2/18/2023 0 Comments Gingival overgrowthSince this side-effect is not rare in a group of cardiovascular patients, oral health needs to be emphasized and included as part of a care plan for patients treated with the drugs mentioned above.ĭIGO usually starts as painless enlargement of interdental papillae and progresses towards facial and lingual margins, covering the teeth crowns. As a result, quality of life is reduced significantly. Simultaneously, the extensive disease can cause pain and loss of the teeth. Aside from the cosmetic effect, which is the most apparent feature, patients who develop DIGO experience difficulty maintaining oral hygiene, pronunciation, and mastication. Genetic factors, male gender, bacterial plaque, and gingival inflammation are associated with increased DIGO risk. Significant variability among patients medicated with the same drugs is observed, indicating the importance of additional risk factors involved in the pathogenesis. Antiepic drugs ( e.g., phenytoin, valproic acid, phenobarbital, vigabatrin) are recognized as a prominent group of medications causing DIGO, although in recent years, cases of DIGO resulting from these drugs were less frequently reported.Ĭardiovascular and transplanted patients are at particular risk due to the extensive use of CCBs alone or in combination with immunosuppressants. Although more than 20 different drugs are now known to cause DIGO, it most frequently results from calcium channel blockers (CCBs) and immunosuppressants. Since then, various medications showed to be associated with this side-effect. The first large DIGO case series was described in 1939, showing DIGO in 68 out of 119 patients treated by antiepileptic drug phenytoin. Recognizing the potential of commonly used medications to cause DIGO and its effect on patients' health is necessary for early detection and adequate management of this complication.ĭrug-induced gingival overgrowth (DIGO) is a pathological growth of the gingiva characterized by the accumulation of connective tissue that primarily affects the anterior regions of the maxilla and mandibula. Treatment includes discontinuing the drug and switching to one with a better profile, improving oral hygiene, and surgical removal of enlarged tissue. The interdisciplinary approach and cooperation with dental care experts are necessary for patient management. Furthermore, these patients also have an increased risk for cardiovascular diseases. Patients with DIGO may experience severe discomfort, trouble with speech and mastication, pain, and teeth loss, aside from cosmetic implications. Several factors are involved in the pathogenesis and can increase the risk, such as male gender, younger age, pre-existing periodontal inflammation, and concomitant use of other DIGO-inducing medications. Accumulated collagen with inflammatory infiltrates is the histological hallmark of this condition. As for immunosuppress ants, cyclosporin is the leading causative agent, whereas other drugs from this drug-group, including tacrolimus, have better safety profiles. Nifedipine remains the main calcium channel blocker related to the development of this unpleasant side-effect. Consequently, it is mainly seen in cardiovascular and transplanted patients. Drug-induced gingival overgrowth (DIGO) is a pathological growth of gingival tissue, primarily associated with calcium channel blockers and immunosuppre ssants.
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