GINGIVAL ENLARGEMENT INDUCED BY DRUGS

Gingival enlargement, an abnormal growth of the periodontal tissue, is mainly associated with dental plaque-related inflammation and drug th erapy. Its true incidence in the general population is unknown. Gingiv al enlargement produces aesthetic changes, pain, gingival bleeding and periodontal disorders. Although gingival overgrowth has been traditio nally recognised as an adverse effect of phenytoin therapy, it has rec ently been reported in association with the use of cyclosporin and cal cium antagonists. These 3 classes of drugs produce important changes i n fibroblast function, which induce an increase in the extracellular m atrix of the gingival connective tissue. In the majority of those pati ents for whom dosage reduction, or drug discontinuation or substitutio n is not possible, and for whom prophylactic measures have failed, sur gical excision of gingival tissue remains the only treatment of choice .