Phenytoin Induced Gingival Enlargement

Abstract

Certain anticonvulsants, cyclosporine, and calcium channel blockers like amlodipine have been
shown to produce clinically and histologically similar gingival enlargements in certain susceptible patients in
response to local factors. These drugs appear to be similar with respect to their pharmacologic mechanism of
action at the cellular level. Therefore, it is tempting to speculate that these agents may act similarly on
gingival connective tissue and cause a hyperplastic response. This tissue reaction may involve a disturbance
of calcium ion influx into specific cell populations with a resulting alteration in collagen metabolism and
other host cell response mechanisms. A connection between ion exchange, folate uptake, collagenase
activation, and bacterial inflammation may exist. The management involves Phase I therapy followed by
surgical intervention. The purpose of these case reports is to highlight certain modifications in existing
surgical techniques like gingivectomy, to have better aesthetic and functional outcome.