Untypical amlodipine-induced gingival hyperplasia.

Area of Science:

• Cardiology
• Pharmacology
• Periodontology

Background:

• Amlodipine, a common antihypertensive, is known to cause gingival overgrowth (GO).
• Gingival overgrowth (GO) typically manifests within three months at 10mg/day amlodipine.
• Reports of amlodipine-induced gingival overgrowth (AIGO) at lower doses (5mg/day) and after long-term use are rare.

Purpose of the Study:

• To report a case of amlodipine-induced gingival overgrowth (AIGO) occurring at a lower dose (5mg/day) and after prolonged administration.
• To emphasize the need to consider AIGO in patients presenting with gingival issues despite lower amlodipine dosage and extended treatment duration.

Main Methods:

• A 64-year-old male patient with hypertension on 5mg/day amlodipine for four years presented with extensive maxillary gingival overgrowth.
• Clinical and histological examinations confirmed amlodipine-induced gingival overgrowth (AIGO).
• Treatment involved amlodipine substitution with enalapril (5mg/day), scaling and root planing (SRP), and subsequent gingivectomy/gingivoplasty.

Main Results:

• The patient experienced masticatory problems, pain, bleeding, and foul odor due to the gingival overgrowth.
• Following amlodipine substitution and SRP, a reduction in inflammation and symptoms was observed at one month.
• Gingivectomy/gingivoplasty provided further resolution of the gingival overgrowth.

Conclusions:

• Amlodipine-induced gingival overgrowth (AIGO) should be considered even with lower doses (5mg/day) and late presentations.
• Early recognition and management, including drug substitution and periodontal therapy, are crucial for treating AIGO.
• This case underscores the variability in amlodipine's side effect profile regarding gingival overgrowth.