Management of Amlodipine-Induced Gingival Enlargement in Hypersensitive Patient with Gingivectomy

Jennifer Tjokro

Hello uh good afternoon my name is jennifer chopra i am from paradontology specialist educational program faculty of dentistry housing university magazine indonesia today i’m going to present about the management of amniotipine induced gingiva enlargement in hypertensive patients with gingivectomy a case report so first of all we are going to talk about gingiva

Enlargement g4 enlargement is a feature of periodontal disease where genital growth exceeds normal genital tissue dimension increasing g for size hyperplasia which is increase of number of cells hypertrophy increased in cell sizes and fibrosis are observed during g4 enlargement and cannot be accurately differentiated calcium channel blocker-induced genome enlargement

Especially those induced by the philippines shows mixed inflammatory and fibrotic tissues gingiva enlargement is one of the side effects associated with administration of certain drugs drugs that can induce gingival overprickly can be divided into three categories anticonvulsant calcium channel blockers and immunosuppressants today we are going to focus more on

Calcium channel blockers which are often used as antihypertensive drugs therefore increases the number of g4 enlargement in cases with hypertensive patients castle channel blockers dilates arteries by inhibiting low of extracellular calcium into cells through voltage-operated calcium cells calcium channels causing relaxation of vascular smooth muscle cells thus

Effectively reducing blood pressure based on the vascular and cardiac selectivity calcium channel blockers can be classified into three main groups namely dehydropyridines is included in nephilipine and amlodipine diphtherial alkalamines or verapamil and benzodiazepines which is built-in dihydropyridines block the long-lasting type or l-type calcium channels thus

Block the depolarization of vascular smooth muscle cells cardiac myocytes and cardiac neural tissues which are primarily dependent on calcium influx the other two are more effective in cardiac muscle death in vascular smooth cells among all the calcium channel blockers nymphatipine is the most frequently associated with gdpr overgrowth diaphragmatic alkalamines and

Mesotheliazepines have significantly lower prevalences than the philippines so related to this case how does amlodipine induce g4 enlargement so a little bit information about amlodipine amlodipine is the derivative of dihydropyridine first supported by seymour in 1994 which is a long-acting drug shows relatively fewer side effects and offers greater protection

Against major complications of hypertension compared to nephilipine it is actually comparatively less common among other calcium channel blockers for i’m looking to induce digital enlargement the prevalence of it is 3.3 percent so actually the pathogenesis of two enlargement induced by the use of ammonium is still unclear but there are two pathways suggested

By a few studies first one is the non-inflammatory pathway second one is the inflammatory pathway so they’re not according to the non-inflammatory pathways degrees uptake of folic acid blockage of aldosterone synthesis feedback increase in adrenal corticocropic hormone level cause acceleration in colonized activity and upregulation of curbside growth factor

Amlodipine also overexpresses interleukin bone alpha and other pro-inflammatory cytokines in gingival fiber breasts hence increase the inflammatory process amlodipine also affects the modulation of fibrosis response in gdpr fibroblasts upregulates extracellular matrix proteases and favors the deposition of fibrotic tissue some risk factors includes dose and length

Of use age gender oral health status and judicial inflammation since this is not really fully understood it is challenged for periodontists to diagnose and treat these cases effectively so what is the problem with ginger enlargement it has three problems it hinders the maintenance of oral hygiene which makes it harder for patients with gingiva enlargement it can

Elevate the risk of infections also related to the plague and bacteria trapped in excessive juvenile tissues and this could lead to increased inflammatory complications which may aggravate systemic inflammations the treatment in this case can be classified into two non-surgical treatment and surgical treatment firstly is the non-surgical treatment which is our

Hydro instruction and motivation scaling and weight planning and drug substitution if the treatment of enlargement have no response and doesn’t have any resolution then we can proceed to the surgical procedure which is generifectomy or genotype in this case so genovectomy is a surgical association of pathological and large default tissue shown in this picture it

Aims to eliminate pocket produce good visual field and determine a predictable gigifer morphology according to surgery so this case this case report aims to highlight genevectomy as an effective treatment modality in managing ammunition for enlargement in hypertensive patients case report a 59 year old female patient was referred to the periodontology department

Of hassan university dental hospital but the chief complaint of gum swelling and redness in a mandibular area starting from six months ago medical history revealed that the patient was diagnosed with hypertension and was prescribed amordipine time underground for the last one year dental history revealed that the last scaling and replanning was performed one

Month ago and patient brushes to the teeth twice a day extra oral examination shows blood pressure was 130 over 80. no cervical lymphadenopathy no swelling normal cranial nerve responses internal expanded intraoral examination shows diffuse lobulated nodular gdpr enlargement involving interdental marginal and attached gym with gingiva of 36 to 45 bleeding on

Propane with fuel plate and calculus deposits and inflamed genifire with soft suffering consistency the diagnosis drug induced different enlargement concerning 36 to 45 due to the use of amlodipine so initially oral hygiene instructions and motivation simulating super general scaling and polishing followed by subjugal scaling and root planning would perform the

Patient was consulted back with her interns for drug substitution and blood pressure control then her internist referred her back to us amlodipine was replaced with cutter press or clonidine 150 milligram so these are the pre-operative photographs which shows gingival enlargements in the right posterior area anterior area in the left posterior area geophytome

Procedure was performed in three visits okay starting with the anterior then the left and then the right posterior of the mandible the surgery begins with the disinfection of the operating site infiltration of non-apparent of non-epinephrine local anesthesia use pocket markers to determine the bleeding points of three six and two four five then a number fifteen

Skateboard was used for incision now the facial aspect and the angle of 45 degrees apical to a point marking and directed currently which forms the external bevel following the contour of the gingiva gingivoplasty was done using urban and kubra knife the operating site was irrigated with saline solution and the surgical area was covered with a preventative pack

And detailed post-operative instructions and medications were given one week after the surgery the parental part was removed the patient had no complaints however clinical examinations which are shown in the pictures above reveals redness in the area of the operation post surgical area was cleaned with washing professionally and irrigated with saline solution

Then oral hygiene procedures and motivations for reinforced one month after surgery shows improved aesthetic in terms of genital experience gene for appearance and healthy stable juniper tissues so discussion amlodipine induced gingiva enlargement clinically shows as liberal or nuclear enlargement of the interdental papilla in the anterior region and it can occur

Within six months after starting amlodipine consumption at a dose of 10 milligram per day or 5 milligrams for more than 6 months or a case also presents juniper enlargement after two years at the dose of five milligram per day so even though amudipine causes molecular and similar changes in digital tissues which are approved in several studies g4 enlargement also

Fully depends on parallel health and hygiene as predominant health worsens the degree of gingival overgrowth increase the presence of plaque and inflammation exhibits gingival enlargement irrespective of initiating drug so this giveaway overgrowth also increased the potential for plaque retention setting unwanted chronic information which might aggravate system

Information in this case gingiva enlargement persists up to initial non-surgical treatment so it indicates further surgical involvement there are no underlying bone loss so external balancing difficulty and general property were done so uh removal of excessive juice tissue improve access for professional and home cleaning facilitating good hygiene and aesthetic

Outcome patient education proper practice of oral hygiene plays an important role in the case measurement success preventing recurrence of gdpr enlargement conclusion g4 enlargement can be used by drug consumption in this report it is induced by ayurvedic pain consumption good maintenance of our hygiene prescribing alternative medicine performing professional

Non-surgical management and surgical therapy repeated are the main available treatment modalities in this case gingivitamine along with drug substitution and oral prophylaxis provides satisfying treatment results this is my presentation for today thank you

Transcribed from video
Management of Amlodipine-Induced Gingival Enlargement in Hypersensitive Patient with Gingivectomy By Dentistry – Hasanuddin University