Drug-induced gingival enlargement

Drug-induced gingival enlargement (DIGE) is a pathological condition characterized by an abnormal overgrowth or increase in the size of the gums. This condition is commonly associated with certain medications, including anticonvulsants, immunosuppressants, and calcium channel blockers.

Etiology

The exact etiology of drug-induced gingival enlargement is not fully understood. However, it is believed to be a side effect of certain medications. The three main classes of drugs associated with this condition are:

• Anticonvulsants: These are medications used to treat epilepsy and other seizure disorders. The most common anticonvulsant associated with gingival enlargement is phenytoin.
• Immunosuppressants: These are drugs used to prevent the body's immune system from rejecting a transplanted organ. The most common immunosuppressant associated with this condition is cyclosporine.
• Calcium channel blockers: These are medications used to treat high blood pressure, angina, and certain types of heart arrhythmias. The most common calcium channel blocker associated with gingival enlargement is nifedipine.

Pathogenesis

The pathogenesis of drug-induced gingival enlargement involves an increase in the production of collagen and other extracellular matrix components by the fibroblasts in the gingival tissue. This is believed to be due to an alteration in the balance between the synthesis and degradation of these components.

Clinical Features

The clinical features of drug-induced gingival enlargement typically include a painless, firm, and fibrous enlargement of the gums. The enlargement usually starts at the interdental papilla and can extend to cover the entire gum. The condition can affect both the upper and lower gums, and it can range from mild to severe.

Management

The management of drug-induced gingival enlargement involves both non-surgical and surgical approaches. Non-surgical management includes good oral hygiene practices and possible modification or discontinuation of the causative drug. Surgical management involves gingivectomy or periodontal flap surgery to remove the excess gingival tissue.

See Also

• Gingival hyperplasia
• Gingivitis
• Periodontitis