AMLODIPINE-INDUCED GINGIVAL HYPERPLASIA IN CHRONIC PERIODONTITIS: A CLINICAL CASE REPORT WITH ONE YEAR FOLLOW-UP

Background: Drug-induced gingival overgrowth (DIGO) is a common side effect of certain medications used for non-dental purposes, notably anticonvulsants, calcium channel blockers (CCBs), and immunosuppressants. These drugs, despite differing pharmacologically, inhibit intracellular calcium ion influx, leading to a decrease in collagenolytic activity and an increase in fibroblasts and collagen synthesis, ultimately causing gingival overgrowth. Case Presentation: A 54-year-old male presented with significant gingival enlargement and periodontal disease. Clinical examination revealed generalized mild to moderate calculus, erythematous and indurated gingiva with severe periodontal attachment loss, and tooth mobility. Despite scaling and root planning, the gingival enlargement persisted, necessitating surgical intervention. Open flap debridement was performed, leading to a successful outcome with no recurrence of gingival enlargement after one year of follow-up. Discussion: The case highlights amlodipine-induced gingival overgrowth, a recognized side effect of CCBs. The exact mechanisms remain unclear, with both inflammatory and non-inflammatory pathways implicated. The inflammatory process involves cytokine upregulation, leading to fibroblast proliferation and fibrotic gingival hyperplasia. The case underscores the importance of early diagnosis, medication management, and surgical intervention in managing DIGO. Conclusion: DIGO is a significant side effect of systemic medications affecting periodontal tissues, with mechanisms that are not yet fully understood. Identifying risk factors and employing advanced molecular research is essential to developing effective prophylactic and therapeutic strategies.