Cited by 201Oral and gingival health researchOral microbiology and periodontitis researchOral Health Pathology and Treatment

Informational Paper: Drug‐Associated Gingival Enlargement

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Anna I. Dongari‐Bagtzoglou·2004·Journal of Periodontology

Abstract

This informational paper is intended to provide the dental profession with an overview of existing evidence regarding the prevalence, risk factors, pathogenesis, and clinical management of drug‐associated gingival enlargement. J Periodontol 2004;75:1424‐1431.

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Registry

Crossref · 10.1902/jop.2004.75.10.1424

Cites

62 of 62 references verified0 citation errors · 0 not checkable

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  • The severity of gingival overgrowth varies among different classes of drugs.

    “The severity of overgrowth varies among different classes of drugs, with phenytoin having the highest incidence of reported cases, whereas cases associated with sodium valproate are minimal.”

    From Sodium Valproate-Induced Gingival Enlargement in a Pediatric Patient: A Case Report With Surgical Intervention (2025) · cites this paper as [3]

    The paper reports that gingival-overgrowth severity can differ with medication combinations: patients taking cyclosporine A plus a calcium channel blocker had more severe lesions than those taking cyclosporine A alone (Pharmacologic Category Agent Trade Name Prevalence; page not given). But its comparison of phenytoin with other drug categories concerns prevalence, not severity (Conclusion; page not given), so it does not establish the claimed severity difference across drug classes. (LLM, conf=0.83)

    Experimental — accuracy not yet measured
  • Risk factors for drug-induced gingival overgrowth include drug dose, genetic factors, plaque, gingival inflammation, periodontal health, age, and bacteria.

    “The risk factors and causative agents that increase the abnormal growth of gingiva include age, genetic factors, drug doses, plaque inflammation, and bacteria [3,9].”

    From Sodium Valproate-Induced Gingival Enlargement in a Pediatric Patient: A Case Report With Surgical Intervention (2025) · cites this paper as [3]

    The “RISK FACTORS Plaque” section links plaque and gingival inflammation to enlargement, while “Other Factors” identifies age and HLA-associated genetic differences. But “Other Factors” says most studies found no significant association with drug dose, and the copy does not identify bacteria as a risk factor for the enlargement itself. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • Documented cases of sodium valproate-induced gingival enlargement are minimal.

    “The documented cases of sodium valproate are minimal.”

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Cites

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Research works printed but not linked: 17

  1. Rees TD, Levine RA. Systemic drugs as a risk factor for periodontal disease initiation and progression. Com- pend Contin Educ Dent 1995;16:20-42.
  2. Lewis IK, Hanlon JT, Schmader KE, et al. Use of medica- tions with potential oral adverse drug interactions in com- munity-dwelling elderly. Spec Care Dentist 1993;13: 171-176.
  3. Seymour R, Heasman P. Drugs, Diseases and the Peri- odontium. Oxford: Oxford University Press; 1992.
  4. Gregoriou A, Schneider P, Shaw P. Phenobarbital-induced gingival overgrowth? Report of two cases and complica- tions in management. ASDC J Dent Child 1996;63: 408-413.
  5. Katz J, Givol N, Chaushu G, Taicher S, Shemer J. Viga- batrin-induced gingival overgrowth. J Clin Periodontol 1997;24:180-182.
  6. Billingham ME. Diagnosis of acute cardiac rejection by endomyocardial biopsy. Bibl Cardiol 1988;43:83-102.
  7. Boltchi FE, Rees TD, Iacopino AM. Cyclosporine A- induced gingival overgrowth: A comprehensive review. Quintessence Int 1999;30:775-783.
  8. Ciancio S, Bartz N, Lauciello F. Cyclosporine-induced gingival hyperplasia and chlorhexidine: A case report. Int J Periodontics Restorative Dent 1991;11:241-245.
  9. Payne VM. Re: Periodontal management of gingival over- growth in the heart transplant patient: A case report (1997;68:1140-1146). J Periodontol 1998;69:1314-1315.
  10. Mariani G, Calastrini C, Carinci F, et al. Ultrastructural features of CsA-induced gingival hyperplasia. J Peri- odontol 1993;64:1092-1097.
  11. Santi E, Bral M. Effect of treatment on cyclosporine- and nifedipine-induced gingival enlargement: Clinical and histologic results. Int J Periodontics Restorative Dent 1998;18:80-85.
  12. Montebugnoli L, Bernardi F. Cyclosporin A effects on extraoral connective tissue in heart transplanted patients. J Int Acad Periodontol 1999;1:91-94.
  13. Hassell TM, Buchanan J, Cuchens M, et al. Fluores- cence activated vital cell sorting of human fibroblast subpopulations that bind CsA. J Dent Res 1988;67:273- 276.
  14. Myrillas TT, Linden GJ, Marley JJ, Irwin CR. Cyclo- sporin A regulates interleukin-1beta and interleukin-6 expression in gingiva: Implications for gingival over- growth. J Periodontol 1999;70:294-300.
  15. Kataoka M, Shimizu Y, Kunikiyo K, et al. Cyclosporin A decreases the degradation of type I collagen in rat gin- gival overgrowth. J Cell Physiol 2000;182:351-358.
  16. Hall EE. Prevention and treatment considerations in patients with drug-induced gingival enlargement. Curr Opin Periodontol 1997;4:59-63.
  17. Boraz RA. A dental protocol for the pediatric cardiac transplant patient. ASDC J Dent Child 1986;53:382- 385.

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Authors
Dongari‐Bagtzoglou, A. I.
Corresponding author
Anna I. Dongari‐Bagtzoglou
Venue
Journal of Periodontology
Publisher
Wiley
Published
2004-10
Volume
75
Issue
10
Pages
1424-1431
ISSN
  • 0022-3492 (ISSN-L)
  • 1943-3670
OpenAlex
W46952399
Cited by
201
References
62
Citations by year
2026: 2 · 2025: 8 · 2024: 13 · 2023: 6 · 2022: 9 · 2021: 23 · 2020: 12 · 2019: 15 · 2018: 6 · 2017: 12 · 2016: 6 · 2015: 14 · 2014: 13 · 2013: 10 · 2012: 9
FWCI
16.36
Type
journal article
Language
en
Open access
Locations
  • Journal of Periodontology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Pharmacy › Oral and gingival health research
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Dentistry › Periodontics › Oral Health Pathology and Treatment
Keywords
gingival hyperplasia, prevalence, risk factors, pathogenesis, clinical management, antiepileptic drugs, immunosuppressants, antithrombotic agents
MeSH terms
Anticonvulsants, Calcium Channel Blockers, Humans, Immunosuppressive Agents, Risk Factors, Gingival Overgrowth

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