PREVALENCE, CLINICAL FEATURES AND TREATMENT ALGORITM OF PATIENTS WITH DRUG-INDUCED GINGIVAL ENLARGEMENT

Abstract

Some pharmacological drugs, with constant daily use, can cause a side effect in humans such as gingival enlargements. These include: anticonvulsants (phenytoin), immunosuppressors (cyclosporine, tacrolimus, azathioprine), calcium tubule blockers from the group of antihypertensive agents (nifedipine, amlodipine, lercanidipine, etc.). In the new International Classification of periodontal and peri-implant diseases and conditions (AAP&EFP, Chicago, 2017) the nosological form "drug-influenced gingival enlargements" is included in a separate subsection C to paragraph 2 "Gingivitis – dental biofilm-induced” of I group “Periodontal health, gingival diseases/conditions". Purpose of the study. To determine the clinical features and the treatment tactics of patients with drug-influenced gingival enlargements. Methods. 28 patients (17 men, 11 women) at the age of 24-73 years with drug-influenced gingival enlargements were examined. Clinical, radiological and laboratory tests were conducted. Results. It was found that more often drug-influenced gingival enlargements occurs in men (60.7%). Periodontitis of varying degrees has been diagnosed in all patients with gingival hyperplasia in various somatic pathologies. 3 persons with druginfluenced gingival enlargements accepted fenitoin, 2 persons after kidney transplant surgery – сyclosporine and 23 patients (82,1%) with grade II-III hypertensive disease accepted calcium channel blockers (nifedipine, amlodipine, lercanidipine). Among drugs most often causes side effect in the gingival enlargement аmlodipine (at 17 people, 60,7%). It is shown that the drug-induced gingival enlargement contributes to a more severe course of periodontitis, which requires clarification of treatment protocols. All patients with drug-induced gingival enlargement received conservative therapy, which included: scaling, air-abrasive polishing, topical antimicrobial (0.12% chlorhexidine) and antiinflammatory (benzydamine hydrochloride) therapy. In 14 patients, a course of photodynamic therapy was additionally performed. All patients were trained in individual hygiene and recommended oral care products. Conclusions. Treatment algorithm of patients with the drug-induced gingival enlargement is proved.