Phenytoin-induced gingival overgrowth is a well-known and frequently reported gingival lesion, which was first detected in 1939. However, there are conflicts in the literature about the agents which affect the severity of the lesion. Un-cooperative dental patients are one of the most unsuccessfully treated periodontal patient groups because of the difficulty in maintaining their oral hygiene. This case report consists of two cases with the same characteristics: phenytoin usage, comprehension and speech defects and poor oral hygiene, but each case differs in the duration of the phenytoin therapy. Both of the cases received scaling, root planning and a gingivectomy.
Adult ; Anticonvulsants/*adverse effects ; Epilepsy/*drug therapy ; Gingival Overgrowth/*chemically induced ; Human ; Male ; Oral Hygiene ; Patient Compliance ; Phenytoin/*adverse effects

OBJECTIVETo investigate the prevalence and risk indicator of nifedipine-induced gingival overgrowth in a community population in Beijing.

METHODSA cross-sectional survey was conducted in 616 community subjects with hypertension or coronary vascular disease in Beijing, China. Among them 205 individuals took nifedipine for at least half year and 411 individuals who had never received calcium channel blocker (CCB) were recruited as controls. Smoking, oral hygienic habit, systemic health, pharmacological and demographic data for each subject were recorded by questionnaire. Sulcus bleeding index (SBI) was assessed in 12 anterior teeth per subject. Turesky modified Quigley-Hein plaque index (PI) and gingival overgrowth index in anterior teeth were scored on photograph. 38.6% was defined as threshold to identify individual with significant gingival overgrowth.

RESULTS7.3% of the subjects taking nifedipine were found to have significant gingival overgrowth in this population. The prevalence of gingival overgrowth in nifedipine group was statistically higher than that in the control group. By logistic regression analysis, SBI was found to be the only risk indicator (odds ratio = 5.92, P = 0.001).

CONCLUSIONSThe presence of gingival inflammation was an important cofactor for the occurrence of gingival overgrowth.

Adult ; Aged ; Aged, 80 and over ; Calcium Channel Blockers ; adverse effects ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Gingival Overgrowth ; chemically induced ; epidemiology ; Humans ; Logistic Models ; Male ; Middle Aged ; Nifedipine ; adverse effects ; Prevalence ; Risk Factors

OBJECTIVETo investigate the effect of cyclosporin A (CsA) and tumor necrosis factor-α (TNF-α) on cell proliferation of cultured human gingival fibroblasts (GF), and the relationship between gingival inflammation and drug-induced gingival overgrowth.

METHODSHuman GF were cultured in vitro using tissue culture method. then cells from the 4 - 8 th passage were used in the experiment. The cells were cultured and incubated with various concentrations of CsA and TNF-α (A: blank group, B1: 10 µg/L CsA, B2: 50 µg/L CsA, B3: 250 µg/L CsA, B4: 1250 µg/L CsA, C: 5 µg/L TNF-α, D1: 10 µg/L CsA + 5 µg/L TNF-α, D2: 50 µg/L CsA + 5 µg/L TNF-α, D3: 250 µg/L CsA + 5 µg/L TNF-α, D4: 1250 µg/L CsA + 5 µg/L TNF-α) solution for 3, 5 and 7 days. Methyl thiazolyl tetrazolium assay was used to evaluate the cell proliferation in the culture meidiun.

RESULTSThe proliferation of fibroblasts was inhibited when exposed to different concentration of CsA and A value decreased. There was no significant difference between group B1, B2, B3 and the control group, while the A value of group B4 was significantly higher than that of control group (P < 0.01). Fibroblast proliferation was significantly increased while cultured with 5 µg/L TNF-α. A value increased (P < 0.01). When exposed to CsA + TNF-α, A value of group D1, D2, D3 was much higher than that of group A, but was lower than that of group C (P < 0.05). Cell proliferation in group D4 was significantly increased, and significantly different with that in group C (P < 0.01).

CONCLUSIONSCsA did not stimulate the cell proliferation, and high concentration of CsA inhibited cell proliferation. TNF-α can stimulate the cell proliferation. High-concentration CsA + TNF-α can enhance the fibroblast proliferation, which suggests that CsA in certain concentration have amplification effect on TNF-α to stimulate fibroblast proliferation.

Adult ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclosporine ; adverse effects ; pharmacology ; Dose-Response Relationship, Drug ; Fibroblasts ; cytology ; Gingiva ; cytology ; Gingival Overgrowth ; chemically induced ; Humans ; Immunosuppressive Agents ; adverse effects ; pharmacology ; Tumor Necrosis Factor-alpha ; adverse effects ; pharmacology

OBJECTIVETo investigate the effect of putative periodontopathogenic bacteria on the development of drug-induced gingival overgrowth (GO) in renal transplant recipients.

METHODSA total of 57 patients undergoing cyclosporine treatment were divided into two groups according to GO index: with gingival overgrowth (group A) and without gingival overgrowth (group B). Demographic, pharmacologic and periodontal data were analyzed. The real-time polymerase chain reaction (PCR) method was used to detect and quantify five putative periodontopathogenic bacteria, including Porphyromonas gingivalis (Pg), Actinobacillus actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Treponema denticola (Td) and Tannerella forsythia (Tf) in subgingival samples. Moreover, the relationship between the bacterial amount and the severity of GO was analyzed.

RESULTSGroup A presented a significantly higher plaque index, sulcus bleeding index and probing depth than group B (P < 0.01). The occurrences of Pg, Td, and Tf in the group A (96%, 82% and 89%) were significantly increased compared with those in the group B (69%, 55% and 66%, P < 0. 05), respectively. The prevalence of Pg, Td, and Tf in the group A (79%) was markedly higher than that in the group B (38%, P < 0.01). The bacterial amount of Pg, Td, Tf and Pi were enhanced along with the severity of GO. However, the bacterial amount of Aa had no difference between two groups.

CONCLUSIONSPg, Td, and Tf may have a significant relationship with the development of GO.

Adult ; Aggregatibacter actinomycetemcomitans ; isolation & purification ; Bacterial Typing Techniques ; Cyclosporine ; adverse effects ; DNA, Bacterial ; Female ; Gingival Overgrowth ; chemically induced ; microbiology ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Porphyromonas gingivalis ; isolation & purification ; Prevotella intermedia ; isolation & purification ; Treponema denticola ; isolation & purification