Drug Induced Gingival Overgrowth : A review
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 7, Pages 1744-1756
AbstractPharmacological drug therapies are frequently associated with undesirable side effects. When considering the periodontal aspects, Drug Induced Gingival Overgrowth (DIGO) is a one such adverse effect. The first case of gingival overgrowth (previously known as hyperplasia) was reported by Kimball (1939) following chronic phenytoin therapy. Since then such proliferative lesions have been reported associated with several other groups of drugs namely Phenytoin (PHT) among the anti- epileptics, Cyclosporine (CsA) amongst immunosuppressants and various Calcium Channel Blockers (CCBs). The condition gradually leads to complications like pain, gingival disfigurement (aesthetic concerns) and difficulty in maintaining oral hygiene measures.
Management of this condition has been of a great challenge to the clinicians due to its relapse and persistence of risk factors (Age, periodontal factors, drug variables and genetic association). When considering the risk factors, their sensitivity and reliability are of utmost importance for determining the incidence of recurrence and formulation of patient specific therapy. Along with periodontal consultation, treatment should be multidisciplinary in approach discussed with the concerned physician. Initially non-surgical approach including elimination of local factors and drug substitution should be opted. The persistence of condition later necessitates the need for periodontal surgery in form of gingivectomy and flap surgery. Following surgery, maintenance by meticulous oral hygiene with chlorhexidine mouth rinses and periodic professional cleaning should be considered to prevent it from recurring and re-treatment.
Thus, for overall benefit of the patient it is fundamental to know the condition while considering its treatment. This review will briefly summarize the clinical aspects, pathogenesis, risk factors and management of DIGO.
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