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Drug-induced gingival overgrowth in cardiovascular patients

Drug-induced gingival overgrowth (DIGO) is a pathological growth of gingival tissue, primarily associated with calcium channel blockers and immunosuppressants. Consequently, it is mainly seen in cardiovascular and transplanted patients. Nifedipine remains the main calcium channel blocker related to...

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Autores principales: Bajkovec, Lucija, Mrzljak, Anna, Likic, Robert, Alajbeg, Ivan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069521/
https://www.ncbi.nlm.nih.gov/pubmed/33968305
http://dx.doi.org/10.4330/wjc.v13.i4.68
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author Bajkovec, Lucija
Mrzljak, Anna
Likic, Robert
Alajbeg, Ivan
author_facet Bajkovec, Lucija
Mrzljak, Anna
Likic, Robert
Alajbeg, Ivan
author_sort Bajkovec, Lucija
collection PubMed
description Drug-induced gingival overgrowth (DIGO) is a pathological growth of gingival tissue, primarily associated with calcium channel blockers and immunosuppressants. Consequently, it is mainly seen in cardiovascular and transplanted patients. Nifedipine remains the main calcium channel blocker related to the development of this unpleasant side-effect. As for immunosuppressants, cyclosporin is the leading causative agent, whereas other drugs from this drug-group, including tacrolimus, have better safety profiles. Accumulated collagen with inflammatory infiltrates is the histological hallmark of this condition. Several factors are involved in the pathogenesis and can increase the risk, such as male gender, younger age, pre-existing periodontal inflammation, and concomitant use of other DIGO-inducing medications. Patients with DIGO may experience severe discomfort, trouble with speech and mastication, pain, and teeth loss, aside from cosmetic implications. Furthermore, these patients also have an increased risk for cardiovascular diseases. The interdisciplinary approach and cooperation with dental care experts are necessary for patient management. Treatment includes discontinuing the drug and switching to one with a better profile, improving oral hygiene, and surgical removal of enlarged tissue. Recognizing the potential of commonly used medications to cause DIGO and its effect on patients' health is necessary for early detection and adequate management of this complication.
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spelling pubmed-80695212021-05-06 Drug-induced gingival overgrowth in cardiovascular patients Bajkovec, Lucija Mrzljak, Anna Likic, Robert Alajbeg, Ivan World J Cardiol Opinion Review Drug-induced gingival overgrowth (DIGO) is a pathological growth of gingival tissue, primarily associated with calcium channel blockers and immunosuppressants. Consequently, it is mainly seen in cardiovascular and transplanted patients. Nifedipine remains the main calcium channel blocker related to the development of this unpleasant side-effect. As for immunosuppressants, cyclosporin is the leading causative agent, whereas other drugs from this drug-group, including tacrolimus, have better safety profiles. Accumulated collagen with inflammatory infiltrates is the histological hallmark of this condition. Several factors are involved in the pathogenesis and can increase the risk, such as male gender, younger age, pre-existing periodontal inflammation, and concomitant use of other DIGO-inducing medications. Patients with DIGO may experience severe discomfort, trouble with speech and mastication, pain, and teeth loss, aside from cosmetic implications. Furthermore, these patients also have an increased risk for cardiovascular diseases. The interdisciplinary approach and cooperation with dental care experts are necessary for patient management. Treatment includes discontinuing the drug and switching to one with a better profile, improving oral hygiene, and surgical removal of enlarged tissue. Recognizing the potential of commonly used medications to cause DIGO and its effect on patients' health is necessary for early detection and adequate management of this complication. Baishideng Publishing Group Inc 2021-04-26 2021-04-26 /pmc/articles/PMC8069521/ /pubmed/33968305 http://dx.doi.org/10.4330/wjc.v13.i4.68 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/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 NonCommercial (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/
spellingShingle Opinion Review
Bajkovec, Lucija
Mrzljak, Anna
Likic, Robert
Alajbeg, Ivan
Drug-induced gingival overgrowth in cardiovascular patients
title Drug-induced gingival overgrowth in cardiovascular patients
title_full Drug-induced gingival overgrowth in cardiovascular patients
title_fullStr Drug-induced gingival overgrowth in cardiovascular patients
title_full_unstemmed Drug-induced gingival overgrowth in cardiovascular patients
title_short Drug-induced gingival overgrowth in cardiovascular patients
title_sort drug-induced gingival overgrowth in cardiovascular patients
topic Opinion Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069521/
https://www.ncbi.nlm.nih.gov/pubmed/33968305
http://dx.doi.org/10.4330/wjc.v13.i4.68
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