Prevalence and risk of gingival overgrowth in patients treated with diltiazem or verapamil

Miranda, Juan Gabriel Loreto; Brunet, Lluís; Roset, Pere N.; Berini, Leonardo; Farré, Magı́; Mendieta, Carlos

doi:10.1111/j.1600-051x.2005.00662.x

Cited by 28 publications

(33 citation statements)

References 30 publications

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“…However, the causes of GO are complex. In fact, the degree of the GO may differ in the same patient's gingiva by location, probably due to the degree of plaque retention (31)(32). Pathologically, the condition of gingival tissues varies by case, ranging from edematous/strongly inflamed to fibrous/weakly inflamed.…”

Section: Discussionmentioning

confidence: 99%

A case report of multiple-drug-induced gingival overgrowth with TIMP-3 over-expression

et al. 2008

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A case of multiple-drug-induced gingival overgrowth (GO) in a 46-year-old male is reported. The patient exhibited severe gingival enlargement throughout the entire mandible and maxilla with a history of multiple medications for psychiatric and internal diseases. A gingivectomy specimen was examined pathologically and further analyzed using immunohistochemical and molecular biological methods for the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). Histologically, the gingival overgrowth was due to fibrous granulation tissue with hyperplastic collagen bundles and squamous epithelia, and the lesion was pathologically diagnosed as drug-induced gingival hyperplasia. An enhanced transcript level for TIMP-3 but reduced levels for MMPs and cathepsin L were quantitatively determined by RT-PCR. TIMP-3 was strongly immunohistochemically localized in fibroblasts and endothelial cells. DNA invader genotyping revealed that the patient carried one GO-related allele (α2 integrin +807C). These findings showed that, in this GO case, collagen accumulation in the gingival granulation tissue was associated with decreased MMPs and increased TIMP-3 expression, which was suggested to be synergistically induced by simultaneous and multiple medications, including nifedipine and antipsychotic drugs.

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Section: Discussionmentioning

confidence: 99%

A case report of multiple-drug-induced gingival overgrowth with TIMP-3 over-expression

et al. 2008

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“…Most studies that evaluated diltiazem-induced gingival enlargement in humans [4][5][6][7] had to deal with a heterogenous sample regarding age, duration of drug use, dose and other variables. Therefore, further research using animal models should be undertaken to evaluate the behavior of gingival tissue after long-term use of diltiazem, in order to evaluate other mechanisms that might be involved in gingival overgrowth, not only gingival infl ammation.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 On the other hand, there are few reports of diltiazeminduced gingival overgrowth in humans. [4][5][6][7] The fi ndings of a recent study 8 showed that in rats with noninfl amed gingival tissue, diltiazem did not induce gingival overgrowth. Nevertheless, the pathogenesis of drug-induced gingival enlargement is uncertain and confl icting and has been related to several factors, namely age, gender, treatment duration, plasmatic and salivary drug concentration, presence of bacterial biofi lm, gingival tissue infl ammation, genetics and synergism with other medicaments.…”

Section: Introductionmentioning

confidence: 99%

Influence of diltiazem in combination with a sucrose-rich diet on gingival alterations in rats

et al. 2009

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The aim of this study was to evaluate the infl uence of diltiazem in combination with a sucrose-rich diet on gingival alterations in rats. One hundred and twenty male Holtzman rats were randomly assigned to 10 groups (n = 12), being 2 control groups treated with saline and 8 test groups treated with diltiazem in daily doses of 5, 25, 50 and 100 mg/kg during 40 or 60 days. Afterwards, the mandibles were removed for macroscopic, histologic and histometric analyses of the buccal gingiva of the mandibular right fi rst molar. No macroscopic characteristic of gingival overgrowth was observed in any of the groups. The microscopic analysis showed characteristics of normality with infl ammatory cells only adjacent to the crevicular epithelium in all groups for both periods. The histometric analysis showed signifi cant differences only for the epithelial tissue area in the 40-day period (Kruskal-Wallis; P = 0.032). Comparing the periods, signifi cant differences regarding the connective and epithelial tissue areas were observed only in the group treated with a 25 mg/kg dose (Mann-Whitney; P = 0.004 and P = 0.007, respectively). Oral administration of diltiazem in combination with a sucrose-rich diet did not induce gingival alterations in rats.

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“…Celle-ci peut être soit inflammatoire (locale par une irritation chronique, généralisée par un désordre systémique), soit fibreuse (génétique, médicamenteuse). L'hyperplasie d'origine médicamenteuse est un effet secondaire connu à la prise de plusieurs molécules, notamment de la phénytoïne, la ciclosporine A et la nifédipine [1], un autre antagoniste calcique. Des facteurs favorisants, tels qu'une hygiène bucco-dentaire déficiente ou des facteurs d'irritation locaux (restaurations débordantes, prothèses mal adaptées) sont également décrits [1].…”

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Une hyperplasie gingivale inhabituelle

Saïd

Stroumsa

Foletti

et al. 2014

Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chiru

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Prevalence and risk of gingival overgrowth in patients treated with diltiazem or verapamil

Abstract: Patients taking diltiazem are at high risk for gingival enlargement and gingivitis has a stronger effect than the drug treatment on gingival enlargement risk.

Cited by 28 publications

References 30 publications

A case report of multiple-drug-induced gingival overgrowth with TIMP-3 over-expression

A case report of multiple-drug-induced gingival overgrowth with TIMP-3 over-expression

Influence of diltiazem in combination with a sucrose-rich diet on gingival alterations in rats

Une hyperplasie gingivale inhabituelle

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