Drugs associated with gingival enlargement: review of the scientific literature on clinical characteristics and related factors
DOI:
https://doi.org/10.20453/reh.v36i1.6640Keywords:
gingival overgrowth, gingival hyperplasia, amlodipine, cyclosporins, phenytoinAbstract
Drug-induced gingival enlargement is a multifactorial condition that compromises the periodontal health of patients undergoing prolonged treatment. This review of the scientific literature aimed to identify the drugs most frequently associated with this condition, describe its clinical characteristics, and analyze related factors. The study was conducted in accordance with the PRISMA 2020 statement. A search for articles was conducted between November 11, 2024, and February 5, 2025, in the PubMed, Scopus, ProQuest, and EBSCOhost databases. Clinical and observational studies in humans (cross-sectional and longitudinal) on gingival enlargement associated with anticonvulsants, calcium channel blockers, and immunosuppressants were included. Of a total of 2,152 records, 2,094 were excluded after title and abstract screening, and 34 after full-text reading (because they were case reports, case-control studies, animal/cell research, and reviews), resulting in eleven studies included. The evidence collected showed that phenytoin had a prevalence of close to 50%; amlodipine, between 1.7% and 37%; and cyclosporine A, between 25% and 53%. The most influential factors were dose, duration of treatment, and level of oral hygiene, while age and sex showed a less consistent relationship.
Downloads
References
Barsoum F, Prete BR, Ouanounou A. Drug-induced gingival enlargement: a review of diagnosis and current treatment strategies. Compend Contin Educ Dent [Internet]. 2022;43(5):276-85. Disponible en: https://europepmc.org/article/MED/35589146
Ramasamy J, Vijayashree RJ, Ravi N, et al. Drug-induced gingival enlargement: a case study. Oral Health Res Clin Evid. 2024;1(1):37-40. doi:10.4103/ORCL.ORCL_8_24
Ramírez-Rámiz A, Brunet-LLobet L, Lahor-Soler E, et al. On the cellular and molecular mechanisms of drug-induced gingival overgrowth. Open Dent J. 2017;11:420-35. doi:10.2174/1874210601711010420
Cañas LV, Pardo MI, Arboleda SS. Agrandamiento gingival inducido por medicamentos: presentación de un caso clínico. Univ Odontol. 2017;36(77):1-14. doi:10.11144/Javeriana.uo36-77.agim
Soriano R, Cáceres A. Resolución del agrandamiento gingival mediante terapia periodontal no quirúrgica: reporte de caso. Rev Odont Mex. 2016;20(4):253-8. doi:10.1016/j.rodmex.2016.11.006
Papadopoulou E, Kouri M, Andreou A, et al. Challenges in differential diagnosis of diffuse gingival enlargement: report of two representative cases and literature review. Dent J. 2024;12(12):403. doi:10.3390/dj12120403
Glick A, Sista V, Johnson C. Oral manifestations of commonly prescribed drugs. Am Fam Physician [Internet]. 2020;102(10):613-21. Disponible en: https://www.aafp.org/pubs/afp/issues/2020/1115/p613.html
Zerón A, Sautto M. Agrandamientos gingivales inducidos por medicamentos. Una visión genómica y genética. Revisión de la literatura. Rev Mex Periodontol [Internet]. 2016;7(1):25-35. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=66486
Nayyar AS, Khan M, Vijayalakshmi KR, et al. Phenytoin, folic acid and gingival enlargement: breaking myths. Contemp Clin Dent. 2014;5(1):59-66. doi:10.4103/0976-237x.128666
Suneja B, Chopra S, Thomas AM, et al. A clinical evaluation of gingival overgrowth in children on antiepileptic drug therapy. J Clin Diagn Res. 2016;10(1):ZC32-6. doi:10.7860/jcdr/2016/16443.7069
Grigore I, Trandafir LM, Toma V, et al. Effect of anti-epileptic drugs on the oral health of epileptic children. En: 2015 E-Health and Bioengineering Conference. Iasi, Romania. Piscataway (NJ): IEEE; 2015. pp. 1-4. doi:10.1109/EHB.2015.7391523
Kothari L, Bajaj P, Jaiswal P, et al. Prevalence of amlodipine induced gingival enlargement - A hospital-based study. J Evolution Med Dent Sci [Internet]. 2020;9(34):2432-35. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/sea-215112
Sharma A, Joshi R, Laxmi SR, et al. Amlodipine induced gingival overgrowth in patients at a tertiary level hospital of nepal. J Nepal Soc Perio Oral Implantol. 2018;2(1):2-5. doi:10.3126/jnspoi.v2i1.23571
Ustaoğlu G, Erdal E, Karaş Z. Influence of different anti-hypertensive drugs on gingival overgrowth: a cross-sectional study in a Turkish population. Oral Dis. 2021;27(5):1313-9. doi:10.1111/odi.13655
Matsuda S, Okanobu A, Hatano S, et al. Relationship between periodontal inflammation and calcium channel blockers induced gingival overgrowth-a cross-sectional study in a Japanese population. Clin Oral Investig. 2019;23:4099-105. doi:10.1007/s00784-019-02846-8
Bhumika S, Haftom Z, Rajeshwar S, et al. Effect of calcium channel blockers on gingival tissues in hypertensive patients visiting Ayder Referral Hospital, Mekelle, Ethiopia. IJPCBS [Internet]. 2019;9(4):159-65. Disponible en: https://www.ijpcbs.com/abstract/effect-of-calcium-channel-blockers-on-gingival-tissues-in-hypertensive-patients-visiting-ayder-referral-hospital-mekelle-77418.html
Vidal F, De Sousa RC, Ferreira DC, et al. Influence of 3 calcium channel blockers on gingival overgrowth in a population of severe refractory hypertensive patients. J Periodont Res. 2018;53(5):1020. doi:10.1111/jre.12556
Mitic K, Kaftandzieva S, Janev E, et al. The role of dental plaque in development of drug-induced gingival overgrowth [DGO]. JSM Dent Surg. 2017;2(3):1020. doi:10.47739/2573-1548/1020
Montes de Oca González A, González Falcón M, Veitia Cabarrocas F, et al. Agrandamiento gingival medicamentoso en pacientes que padecen hipertensión, cardiopatías y epilepsia. Acta Méd Centro [Internet]. 2021;15(1):72-80. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2709-79272021000100072&lng=es
Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I-III periodontitis - The EFP S3 level clinical practice guideline. J Clin Periodontol. 2021;48(1):163. doi:10.1111/jcpe.13290
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Hector Martin Vargas Cornejo, Valeria Fung Mejía, Elisa Isabel Lozada Palacios, Keyla Gianela Rodríguez Celi
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the copyright and cede to the journal the right of first publication, with the work registered with the Creative Commons License, which allows third parties to use what is published as long as they mention the authorship of the work, and to the first publication in this journal.
