tetracycline and Gingival-Overgrowth

Among the aging U.S. population, patients are taking significantly more medications than in the past. In view of this, dentists should take careful medical histories, including use of herbal agents, and be aware of medication-related problems and their potential effect on the diagnosis and treatment of periodontal disease. This review highlights major concerns about medications as a risk factor for periodontal therapy. Medications and their impact on periodontal disease can be categorized as those which affect oral hygiene, diagnosis, gingival and oral mucosa, and alveolar bone.

Topics: Adrenal Cortex Hormones; Alveolar Bone Loss; Anti-Bacterial Agents; Anti-Inflammatory Agents; Bone Density Conservation Agents; Drug Utilization; Drug-Related Side Effects and Adverse Reactions; Gingival Overgrowth; Humans; Mouth Mucosa; Periodontal Diseases; Pigmentation Disorders; Polypharmacy; Risk Factors; Tetracycline; Xerostomia

The hypothesis that nifedipine-induced gingival enlargement in periodontitis patients can be treated with the adjunctive use of tetracycline (TCN) fibers was tested in this study.. Ten patients (mean age 66 +/- 4 years) with chronic periodontitis combined with nifedipine-induced gingival enlargement participated. Full mouth recordings of clinical parameters (probing depth, clinical attachment level, bleeding on probing, presence or absence of plaque) were assessed at baseline and gingival enlargement was estimated from casts. Participants were instructed in proper oral hygiene and received supragingival scaling before being reassessed 1 month later. They subsequently received full-mouth scaling and root planing followed by the immediate placement of TCN fibers in all pockets >5 mm. Clinical parameters were reassessed at 3, 6, and 12 months after completion of treatment.. TCN fiber placement was well tolerated by patients. All clinical parameters recorded displayed significant improvements after treatment, and they were preserved for the 12-month experimental period. A significant reduction of the percentage of pockets >5 mm was noticed after treatment. The reduction of enlargement was still observed at 12 months despite patients not achieving optimal oral hygiene.. Placement of tetracycline fibers as an adjunct to mechanical treatment is an option for the non-invasive therapy of nifedipine-induced gingival enlargement in periodontitis patients whose general medical condition and concomitant ailments do not favor a surgical approach.

Topics: Aged; Analysis of Variance; Anti-Bacterial Agents; Calcium Channel Blockers; Gingival Overgrowth; Humans; Male; Nifedipine; Periodontitis; Tetracycline