Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9926-9934
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9926
Clinical presentation and management of drug-induced gingival overgrowth: A case series
Li Fang, Bao-Chun Tan
Li Fang, Department of Stomatology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian 223800, Jiangsu Province, China
Bao-Chun Tan, Departments of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
Author contributions: Fang L conceived and coordinated the study, designed, performed and analyzed the experiments, wrote the paper; Tan BC carried out the data collection, data analysis and revised the paper; both authors reviewed the results and approved the final version of the manuscript.
Supported by the Nanjing Clinical Research Center for Oral Diseases, No. 2019060009; the Nanjing Medical Science and Technology Development Program, No. YKK17139; and the Medical Innovation Team of Scientific and Educational Health in the Jiangsu Province, No. CXTDB2017014.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Chun Tan, MS, Doctor, Departments of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No. 30 Zhongyang Road, Nanjing 210008, Jiangsu Province, China. tanbaochun2002@163.com
Received: May 21, 2021
Peer-review started: May 21, 2021
First decision: July 15, 2021
Revised: August 2, 2021
Accepted: September 19, 2021
Article in press: September 19, 2021
Published online: November 16, 2021
Processing time: 172 Days and 12.4 Hours
Abstract
BACKGROUND

We report three patients with drug-induced gingiva overgrowth (DIGO) caused by nifedipine, a calcium channel blocker, who were treated and followed up for 1–3 years. We discussed their symptoms, treatment process, treatment prognosis, and follow-up results.

CASE SUMMARY

All the patients had a history of nifedipine treatment to control hypertension. Besides nifedipine, Patient 1 was prescribed immunosuppressant cyclosporine A to control nephritis, which is also implicated in GO. Thus, we assumed that a synergistic effect between the drugs contributed to the severity of Patient 1’s condition. This condition has been reported to be more pronounced in patients with periodontitis. In the course of treatment, Patients 1 and 2 did not stop or change drugs. After initial periodontal treatment, periodontal surgery, and later periodontal support and better plaque control, their gingival hyperplasia was well managed and controlled. Under the guidance of a physician, Patient 3 replaced her calcium-channel blocker drug with losartan potassium and hydrochlorothiazide tablets. She received initial treatment without surgery, obtaining a good curative effect.

CONCLUSION

Patients’ compliance, self-plaque control, and professional periodontal therapy have a vital role in treating and preventing the recurrence of DIGO.

Keywords: Drug-induced gingiva overgrowth; Nifedipine; Periodontal surgery; Treatment prognosis; Case report

Core Tip: Our data suggest that initial periodontal therapy and replacing drugs may be useful for treating drug-induced gingival overgrowth (DIGO) in patients with heavy periodontitis and mild GO. For those patients who cannot replace medications, basic periodontal treatment, periodontal surgery, and timely and effective periodontal maintenance therapy can also be used to treat and prevent a recurrence. Patients’ compliance, self-plaque control, and professional periodontal therapy have a vital role in treating and preventing the recurrence of DIGO.