Gingival Overgrowth Induced by Amlodipine

Is dental plaque the only etiological factor in Amlodipine induced gingival overgrowth? A systematic review of evidence

“…There were 10 cross- sectional ( 7 , 9 - 12 , 14 , 16 , 18 - 20 ) and 3 case control studies ( 13 , 15 , 17 ). About 7 studies were conducted in India ( 7 , 13 - 17 , 19 ) and one each in United States of America ( 9 ), United Kingdom ( 10 ), Japan ( 11 ), Germany ( 12 ), Sudan ( 18 ) and Nigeria ( 20 ). The total number of subjects involved in these studies ranged from 25 to 4290 with the number of males having AIGO being more than females.…”

“…The duration of amlodipine therapy ranged from 3 months to > 9 years. Four studies evaluated development of overgrowth with ≤ 6 months of therapy ( 9 , 11 , 14 , 15 ). However, majority of studies evaluated GO with > 6 months of therapy ( 7 , 10 , 13 - 16 , 19 , 20 ).…”

“…A significant association of AIGO was seen between PI and GI in these studies. Two studies reported presence of GO in amlodipine patients but did not evaluate the levels of plaque and oral hygiene ( 11 , 20 ). The probing depth and CAL were associated with GO in two studies ( 12 , 16 ).…”

“…The dosage of the drug and duration were not significantly correlated with GO in three studies ( 7 , 14 , 19 ) while two studies reported probable association between the duration of therapy and AIGO ( 15 , 16 ). However, two studies, reported a reduction in size of GO following amlodipine withdrawal for two months ( 11 , 17 ). The lowest dose of drug causing GO was 2.5 mg/day in one study ( 19 ) while 10mg/day dosage resulted in rapid overgrowth ( 15 ).…”

“…The lowest dose of drug causing GO was 2.5 mg/day in one study ( 19 ) while 10mg/day dosage resulted in rapid overgrowth ( 15 ). A minimum of 3 months of therapy resulted in overgrowth in one study ( 11 ). Interestingly, two studies reported increased incidence of GO in patients on amlodipine when compared to nifedipine ( 10 , 20 ).…”