Drug-Induced Gingival Hyperplasia Differential Diagnoses

1. Rodriguez-Vazquez M, Carrascosa-Romero MC, Pardal-Fernandez JM, Iniesta I. Congenital gingival hyperplasia in a neonate with foetal valproate syndrome. Neuropediatrics. 2007 Oct. 38(5):251-2. [QxMD MEDLINE Link].

2. Thomason JD, Fallaw TL, Carmichael KP, Radlinsky MA, Calvert CA. Gingival hyperplasia associated with the administration of amlodipine to dogs with degenerative valvular disease (2004-2008). J Vet Intern Med. 2009 Jan-Feb. 23(1):39-42. [QxMD MEDLINE Link].

3. Vorkas CK, Gopinathan MK, Singh A, Devinsky O, Lin LM, Rosenberg PA. Epilepsy and dental procedures. A review. N Y State Dent J. 2008 Mar. 74(2):39-43. [QxMD MEDLINE Link].

4. Mohan RP, Rastogi K, Bhushan R, Verma S. Phenytoin-induced gingival enlargement: a dental awakening for patients with epilepsy. BMJ Case Rep. 2013 Apr 23. 2013:[QxMD MEDLINE Link].

5. Dhingra K, Prakash S. Gingival overgrowth in partially edentulous ridges in an elderly female patient with epilepsy: a case report. Gerodontology. 2012 Jun. 29(2):e1201-6. [QxMD MEDLINE Link].

6. Cornacchio AL, Burneo JG, Aragon CE. The effects of antiepileptic drugs on oral health. J Can Dent Assoc. 2011. 77:b140. [QxMD MEDLINE Link].

7. Bhatia V, Mittal A, Parida AK, Talwar R, Kaul U. Amlodipine induced gingival hyperplasia: a rare entity. Int J Cardiol. 2007 Nov 30. 122(3):e23-4. [QxMD MEDLINE Link].

8. Kaur G, Verhamme KM, Dieleman JP, et al. Association between calcium channel blockers and gingival hyperplasia. J Clin Periodontol. 2010 Jul. 37(7):625-30. [QxMD MEDLINE Link].

9. Breitung K, Remmerbach TW. [Gingival hyperplasia as side effect of the calcium channel blocker amlodipine]. Schweiz Monatsschr Zahnmed. 2010. 120(6):525-31. [QxMD MEDLINE Link].

10. Aldemir NM, Begenik H, Emre H, Erdur FM, Soyoral Y. Amlodipine-induced gingival hyperplasia in chronic renal failure: a case report. Afr Health Sci. 2012 Dec. 12(4):576-8. [QxMD MEDLINE Link]. [Full Text].

11. Csifó-Nagy B, Hulik E, Zsoldos GM, Gera I. [Surgical correction of excessive gingival enlargements. Case studies]. Fogorv Sz. 2013 Jun. 106(2):61-70. [QxMD MEDLINE Link].

12. Charles N, Ramesh V, Babu KS, Premalatha B. Gene polymorphism in amlodipine induced gingival hyperplasia: a case report. J Young Pharm. 2012 Oct. 4(4):287-9. [QxMD MEDLINE Link]. [Full Text].

13. Jorgensen MG. Prevalence of amlodipine-related gingival hyperplasia. J Periodontol. 1997 Jul. 68 (7):676-8. [QxMD MEDLINE Link].

14. Gelfand EW, Cheung RK, Grinstein S, Mills GB. Characterization of the role for calcium influx in mitogen-induced triggering of human T cells. Identification of calcium-dependent and calcium-independent signals. Eur J Immunol. 1986 Aug. 16 (8):907-12. [QxMD MEDLINE Link].

15. Bahamondes C, Godoy J. [Cyclosporine-induced gingival hyperplasia: report of one case]. Rev Med Chil. 2007 Mar. 135(3):370-4. [QxMD MEDLINE Link].

16. Lafzi A, Farahani RM, Shoja MA. Phenobarbital-induced gingival hyperplasia. J Contemp Dent Pract. 2007 Sep 1. 8(6):50-6. [QxMD MEDLINE Link].

17. Moffitt ML, Bencivenni D, Cohen RE. Drug-induced gingival enlargement: an overview. Compend Contin Educ Dent. 2013 May. 34(5):330-6. [QxMD MEDLINE Link].

18. Gursoy UK, Sokucu O, Uitto VJ, et al. The role of nickel accumulation and epithelial cell proliferation in orthodontic treatment-induced gingival overgrowth. Eur J Orthod. 2007 Dec. 29(6):555-8. [QxMD MEDLINE Link].

19. Hyland PL, Traynor PS, Myrillas TT, et al. The effects of cyclosporin on the collagenolytic activity of gingival fibroblasts. J Periodontol. 2003 Apr. 74(4):437-45. [QxMD MEDLINE Link].

20. Kinane DF, Drummond JR, Chisholm DM. Langerhans cells in human chronic gingivitis and phenytoin-induced gingival hyperplasia. Arch Oral Biol. 1990. 35(7):561-4. [QxMD MEDLINE Link].

21. Salman BN, Vahabi S, Movaghar SE, Mahjour F. Proliferative and inductive effects of Cyclosporine a on gingival fibroblast of child and adult. Dent Res J (Isfahan). 2013 Jan. 10(1):52-8. [QxMD MEDLINE Link]. [Full Text].

22. Devanna R, Asif K. Interdisciplinary management of a patient with a drug-induced gingival hyperplasia. Contemp Clin Dent. 2010 Jul. 1(3):171-6. [QxMD MEDLINE Link]. [Full Text].

23. Tejnani A, Mani A, Sodhi NK, et al. Incidence of amlodipine-induced gingival overgrowth in the rural population of Loni. J Indian Soc Periodontol. 2014 Mar. 18(2):226-8. [QxMD MEDLINE Link]. [Full Text].

24. Srivastava AK, Kundu D, Bandyopadhyay P, Pal AK. Management of amlodipine-induced gingival enlargement: Series of three cases. J Indian Soc Periodontol. 2010 Oct. 14(4):279-81. [QxMD MEDLINE Link]. [Full Text].

25. Modeer T, Anduren I, Lerner UH. Enhanced prostaglandin biosynthesis in human gingival fibroblasts isolated from patients treated with phenytoin. J Oral Pathol Med. 1992 Jul. 21(6):251-5. [QxMD MEDLINE Link].

26. Schincaglia GP, Forniti F, Cavallini R, Piva R, Calura G, del Senno L. Cyclosporin-A increases type I procollagen production and mRNA level in human gingival fibroblasts in vitro. J Oral Pathol Med. 1992 Apr. 21(4):181-5. [QxMD MEDLINE Link].

27. Tipton DA, Stricklin GP, Dabbous MK. Fibroblast heterogeneity in collagenolytic response to cyclosporine. J Cell Biochem. 1991 Jun. 46(2):152-65. [QxMD MEDLINE Link].

28. Sonmez S, Cavdar C, Gunduz C, et al. Do MMP-1 levels of gingival fibroblasts have a role in the gingival overgrowth of cyclosporine-treated patients?. Transplant Proc. 2008 Jan-Feb. 40(1):181-3. [QxMD MEDLINE Link].

29. Chiu HC, Lan GL, Chiang CY, et al. Upregulation of heme oxygenase-1 expression in gingiva after cyclosporin A treatment. J Periodontol. 2008 Nov. 79(11):2200-6. [QxMD MEDLINE Link].

30. Lin CJ, Yen MF, Hu OY, et al. Association of galactose single-point test levels and phenytoin metabolic polymorphisms with gingival hyperplasia in patients receiving long-term phenytoin therapy. Pharmacotherapy. 2008 Jan. 28(1):35-41. [QxMD MEDLINE Link].

31. Daly CG. Resolution of cyclosporin A (CsA)-induced gingival enlargement following reduction in CsA dosage. J Clin Periodontol. 1992 Feb. 19(2):143-5. [QxMD MEDLINE Link].

32. Fu E, Nieh S, Chang HL, Wang SL. Dose-dependent gingival overgrowth induced by cyclosporin in rats. J Periodontol. 1995 Jul. 66(7):594-8. [QxMD MEDLINE Link].

33. Brochet MS, Harry M, Morin F. Nifedipine induced gingival hyperplasia in pregnancy: a case report. Curr Drug Saf. 2016 Apr 26. [QxMD MEDLINE Link].

34. George A, George SP, John S, George N, Joe S, Mathew R. Changes in Inflammatory Markers in Bacterial- and Nifedipine-Induced Gingival Inflammation. J Int Oral Health. 2015. 7 (Suppl 2):64-7. [QxMD MEDLINE Link].

35. Carty O, Walsh E, Abdelsalem A, MaCarthy D. Case report: drug-induced gingival overgrowth associated with the use of a calcium channel blocker (amlodipine). J Ir Dent Assoc. 2015 Oct-Nov. 61 (5):248-51. [QxMD MEDLINE Link].

36. De Rop C, Picksak G, Stichtenoth DO. [Gingival hyperplasia]. Med Monatsschr Pharm. 2010 Jan. 33(1):23-4. [QxMD MEDLINE Link].

37. Muralikrishna T, Kalakonda B, Gunupati S, Koppolu P. Laser-Assisted Periodontal Management of Drug-Induced Gingival Overgrowth under General Anesthesia: A Viable Option. Case Rep Dent. 2013. 2013:387453. [QxMD MEDLINE Link]. [Full Text].

38. D'Errico B, Albanese A. Drug-induced gingival hyperplasia, treatment with diode laser. Ann Stomatol (Roma). 2013. 4:14. [QxMD MEDLINE Link]. [Full Text].

39. Cafaro A, Arduino PG, Broccoletti R, Romagnoli E. Low level laser therapy (LLLT) as adjuvant in the management of drug induced gingival hyperplasia: a case report. Ann Stomatol (Roma). 2013. 4:8-9. [QxMD MEDLINE Link]. [Full Text].

40. Cebeci I, Kantarci A, Firatli E, Carin M, Tuncer O. The effect of verapamil on the prevalence and severity of cyclosporine-induced gingival overgrowth in renal allograft recipients. J Periodontol. 1996 Nov. 67(11):1201-5. [QxMD MEDLINE Link].

41. Conde SA, Aarestrup FM, Vieira BJ, Bastos MG. Roxithromycin reduces cyclosporine-induced gingival hyperplasia in renal transplant patients. Transplant Proc. 2008 Jun. 40(5):1435-8. [QxMD MEDLINE Link].

42. Kwun WH, Suh BY, Kwun KB. Effect of azithromycin in the treartment of cyclosporine-induced gingival hyperplasia in renal transplant recipients. Transplant Proc. 2003 Feb. 35(1):311-2. [QxMD MEDLINE Link].

43. Nash MM, Zaltzman JS. Efficacy of azithromycin in the treatment of cyclosporine-induced gingival hyperplasia in renal transplant recipients. Transplantation. 1998 Jun 27. 65(12):1611-5. [QxMD MEDLINE Link].

44. Wirnsberger GH, Pfragner R. Comment on "Efficacy of azithromycin in the treatment of cyclosporine-induced gingival hyperplasia in renal transplant recipients" by Nash and Zaltzman. Transplantation. 1999 May 15. 67(9):1289-91. [QxMD MEDLINE Link].

45. Ramalho VL, Ramalho HJ, Cipullo JP, Azoubel R, Burdmann EA. Comparison of azithromycin and oral hygiene program in the treatment of cyclosporine-induced gingival hyperplasia. Ren Fail. 2007. 29(3):265-70. [QxMD MEDLINE Link].

46. Macartney C, Freilich M, Odame I, Charpentier K, Dror Y. Complete response to tacrolimus in a child with severe aplastic anemia resistant to cyclosporin A. Pediatr Blood Cancer. 2009 Apr. 52(4):525-7. [QxMD MEDLINE Link].

47. Nassar CA, Nassar PO, Andia DC, Guimaraes MR, Spolidorio LC. The effects of up to 240 days of tacrolimus therapy on the gingival tissues of rats--a morphological evaluation. Oral Dis. 2008 Jan. 14(1):67-72. [QxMD MEDLINE Link].

48. Ramalho VL, Ramalho HJ, Cipullo JP, Azoubel R, Burdmann EA. Comparison of azithromycin and oral hygiene program in the treatment of cyclosporine-induced gingival hyperplasia. Ren Fail. 2007. 29(3):265-70. [QxMD MEDLINE Link].

Lina M Mejia, DDS, MPH Assistant Professor, Oral Medicine and Diagnostic Sciences, Nova Southeastern University College of Dental Medicine

Lina M Mejia, DDS, MPH is a member of the following medical societies: American Academy of Oral Medicine, American Dental Association, California Dental Association

Disclosure: Nothing to disclose.

Francina Lozada-Nur, DDS, MS, MPH Professor Clinical Oral Medicine (Emerita), University of California at San Francisco School of Dentistry

Francina Lozada-Nur, DDS, MS, MPH is a member of the following medical societies: American Academy of Oral Medicine

Disclosure: Nothing to disclose.

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS Consulting Staff, Dermatology of Southwest Ohio

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Jeff Burgess, DDS, MSD (Retired) Clinical Assistant Professor, Department of Oral Medicine, University of Washington School of Dental Medicine; (Retired) Attending in Pain Center, University of Washington Medical Center; (Retired) Private Practice in Hawaii and Washington; Director, Oral Care Research Associates

Disclosure: Nothing to disclose.

Franklin Flowers, MD Professor Emeritus, Department of Dermatology, Affiliate Associate Professor of Pathology, University of Florida College of Medicine

Franklin Flowers, MD is a member of the following medical societies: American College of Mohs Surgery

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Piamkamon Vacharotayangul, DDS, PhD, to the development and writing of this article.

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