes sob esse tipo de terapia são fundamentais, bem como o diagnóstico precoce e o follow-up, de modo a minimizar as consequências adversas e diminuir a prevalência e severidade do aumento de volume gengival.
Palavras-Chave:
Aumento de volume gengival induzido por fármacos
Crescimento gengival induzido por fármacos
Doenças gengivais
Fármacos
El Texto completo está disponible en PDF
Bibliografia
[1-]
I. Darby.
Drugs and gingival bleeding.
Aust Prescr, 29 (2006), pp. 154-155
[2-]
A. Doufexi, M. Mina, E. Ioannidou.
Gingival overgrowth in children: epidemiology, pathogenesis, and complications. A literature review.
J Periodontol, 76 (2005), pp. 3-10
[3-]
R. Seymour, M. Rudralingham.
Oral and dental adverse drug Reactions.
Periodontol, 46 (2008), pp. 9-26
[4-]
P. Vescovi, M. Meleti, M. Manfredi, E. Merigo, G. Pedrazzi.
Cyclosporin-induced gingival overgrowth: a clinical-epidemiological evaluation of 121 Italian renal transplant recipients.
J Periodontol, 76 (2005), pp. 1259-1264
[5-]
A. Dongari.
Drug-Associated Gingival Enlargement.
J Periodontol, 75 (2004), pp. 1424-1431
[6-]
P. Khera, M.J. Zirwas, J.C. English III.
Diffuse gingival enlargement.
J Am Acad Dermatol, 52 (2005), pp. 491-499
[7-]
N. Nishide, T. Nishikawa, N. Kanamura.
Extensive bleeding during surgical treatment for gingival overgrowth in a patient on haemodialysis – a case report and review of the literature.
Aust Dent J, 50 (2005), pp. 276-281
[8-]
S. Tyrzyk, et al.
Clinical and Bacteriological Evaluation of Periodontium in Patients After Renal Transplantation Receiving Cyclosporine A.
Dent Med Probl, 43 (2006), pp. 492-498
[9-]
A.A. Fay, K. Satheesh, R. Gapski.
Felodipine-influenced gingival enlargement in an uncontrolled type 2 diabetic patient.
J Periodontol, 76 (2005), pp. 1217
[10-]
J. Guo, W. Wang, L. Yao, F. Yan.
Local Inflammation Exacerbates Cyclosporine A-Induced Gingival Overgrowth in Rats.
Inflammation, 31 (2008), pp. 399-407
[11-]
R.T. Sekiguchi, C.G. Paixão, L. Saraiva, G.A. Romito, C.M. Pannuti, R.F. Lotufo.
Incidence of tacrolimus- induced gingival overgrowth in the absence of calcium channel blockers: a short-term study.
J Clin Periodontol, 34 (2007), pp. 545-550
[12-]
P. Meisel, C. Schwahn, U. John, H.K. Kroemer, T. Kocher.
Calcium antagonists and deep gingival pockets in the population-based SHIP study Br.
J Clin Pharmacol, 60 (2005), pp. 552-559
[13-]
J.Y. Jung, Y.J. Jeong, T.S. Jeong, H.J. Chung, W.J. Kim.
Inhibition of apoptotic signals in overgrowth of human gingival fibroblasts by cyclosporin A treatment.
Arch Oral Biol, 53 (2008), pp. 1042-1049
[14-]
S. Namazi, A.B. Haghighi, I. Karimzadeh.
Is oral azithromycin effective for the treatment of phenytoin-induced gingival overgrowth in epileptic patients?.
Med Hypotheses, 69 (2007), pp. 1159-1160
[15-]
Y.M. Gong, L.F. Cao, Y. Yang, Z.Y. Gu.
Relationship of putative periodontopathogenic bacteria and drug-induced gingival overgrowth.
Zhonghua Kou Qiang Yi Xue Za Zhi, 43 (2008), pp. 347-351
[16-]
D. Ciavarella, et al.
Update on gingival overgrowth by cyclosporine A in renal transplants.
Med Oral Patol Oral Cir Bucal, 12 (2007), pp. 19-25
[17-]
P. Nurmenniemi.
Inflammatory cells and mitotic activity of keratinocytes in gingival overgrowth induced by immunosuppressive and nifedipine medication.
Acta Universitatis Ouluensis, (2007), pp. 869
[18-]
C.M. Kanno, J.A. Oliveira, J.F. Garcia, A.L. Castro, M.M. Crivelini.
Effects of cyclosporin, phenytoin, and nifedipine on the synthesis and degradation of gingival collagen in tufted capuchin monkeys (Cebus apella): histochemical and MMP-1 and -2 and collagen I gene expression analyses.
J Periodontol., 79 (2008), pp. 114-122
[19-]
R.B. Lima, V. Benini, Y.A. Sens.
Gingival overgrowth in renal transplant recipients: a study concerning prevalence, severity, periodontal, and predisposing factors.
Transplant Proc, 40 (2008), pp. 1425-1428
[20-]
F. de Oliveira Costa, S. Diniz Ferreira, L.O. de Miranda Cota, J.E. da Costa, M.A. Aguiar.
Prevalence, severity, and risk variables associated with gingival overgrowth in renal transplant subjects treated under tacrolimus or cyclosporin regimens.
J Periodontol, 77 (2006), pp. 969-975
[21-]
V. Grover, A. Kapoor, C.M. Marya.
Amlodipine Induced Gingival Hyperplasia.
J Oral Health Comm Dent, 1 (2007), pp. 19-22
[22-]
J.M. Thomason, R.A. Seymour, J.S. Ellis.
Risk factors for gingival overgrowth in patients medicated with ciclosporin in the absence of calcium channel blockers.
J Clin Periodontol, 32 (2005), pp. 273-279
[23-]
A. Prabhu, D.S. Mehta.
A morphologic comparison of gingival changes influenced by cyclosporin and tacrolimus in rats: an experimental study.
J Periodontol, 77 (2006), pp. 265-270
[24-]
M. Kataota, et al.
Drug-Induced Gingival Overgrowth-a Review.
Biol Pharm Bull, 28 (2005), pp. 1817-1821
[25-]
P. Bullon, I. Gallardo, G. Goteri, C. Rubini, M. Battino, J. Ribas, H.N. Newman.
Nifedipine and cyclosporin affect fibroblast calcium and gingiva.
J Dent Res, 86 (2007), pp. 357-362
[26-]
A. Kantarci, et al.
Epithelial and connective tissue cell CTGF/CCN2 expression in gingival fibrosis.
J Pathol, 210 (2006), pp. 59-66
[27-]
T. Kato, et al.
Impaired degradation of matrix collagen in human gingival fibroblasts by the antiepileptic drug phenytoin.
J Periodontol, 76 (2005), pp. 941-950
[28-]
B.O. Cetinkaya, G. Acikgoz, B. Ayas, E. Aliyev, E.E. Sakallioglu.
Increased expression of vascular endothelial growth factor in cyclosporine A-induced gingival overgrowth in rats.
J Periodontol, 77 (2006), pp. 54-60
[29-]
M. Ogino, et al.
Integrin polymorphism in Drug-induced Gingival Overgrowth.
J Dent Res, 84 (2005), pp. 1183-1186
[30-]
B. Dannewitz, et al.
Elevation of collagen type I in fibroblast-keratinocyte cocultures emphasizes the decisive role of fibroblasts in the manifestation of the phenotype of cyclosporin A-induced gingival overgrowth.
J Periodontal Res, 44 (2009), pp. 62-72
[31-]
B. Dannewitz, et al.
Elevated gene expression of MMP-1, MMP-10, and TIMP-1 reveal changes of molecules involved in turnover of extracellular matrix in cyclosporine-induced gingival overgrowth.
Cell Tissue Res, 325 (2006), pp. 513-522
[32-]
H.C. Chiu, et al.
Cyclosporine A inhibits the expression of membrane type-I matrix metalloproteinase in gingiva.
J Periodontal Res, 44 (2009), pp. 338-347
[33-]
A. Almeida, G. Seguro Dias.
Hiperplasia Gengival- diagnóstico e tratamento.
Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilo-Facial, 45 (2004), pp. 35-40
[34-]
M. Abdollahi, R. Rahimi, M. Radfar.
Current Opinion on Drug-induced Oral Reactions: A Comprehensive Review.
J Contemp Dent Pract, 3 (2008), pp. 1-15
[35-]
S. Bulut, H. Uslu, B.H. Ozdemir, O.E. Bulut.
Analysis of proliferative activity in oral gingival epithelium in immunosuppressive medication induced gingival overgrowth.
Head Face Med, 19 (2006), pp. 2-13
[36-]
Y. Tamamori, et al.
Establishment of Rat Model of Drug-Induced Gingival Overgrowth Induced by Continuous Administration of Phenytoin.
J Pharmacol Sci, 98 (2005), pp. 290-297
[37-]
E.E. Alaaddinoglu, G. Karabay, S. Bulut, F.B. Oduncuoglu, H. Ozdemir, O.E. Bulut, T. Colak.
Apoptosis in cyclosporin A-induced gingival overgrowth: a histological study.
J Periodontol, 76 (2005), pp. 166-170
[38-]
B. Li, S. Weibin, J. Yong.
The effect of Nifedipine on the expression of type I collagen in gingival fibroblasts.
J Nanjing Medical University, 22 (2008), pp. 92-95
[39-]
K. Lin, et al.
Drug-induced Gingival Enlargement – Part II Antiepileptic Drugs: Not Only Phenytoin is Involved.
J Epilepsy Clin Neurophysiol, 13 (2007), pp. 83-88
[40-]
F.A. Carranza, E.L. Hogan.
Gingival enlargement.
Carranza's clinical periodontology, 9th, pp. 279-296
[41-]
M. Mavrogiannis, J.S. Ellis, J.M. Thomason, R.A. Seymour.
The management of drug-induced gingival overgrowth.
J Clin Periodontol, 33 (2006), pp. 434-439
[42-]
M. Mavrogiannis, J.S. Ellis, R.A. Seymour, J.M. Thomason.
The efficacy of three different surgical techniques in the management of drug-induced gingival overgrowth.
J Clin Periodontol, 33 (2006), pp. 677-682
[43-]
S.A. Condé, F.M. Aarestrup, B.J. Vieira, M.G. Bastos.
Roxithromycin reduces cyclosporine-induced gingival hyperplasia in renal transplant patients.
Transplant Proc, 40 (2008), pp. 1435-1438
[44-]
C.A. Nassar, P.O. Nassar, D.C. Andia, M.R. Guimarães, L.C. Spolidorio.
The effects of up to 240 days of tacrolimus therapy on the gingival tissues of rats--a morphological evaluation.
Oral Dis, 14 (2008), pp. 67-72
[45-]
C.M. Haytac, Y. Ustun, E. Essen, O. Ozcelik.
Combined treatment approach of gingivectomy and CO2 laser for cyclosporineinduced gingival overgrowth.
Quintessence Int, 38 (2007), pp. 54-59
[46-]
P. Kafas, N. Dabarakis, M. Theodoridis.
Performing gengivoplasty without injected anaesthesia: a case report.
Surgery J, 3 (2008), pp. 27-29
[47-]
A. Popova.
Surgical Approach to drug induced gingival enlargement in renal transplant patients. Case report.
J IMAB - Annual Proceeding (Scientific Papers), (2007), pp. 2
(Dias GS, Osório VV, Almeida A. Aumento de Volume Gengival Induzido por Fármacos. Rev Port Estomatol Med Dent Cir Maxilofac 2010;51:177–184)
Copyright © 2010. Sociedade Portuguesa de Estomatologia e Medicina Dentária