Gingival hyperplasia induced by amlodipine in a patient with chronic periodontitis. Case presentation

Abstract

Introduction: numerous reports based on epidemiological studies have demonstrated the existence of a relationship between periodontal infections and systemic diseases, while increases in gingival hyperplasia associated with the use of calcium channel blockers are reported.

Objective: to present a case of gingival hyperplasia induced by amlodipine, which is of interest to health professionals because it is a rare entity in the stomatological practice and also is the least studied adverse effect of this drug.

Case presentation: female patient of 40 years of age and white skin color, who attended the Periodontal Consultation due to bleeding and severe inflammation of the gums, with discomfort when speaking and during chewing. The patient suffers high blood pressure and she was decompensated, so she had been treated with amlodipine at doses of 10 mg daily for four months. Physical and radiographic exams revealed a gingival hyperplasia associated with chronic, deep and generalized adult periodontitis, for which antimicrobial treatment was combined with aqueous chlorhexidine rinses, tartrectomy (manual and ultrasonic) and amlodipine replacement with atenolol. At two months of treatment, the symptoms went forward.

Conclusions: in patients with chronic periodontitis it is not recommended to use amlodipine to compensate the arterial hypertension, because induced gingival hyperplasia forms a vicious cycle with the underlying disease and aggravates it, which can lead to cardiovascular atherosclerotic disease.