Speroni Stefano, Giuffrè Marco, Tura Tommaso, Al Jawaheri Qamar Ammar Salman, Antonelli Luca, Coccoluto Luca, Bortune Giulia, Sarnelli Francesco, Abati Silvio
Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy.
Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy.
Diagnostics (Basel). 2025 Jan 30;15(3):320. doi: 10.3390/diagnostics15030320.
: Drug-induced gingival enlargement is a commonly documented adverse effect in patients administered with calcium antagonist medications. Nifedipine is the medicine most frequently linked to instances of gingival enlargement; nevertheless, amlodipine, likewise a calcium antagonist, can elicit this adverse effect. This case report aims to detail a case of amlodipine-induced gingival hyperplasia, emphasizing the significance of a multidisciplinary approach and outlining its therapy across various surgical phases. : A 48-year-old hypertensive patient using amlodipine therapy presents with aberrant gingival tissue growth in the upper arch. Intraoral examination reveals localized inflammation and tissue enlargement in the papillae areas of the upper arch gingiva, leading to partial covering of the dental crowns. The patient experienced painful sensations and episodes of spontaneous bleeding in the enlarged gingival tissue. Following an initial professional dental hygiene treatment, which included root planning in the upper quadrants, and in consultation with the referring cardiologist, it was determined to discontinue amlodipine and initiate a replacement therapy with olmesartan medoxomil. Fifteen days following the cessation of amlodipine, surgical excision of the thickened interdental gingival tissues in the anterior region was conducted to obtain biopsies for histological confirmation of the observed pathological condition. : Histopathological examination validated the diagnosis of drug-induced gingival enlargement, characterized by chorion fibrosis and significant lymphoplasmacytic infiltration. Specifically, parakeratotic and acanthotic characteristics were seen in the gingival epithelium. Adjacent to the inflammatory regions, fibrosis was noted, along with the presence of cytoid bodies, which are typically linked to pathological diseases driven by inflammatory processes. These histological characteristics were consistent with the diagnosis of drug-induced gingival enlargement. : A multidisciplinary approach involving the treating physician, dentist, and hygienist, incorporating drug replacement and targeted oral hygiene sessions, is crucial for the management and resolution of calcium channel blocker-induced gingival enlargement.
药物性牙龈增生是服用钙拮抗剂药物的患者中常见的不良反应。硝苯地平是最常与牙龈增生病例相关的药物;然而,氨氯地平同样作为一种钙拮抗剂,也可引发这种不良反应。本病例报告旨在详细描述一例氨氯地平引起的牙龈增生病例,强调多学科方法的重要性,并概述其在各个手术阶段的治疗方法。:一名48岁正在接受氨氯地平治疗的高血压患者出现上颌牙弓牙龈组织异常生长。口腔检查发现上颌牙弓牙龈乳头区域局部炎症和组织肿大,导致牙冠部分被覆盖。患者在肿大的牙龈组织中感到疼痛和自发性出血。在进行了初步的专业牙齿清洁治疗(包括对上颌象限进行根面平整)并与转诊的心脏病专家协商后,决定停用氨氯地平,并开始用奥美沙坦酯进行替代治疗。停用氨氯地平15天后,对前部区域增厚的龈间牙龈组织进行手术切除,以获取活检组织用于组织学确认观察到的病理状况。:组织病理学检查证实了药物性牙龈增生的诊断,其特征为绒毛膜纤维化和显著的淋巴浆细胞浸润。具体而言,牙龈上皮可见不全角化和棘层肥厚特征。在炎症区域附近,发现了纤维化以及细胞样体,这些通常与炎症过程驱动的病理疾病有关。这些组织学特征与药物性牙龈增生的诊断一致。:涉及治疗医生、牙医和口腔卫生师的多学科方法,包括药物替代和针对性的口腔卫生护理,对于钙通道阻滞剂引起的牙龈增生的管理和解决至关重要。