Medications affecting the outcomes and prognosis of dental treatment. Focus: calcium channel blockers and drug-induced gingival hyperplasia

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Abstract

In the interdisciplinary relationship between an internist and other specialists, the least studied aspects are their interactions with the stomatologist. However, somatic diseases can cause changes in the organs and tissues of the oral cavity. Drug therapy for somatic diseases can also affect the patient’s dental status, as well as the outcome and prognosis of dental treatment. Calcium channel blockers are widely used to treat arterial hypertension and prevent angina attacks in patients with coronary artery disease. A significant group-specific side effect of calcium antagonists in dental practice is gingival hyperplasia (bleeding, pain, swelling) and hypertrophic gingivitis, often referred to as drug-induced gingival hyperplasia.

This review, based on publications in the PubMed and Scopus databases, examines experimental studies and possible mechanisms for the development of calcium antagonist-induced gingival hyperplasia. Clinical studies, reviews, and meta-analyses demonstrate a potential association between the development of drug-induced gingival hyperplasia and the use of calcium antagonists, primarily nifedipine and amlodipine. The presence of preexisting periodontal inflammation strengthens this association, and the use of calcium antagonists aggravates the clinical manifestations of periodontitis. When treating patients with comorbid cardiovascular pathology and periodontal disease, interdisciplinary collaboration between an internist and a stomatologist is essential.

About the authors

Dmitry I. Trukhan

Omsk State Medical University

Author for correspondence.
Email: dmitry_trukhan@mail.ru
ORCID iD: 0000-0002-1597-1876

Dr. Sci. (Med.), Associate Professor, Professor, Department of Outpatient Therapy and Internal Medicine

Russian Federation, Omsk

Anatoly F. Sulimov

Omsk State Medical University

Email: afsulimov@yandex.ru
ORCID iD: 0009-0004-3249-3425

Dr. Sci. (Med.), Professor, Head of the Department of Maxillofacial Surgery

Russian Federation, Omsk

Larisa Y. Trukhan

Omsk State Medical University

Email: larissa_trukhan@mail.ru
ORCID iD: 0000-0002-4721-6605

Cand. Sci. (Med.), Stomatologist

Russian Federation, Omsk

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