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Anticonvulsant agents, such as phenytoin, are associated with common forms of gingival overgrowth. [2] It is caused by the increase of metabolites from the breakdown of anticonvulsants in the body. [3] It should also be noted that concurrent usage of different anticonvulsants in children has resulted in accumulative gingival enlargement. [2]
Gingival enlargement has a multitude of causes. The most common is chronic inflammatory gingival enlargement, when the gingivae are soft and discolored. This is caused by tissue edema and infective cellular infiltration caused by prolonged exposure to bacterial plaque, and is treated with conventional periodontal treatment, such as scaling and root planing.
Drug-related gingival hyperplasia is a cutaneous condition characterized by enlargement of the gums noted during the first year of drug treatment. [1] Although the mechanism of drug related gingival hyperplasia is not well understood, some risk factors for the condition include the duration of drug use and poor oral hygiene . [ 2 ]
Hereditary gingival fibromatosis (HGF), also known as idiopathic gingival hyperplasia, is a rare condition of gingival overgrowth. [1] HGF is characterized as a benign, slowly progressive, nonhemorrhagic, fibrous enlargement of keratinized gingiva. It can cover teeth in various degrees, and can lead to aesthetic disfigurement. [2]
Trauma, reactions to foreign bodies, or toxic reactions can also contribute to this non-plaque-induced gingivitis. Furthermore, genetics can play a significant role. Specifically, hereditary gingival fibromatosis is known to cause non-plaque-induced gingival lesions. However, sometimes, there is no specific cause for this form of gingival disease.
Phenytoin has been associated with drug-induced gingival enlargement (overgrowth of the gums), probably due to above-mentioned folate deficiency; indeed, evidence from a randomized controlled trial suggests that folic acid supplementation can prevent gingival enlargement in children who take phenytoin. [37]
Nifedipine, sold under the brand name Procardia among others, is a calcium channel blocker medication used to manage angina, high blood pressure, Raynaud's phenomenon, and premature labor. [2] It is one of the treatments of choice for Prinzmetal angina . [ 2 ]
Dental plaque biofilm-induced gingivitis; Non-dental-plaque-induced gingival disease; Dental plaque biofilm-induced gingivitis is often referred to as "localized inflammation initiated by microbial biofilm accumulation on teeth,". [2] Non-dental-plaque-induced gingival diseases are the most uncommon bacterial infection of the gingiva.