IADR Abstract Archives
Drug induced gingival overgrowth in patients on calcium channel blockers
Objectives: Drug induced gingival overgrowth (DIGO) is a multifactorial disease associated with administration of specific family of drugs like cyclosporine, calcium channel blockers (CCBs) and phenytoin. The onset, severity and susceptibility of DIGO depends on various factors like patient’s age, gender, race, genetic predisposition, gingival health status and oral hygiene. We aim to study the prevalence and risk factors of DIGO in patients taking antihypertensive medications in Singapore.
Methods: Seventy four patients with hypertension attending the dental clinic at National University Hospital were enrolled for the pilot study. Cases include 54 patients who were on CCBs and 22 patients were not on any CCB medications. Details of demographics, personal and family history and use of type of CCB medication were collected from all the subjects and clinical parameters like pocket probing depth, bleeding on probing, plaque score, clinical attachment level, calculus and gingival overgrowth were evaluated at six upper and lower anterior teeth in each patient. Gingival overgrowth was assessed using Ingles criteria with grades ranging from 0 to 4. Gingival overgrowth was graded as being present if the grading was 2 and above. Differences between study group (patients on CCBs) and control group (patients not on CCBs) were assessed using chi square test for binary variables and student’s t-test for continuous variables. For the primary outcome of gingival overgrowth as a binary variable, logistic regression was performed to assess the relationships with different patient demographic factors, symptoms, dental history and clinical parameters.
Results: The mean age of the pilot study cohort was 58.12 ± 8.38 (40-75) years and there were 39 male and 35 female. Prevalence of the DIGO was 42.3% in our study cohort. Administration of CCBs and bleeding on probing was significantly associated with DIGO (p<0.001).
Conclusions: Our study demonstrated significant association of gingival overgrowth with CCBs. Bleeding on probing could be potential markers for underlying inflammation in DIGO in patients on CCBs. Further large scale mechanistic study looking into the relevant biomarkers and risk factors of DIGO is warranted to better manage this complex situation.
Methods: Seventy four patients with hypertension attending the dental clinic at National University Hospital were enrolled for the pilot study. Cases include 54 patients who were on CCBs and 22 patients were not on any CCB medications. Details of demographics, personal and family history and use of type of CCB medication were collected from all the subjects and clinical parameters like pocket probing depth, bleeding on probing, plaque score, clinical attachment level, calculus and gingival overgrowth were evaluated at six upper and lower anterior teeth in each patient. Gingival overgrowth was assessed using Ingles criteria with grades ranging from 0 to 4. Gingival overgrowth was graded as being present if the grading was 2 and above. Differences between study group (patients on CCBs) and control group (patients not on CCBs) were assessed using chi square test for binary variables and student’s t-test for continuous variables. For the primary outcome of gingival overgrowth as a binary variable, logistic regression was performed to assess the relationships with different patient demographic factors, symptoms, dental history and clinical parameters.
Results: The mean age of the pilot study cohort was 58.12 ± 8.38 (40-75) years and there were 39 male and 35 female. Prevalence of the DIGO was 42.3% in our study cohort. Administration of CCBs and bleeding on probing was significantly associated with DIGO (p<0.001).
Conclusions: Our study demonstrated significant association of gingival overgrowth with CCBs. Bleeding on probing could be potential markers for underlying inflammation in DIGO in patients on CCBs. Further large scale mechanistic study looking into the relevant biomarkers and risk factors of DIGO is warranted to better manage this complex situation.