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Phenytoin
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Chronic PHT therapy may result in gingival hyperplasia, acne, and hirsutism. These effects are mild and rarely require discontinuation of therapy. Gingival hyperplasia may lead to malocclusion; good oral hygiene is recommended.
Adverse drug reactions on the skin
Published in Robert A. Norman, Geriatric Dermatology, 2020
Gingival hyperplasia, a common, undesirable, non-allergic drug reaction, begins as a diffuse swelling of the interdental papillae. Particularly prevalent with phenytoin therapy, gingival hyperplasia begins about three months after the onset of therapy and occurs in 30 to 70% of patients receiving it. The severity of the reaction is dose-dependent and children and young adults are more frequently affected. The most severe cases are noted in young women. In many cases gingival hyperplasia is accompanied by painful and bleeding gums. There is often superimposed secondary bacterial gingivitis. This can be so extensive that the teeth of the maxilla and mandible are completely overgrown.
Antiepileptic Drugs Useful in the Treatment of Tonic-Clonic and Partial Seizures
Published in Carl L. Faingold, Gerhard H. Fromm, Drugs for Control of Epilepsy:, 2019
The most common side effects of phenytoin are impairment of cognitive function, drowsiness, dizziness, diplopia, and ataxia. These side effects mainly occur at toxic doses, but approximately 10% of patients cannot tolerate even low doses of phenytoin. Permanent cerebellar damage may occur if toxic drug levels are maintained for a prolonged period.40 Gingival hyperplasia is more common in children but can also occur in adults. Occasionally, phenytoin may deplete folic acid levels sufficiently to cause megaloblastic anemia. This complication responds to folic acid replacement and does not require discontinuing the administration of phenytoin.
miRNA-26-5p inhibits cyclosporine A-induced overgrowth of gingival fibroblasts by regulating PTEN/PI3K/AKT pathway
Published in Growth Factors, 2020
Qiyong Hu, Nadan Guo, Yuting Zhao, Yi Chen, Peng Zhang, Wei Shen, Ziya Gu
Cyclosporine A (CsA) is a common fungal metabolite that was first isolated from the soil specimens in Wisconsin, USA, with significant immunosuppressive effects and very low toxicity (Ponnaiyan and Jegadeesan 2015). Nowadays, CsA is predominately produced by the fungus Tolypocladium inflatum, and it is widely used as an extremely effective immunosuppressant in clinical settings to counteract rejection reactions during organ transplantation and treat patients with various autoimmune disorders (Faulds, Goa, and Benfield 1993; Conde et al. 2008). Nevertheless, application of CsA can cause a series of side effects, such as hepatotoxicity, hypertension, and gingival hyperplasia (Textor et al. 1994; Galan et al. 1995; Seymour, Ellis, and Thomason 2000). Seymour et al. first reported that CsA caused gingival hyperplasia in 1983, and approximately 25%–81% of all patients undergoing CsA treatment experienced this side effect (Seymour and Jacobs 1992). The lesion commonly occurs in the first few months of CsA treatment with an initial symptom of papillary enlargement, which is usually restricted to the keratinised gingiva but could grow over time and eventually cover the crown of teeth, resulting in difficulty in speech and mastication (Marshall and Bartold 1999). Multiple risk factors were proposed including sex, age, genetic factors, treatment duration, gingival inflammation, and concomitant medication use (Bartoli, Castronovo, and Stabile 2004). Recently, the imbalance between human gingival fibroblasts (HGFs) was revealed to contribute to gingival hyperplasia caused by CsA (Kantarci et al. 2007). Although numerous studies have been performed to investigate the cellular and molecular basis of CsA-induced gingival hyperplasia, the pathogenesis of this phenomenon remains unclear.
Use of calcium channel blockers in dermatology: a narrative review
Published in Expert Review of Clinical Pharmacology, 2021
Yang Lo, Lian-Yu Lin, Tsen-Fang Tsai
Other uses of CCB in dermatology include the treatment of vulvodynia, pressure ulcer and calcinosis cutis. Its use in vulvodynia may be due to attenuated contractions of smooth muscle from internal anal sphincter. In pressure sores, nitric oxide donor and antioxidants effects were proposed in addition to its known vasodilator activity. The ability to stimulate gingival hyperplasia as an adverse effect may be another facet of its therapeutic effect. For calcinosis cutis, it is proposed to act by inhibiting mitochondria1 sodium-calcium exchange.
The efficacy of photobiomodulation in the management of gingivitis during orthodontic treatment: A systematic review of clinical studies
Published in Orthodontic Waves, 2021
Sandeep Talluri, Suma M Palaparthi, Basir Barmak, Junad Khan
A literature search was performed based on the ‘Preferred Reporting Items for Systematic Review and Meta-Analysis’ (PRISMA) guidelines [24]. Indexed resources (PubMed, Medline, OVID, Scopus, EMBASE and Cochrane databases) were searched without language and time barriers up to January 2021 by two authors (ST and SMP) using various combinations of the following key words: (a) laser, (b) diode, (c) low-level laser therapy, (d) photobiomodulation, (e) gingivitis, (f) gingival enlargement, (h) gingival hyperplasia, (i) orthodontic treatment, (j) laser+ gingival inflammation, (k) cold laser+ gingival hyperplasia. As a second step, reference lists of potentially relevant original and review articles were hand-searched by the same authors (ST and SMP) to categorize studies that may have remained unidentified in the initial literature search. A disagreement among the authors was resolved via discussion (Figure 1). A search was performed using the following mesh words: (‘laser s’[All Fields] OR ‘lasers’[MeSH Terms] OR ‘lasers’[All Fields] OR ‘laser’[All Fields] OR ‘lasered’[All Fields] OR ‘lasering’[All Fields] OR (‘low’[All Fields] AND (‘level’[All Fields] OR ‘levels’[All Fields]) AND (‘laser s’[All Fields] OR ‘lasers’[MeSH Terms] OR ‘lasers’[All Fields] OR ‘laser’[All Fields] OR ‘lasered’[All Fields] OR ‘lasering’[All Fields])) OR ‘photobiomodulation’[All Fields] OR (‘lasers, semiconductor’[MeSH Terms] OR (‘lasers’[All Fields] AND ‘semiconductor’[All Fields]) OR ‘semiconductor lasers’[All Fields] OR (‘diode’[All Fields] AND ‘laser’[All Fields]) OR ‘diode laser’[All Fields])) AND (‘gingivitis’[MeSH Terms] OR ‘gingivitis’[All Fields] OR (‘gingival’[All Fields] AND ‘inflammation’[All Fields]) OR ‘gingival inflammation’[All Fields]) AND (‘orthodontal’[All Fields] OR ‘orthodontic’[All Fields] OR ‘orthodontical’[All Fields] OR ‘orthodontically’[All Fields] OR ‘orthodontics’[MeSH Terms] OR ‘orthodontics’[All Fields]).