Title: Amlodipine associated gingival overgrowth: A multidisciplinary periodontal management approach
Abstract:
Background: Amlodipine is a third-generation dihydropyridine calcium channel blocker widely prescribed for the management of hypertension and angina. Gingival overgrowth is a well-documented adverse effect that may compromise esthetics, oral hygiene, periodontal health, tooth position, and masticatory function. Its management may require a combination of pharmacological modification, nonsurgical periodontal therapy, and surgical intervention.
Case Presentation: A 55-year-old woman was referred to the Department of Periodontology at the University Hospital of Rabat with a chief complaint of generalized gingival enlargement. Clinical and periodontal examination revealed significant gingival overgrowth associated with amlodipine therapy, with local factors contributing to plaque accumulation and inflammation.
Management and Outcome: Initial treatment consisted of comprehensive nonsurgical periodontal therapy, including oral hygiene instruction, scaling, and root surface debridement. Following consultation with the patient's physician, amlodipine was substituted with an alternative antihypertensive medication. Persistent gingival enlargement was subsequently managed surgically. The patient was enrolled in a regular supportive periodontal therapy program, with reinforcement of oral hygiene measures and periodic periodontal reassessment. A favorable clinical response was observed, with stable periodontal conditions and no significant recurrence of gingival overgrowth throughout a 2-year follow-up period.
Conclusion: Amlodipine-associated gingival overgrowth can be successfully managed through an individualized, multidisciplinary approach combining effective plaque control, nonsurgical periodontal therapy, appropriate modification of the offending medication, and surgical treatment when indicated. Long-term supportive periodontal therapy is essential for maintaining clinical stability and minimizing the risk of recurrence.
