DRUG-INDUCED GINGIVAL OVERGROWTH

Certain anticonvulsants, cyclosporine, and a variety of calcium channe l blockers have been shown to produce clinically and histologically si milar gingival enlargements in certain susceptible patients. These dru gs appear to be similar with respect to their pharmacologic mechanism of action at the cellular level. The primary target tissue is the most essential difference among them, Therefore it is tempting to speculat e that these agents may act similarly on a common secondary target tis sue, such as gingival connective tissue, and cause a hyperplastic resp onse. This tissue reaction may involve a disturbance of calcium ion in flux into specific cell populations with a resulting alteration in col lagen metabolism and other host cell response mechanisms. A connection between ion exchange, folate uptake, collagenase activation, and bact erial inflammation may exist. Until a more effective approach can be d eveloped from future research results, treatment should continue to em phasize plaque control, professional debridement, and resective gingiv al procedures to improve function, esthetics, and access for home care .