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Gingival hyperplasia: case report A 64-year-old man developed gingival hyperplasia during treatment with ciclosporin and nifedipine [dosages not stated]. The man, who had previously had gingival hyperplasia, underwent renal transplantation and started receiving ciclosporin. About 5 months later, a diagnosis of ciclosporinand nifedipine-associated gingival overgrowth in the upper and lower front teeth was made [duration and therapeutic indication of nifedipine treatment not stated]. The man underwent six consecutive periodontal surgeries over the following 2 years for constantly recurring gingival hyperplasia; he also received non-surgical dental treatment at that time. Less than 7 months after the last treatment, gingival overgrowth recurred and periodontal treatment focussing on bacterial biofilm was started. On presentation, he had a large accumulation of bacterial biofilm due to inadequate oral hygiene. His oral hygiene was improved, the radicles were polished and excess gingival tissue was surgically removed. A biopsy revealed a multi-layer, thin and irregular parakeratinised epithelium; epithelial crests were deep within moderately collagenised connective tissue, vascularised and penetrated by inflammatory cells. Mild gingival overgrowth recurred 10 months after treatment and the remaining tissue was again surgically removed. Author comment: Exhaustive examination of the bacterial biofilm during treatment prevented the recurrence that the patient had experienced in his prior periodontal history. It must be borne in mind that the patient is taking two drugs that are considered in the aetiology of gingival overgrowth, which possibly accounted for the extreme severity of his symptoms. Bahamondes CB, et al. Cyclosporine-induced gingival hyperplasia: report of one case. Revista Medica de Chile 135: 370-374, No. 3, Mar 2007 [Spanish; 801081749 summarised from an English translation.] - Chile

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Reactions 28 Jul 2007 No. 1162