Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK; Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, KSA.
J Dent. 2024 Oct;149:105315. doi: 10.1016/j.jdent.2024.105315. Epub 2024 Aug 17.
As reported by the existing literature, calcium-channel blockers (CCB) can lead to gingival enlargement. The aims of this study were to investigate the factors associated with gingival enlargement in patients on CCB and to assess the saliva and gingival crevicular fluid (GCF) profile of patients on CCB with gingival enlargement.
A total of 131 participants were included. Data were collected from 91 patients taking CCB for treatment of systemic hypertension. The presence of drug-induced gingival enlargement (DIGE) was assessed clinically and associated with patient factors. Patients with DIGE were group-matched for gender and ethnicity with an equal number of consecutive CCB non-DIGE patients (control 1), no-CCB no-DIGE (control 2) and periodontally healthy with no DIGE (control 3) for the saliva and GCF analysis. A bead-based multiplex immunoassay was used to assess a panel of biomarkers.
Twenty-two percent of patients on CCB were diagnosed with DIGE. Lack of daily interdental cleaning and self-reported diagnosis of type II diabetes were associated with the diagnosis of DIGE. When analysing patients only on CCB, those with DIGE had higher GCF levels of vascular endolthelial growth factor (VEGF) (p = 0.032), epidermal growth factor (EGF) (p = 0.030) and matrix metalloproteinase-8 (MMP-8) (p = 0.008). Among the salivary markers, only MMP-8 showed a statistically significant difference across groups (p < 0.001).
This is the first study investigating saliva and GCF biomarkers in patients with DIGE and different control groups, suggesting that causes of the overgrowth might involve inflammatory processes, tissue damage pathways, and potentially an impact on growth factors like VEGF. Future research should verify these results in independent populations and explore the underlying pathogenic mechanisms in-depth.
Calcium-channel blockers (CCB) can lead to gingival enlargement. This study confirms lack of interdental cleaning and type II diabetes as risk factors. Elevated levels of VEGF, EGF, and MMP-8 in gingival crevicular fluid and MMP-8 in saliva suggest inflammatory processes and growth factors might play roles in this condition.
现有文献报道，钙通道阻滞剂（CCB）可导致牙龈增生。本研究旨在探讨 CCB 治疗的系统性高血压患者中与牙龈增生相关的因素，并评估患有 CCB 相关牙龈增生（DIGE）患者的唾液和龈沟液（GCF）特征。
共纳入 131 名参与者。数据来自 91 名接受 CCB 治疗系统性高血压的患者。临床评估药物诱导性牙龈增生（DIGE）的存在，并将其与患者因素相关联。将患有 DIGE 的患者按性别和种族与等量的连续 CCB 非 DIGE 患者（对照组 1）、无 CCB 无 DIGE 患者（对照组 2）和牙周健康无 DIGE 患者（对照组 3）进行分组匹配，以用于唾液和 GCF 分析。采用基于珠的多重免疫分析检测一组生物标志物。
22%的 CCB 治疗患者被诊断为 DIGE。缺乏日常牙间清洁和自我报告的 2 型糖尿病诊断与 DIGE 的诊断相关。在仅分析接受 CCB 治疗的患者时，患有 DIGE 的患者 GCF 血管内皮生长因子（VEGF）（p=0.032）、表皮生长因子（EGF）（p=0.030）和基质金属蛋白酶-8（MMP-8）（p=0.008）水平更高。在唾液标志物中，只有 MMP-8 在组间显示出统计学差异（p<0.001）。
这是第一项研究 CCB 相关 DIGE 患者和不同对照组的唾液和 GCF 生物标志物的研究，表明过度生长的原因可能涉及炎症过程、组织损伤途径，并且可能对 VEGF 等生长因子产生影响。未来的研究应在独立人群中验证这些结果，并深入探讨潜在的发病机制。
钙通道阻滞剂（CCB）可导致牙龈增生。本研究证实缺乏牙间清洁和 2 型糖尿病是危险因素。龈沟液中 VEGF、EGF 和 MMP-8 水平升高，唾液中 MMP-8 水平升高，提示炎症过程和生长因子可能在这种情况下发挥作用。
