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Journal of Oral Biology and... 2020Cyclosporine is one of the powerful immunosuppressant drugs commonly used to avoid transplant rejection and autoimmune condition management. However, this drug has many... (Review)
Review
BACKGROUND
Cyclosporine is one of the powerful immunosuppressant drugs commonly used to avoid transplant rejection and autoimmune condition management. However, this drug has many side effects, such as nephrotoxicity, hepatotoxicity, hypertension, and gingival overgrowth. Gingival enlargement is one of the most commonly reported adverse drug outcome in patients with long term usage of the drug with the exclusion of other confounding factors. Hence, this systematic review and Meta-analysis was planned to investigate the effect of azithromycin on cyclosporine A-induced gingival enlargement.
METHODS
We used 4 electronic databases: MEDLINE (up to January 2018), EMBASE (up to January 2018), CINAHL (up to January 2018), Cochrane Library (up to January 2018) to search all the available literature between February 1, 2018, and January 1, 2019. All papers, published up to January 2018, on the efficacy of azithromycin on cyclosporine-induced gingival enlargement were included on this systematic review and meta-analysis. RevMan 5.3 software was used to make the quantitative analysis and the pooled effect presented in terms of the mean difference. Meanwhile, the presence of heterogeneity is presented in terms of I.
RESULTS
Five Randomized controlled trials with a total of 167 participants were eligible for this study. The effect of azithromycin on cyclosporine-induced gingival growth, probing depth and plaque index was reported in 3 studies and the selected 5 studies reported its effect on bleeding on probing. The pooled effect revealed there was a significant reduction of gingival enlargement (MD, 1.58, 95%CI: 0.77-2.39) and bleeding on probing in the intervention group (MD, 1.32, 95%CI: 0.39-2.24). Statistically non-significant effects were observed on the effect of azithromycin on plaque index and probing depth in patients with cyclosporine-induced gingival enlargement.
CONCLUSION
Azithromycin has a clinically significant effect on the reduction of cyclosporine-induced gingival enlargement and bleeding on probing.
PubMed: 32489824
DOI: 10.1016/j.jobcr.2019.12.005 -
Journal of Clinical and Experimental... Jun 2018Amlodipine, a dihydropyridine calcium channel blocker (CCB) is commonly prescribed for cardiovascular conditions. Its administration may produce an uncommon adverse oral... (Review)
Review
BACKGROUND
Amlodipine, a dihydropyridine calcium channel blocker (CCB) is commonly prescribed for cardiovascular conditions. Its administration may produce an uncommon adverse oral manifestation, the gingival overgrowth (GO). Lately, there has been an increase in the rate of GO in patients on amlodipine therapy. The current systematic review was undertaken to evaluate the evidence on plausible risk factors involved in amlodipine induced gingival overgrowth (AIGO).
MATERIAL AND METHODS
Literature search was conducted in the databases like Pubmed (Medline), Scopus and Google Scholar to include the original research articles related to etio-pathogenesis of AIGO.
RESULTS
About 270 documents were identified through primary search, of which 13 original research articles were included. Most common risk factor for AIGO was administration of amlodipine in subjects with poor plaque control. However, high dosage of drug, duration of therapy and inherent genetic susceptibility were recognized as other plausible risk factors.
CONCLUSIONS
It was concluded that AIGO is no longer a rare phenomenon. It is therefore imperative for the physician to identify and inform patients, about the risk factors associated with the overgrowth at the initiation of therapy. This would prevent the development of GO's and improve the patient's quality of life. Amlodipine, calcium channel blockers, gingival overgrowth, hypertension.
PubMed: 29930781
DOI: 10.4317/jced.54715 -
Journal (Canadian Dental Association) 2011Long-term use of phenytoin (PHT) causes gingival hyperplasia; however, little is known about the oral side effects of other antiepileptic drugs (AEDs). Through a... (Review)
Review
OBJECTIVE
Long-term use of phenytoin (PHT) causes gingival hyperplasia; however, little is known about the oral side effects of other antiepileptic drugs (AEDs). Through a systematic review of the literature, we explored the effects of AEDs on the oral health of patients with epilepsy.
METHODS
We searched PubMed, EMBASE and the Cochrane library between January 1963 and August 2010. The search strategy retrieved 170 abstracts. We included studies that involved original research and had ≥ 10 patients in our review. We also checked the reference lists of reviews, letters and other manuscripts to find studies that met our selection criteria.
RESULTS
Only 15 articles were included in the final analysis. Gingival hyperplasia was very common in patients taking PHT (16%-94% of patients). Alveolar bone loss occurred in patients taking carbamazepine or PHT. Patients taking valproate, carbamazepine or phenobarbital also had gingival hyperplasia. We found no published studies of newer-generation AEDs.
CONCLUSION
Although several studies examined the effects of PHT on oral health, none have studied those of the newer generation of AEDs. Studies exploring oral side effects of AEDs are needed.
Topics: Alveolar Bone Loss; Anticonvulsants; Carbamazepine; Epilepsy; Gingival Hyperplasia; Humans; Oral Health; Phenobarbital; Phenytoin
PubMed: 22260801
DOI: No ID Found -
BMC Oral Health Dec 2008In daily clinical practice of a dental department it's common to find gingival overgrowth (GO) in periodontal patients under treatment with Cyclosporine A (CsA). The...
BACKGROUND
In daily clinical practice of a dental department it's common to find gingival overgrowth (GO) in periodontal patients under treatment with Cyclosporine A (CsA). The pathogenesis of GO and the mechanism of action of Azithromycin (AZM) are unclear. A systematic review was conducted in order to evaluate the efficacy of Azithromycin in patients with gingival overgrowth induced by assumption of Cyclosporine A.
METHODS
A bibliographic search was performed using the online databases MEDLINE, EMBASE and Cochrane Central of Register Controlled Trials (CENTRAL) in the time period between 1966 and September 2008.
RESULTS
The literature search retrieved 24 articles; only 5 were Randomised Controlled Trials (RCTs), published in English, fulfilled the inclusion criteria. A great heterogeneity between proposed treatments and outcomes was found, and this did not allow to conduct a quantitative meta-analysis. The systematic review revealed that a 5-day course of Azithromycin with Scaling and Root Planing reduces the degree of gingival overgrowth, while a 7-day course of metronidazole is only effective on concomitant bacterial over-infection.
CONCLUSION
Few RCTs on the efficacy of systemic antibiotic therapy in case of GO were found in the literature review. A systemic antibiotic therapy without plaque and calculus removal is not able to reduce gingival overgrowth. The great heterogeneity of diagnostic data and outcomes is due to the lack of precise diagnostic methods and protocols about GO. Future studies need to improve both diagnostic methods and tools and adequate classification aimed to determine a correct prognosis and an appropriate therapy for gingival overgrowth.
PubMed: 19087331
DOI: 10.1186/1472-6831-8-34 -
Oral Health & Preventive Dentistry Oct 2020To present an update the orofacial manifestations of granulomatosis with polyangiitis (GPA) and present a clinical case with the initial signs in the oral cavity.
PURPOSE
To present an update the orofacial manifestations of granulomatosis with polyangiitis (GPA) and present a clinical case with the initial signs in the oral cavity.
MATERIALS AND METHODS
A bibliographic search was performed on Pubmed with the keywords 'Wegener's granulomatosis', 'etiology', 'oral manifestations', 'oral cavity', 'gingiva'. The inclusion criteria were papers published in English in the last 10 years that made reference to clinical cases with in which the oral cavity was affected. The quality of the results was assessed with 'The 2013 Care Checklist'.
RESULTS
Nineteen clinical cases were analysed. The average quality was 7.68/13 (range 5-10/13). 73.7% of patients were women, the most frequent area for the lesions was the gingiva and the most prevalent lesion was gingival hyperplasia. 68.4% of the patients had this lesion as a first sign, 21.1% as a progression and 10.5% as a recurrence. 68.4% of the lesions resolved once medical treatment was established.
CONCLUSION
GPA is a multisystem disorder associated with considerable morbidity and mortality if not treated. Early diagnosis improves the prognosis. The first manifestation of the disease can be seen in the oral cavity. It is important that dentists recognise the oral manifestation in order to improve the prognosis. Key words: granulomatosis, polyangiiitis, Wegener's granulomatosis.
Topics: Female; Gingiva; Gingival Hyperplasia; Granulomatosis with Polyangiitis; Humans; Prognosis
PubMed: 33215484
DOI: 10.3290/j.ohpd.a45433