Wan Mohamad, Wan Majdiah
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Prevalence and Risk Factors of Drug-induced Gingival Overgrowth in Hypertensive Patients Taib, Haslina; Mohd Radzwan, Muhammad Haziq; Sabaruddin, Muhammad Annurdin; Wan Mohamad, Wan Majdiah; Mohamad, Noraini
Journal of Dentistry Indonesia Vol. 28, No. 1
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Gingival overgrowth (GO) or enlargement is an unwanted effect occurring on the gingiva that commonly associated with medications. Hypertension is a global burden systemic conditions and showed high prevalent and more patients are taking antihypertensive drugs. Objective: This study aimed to assess the prevalence of drug-induced gingival overgrowth (DIGO) and its associated risk factors among hypertensive patients attending Hospital Universiti Sains Malaysia, Kelantan, Malaysia. Methods: A total of 42 patients with the mean age of 57.1 (SD=9.3) years had participated in this cross-sectional study. They were recruited if they had consumed anti-hypertensive agents for at least 6 months. Demographic data and oral hygiene status were recorded and the presence of DIGO was assessed based on clinical index for gingival overgrowth. Data were analyzed using SPSS version 24.0 with p < 0.05 is considered statistically significant. Results: Majority of patients were taking calcium channel blockers (CCB) (81.0%) with amlodipine reported as the most common antihypertensive prescribed (47.6%). About 52% presented with DIGO and among them 55.9% were in those on CCB by which 9.5% presented with clinically significant enlargement. Except for gingivitis, oral hygiene status and demographic data were not significant risk factors for DIGO (p > 0.05). Conclusion: We found that DIGO is prevalent among hypertensive patients on CCB and its occurrence is coexists with gingivitis. Therefore, periodontal assessment is recommended among these patients for early detection and management of drug-induced gingival overgrowth.
Periodontal Parameters and Anti-Cardiolipin Antibodies Following Periodontal Therapy in Chronic Periodontitis Wan Mohamad, Wan Majdiah; Saad, Noor Rashidah; Zainuddin, Siti Lailatul Akmar; Taib, Haslina
Journal of Dentistry Indonesia Vol. 28, No. 1
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Anti-cardiolipin (anti-CL) antibodies are autoantibodies which are directed against cell membrane phospholipids. A significant number of periodontitis patients showed positive for anti-CL antibody. Objective: This study aimed to determine the periodontal parameters and anti-CL antibodies levels before and after non-surgical periodontal therapy in chronic periodontitis. Methods: This cross-sectional study had been carried out at Periodontal Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Thirty five chronic periodontitis (CP) and 39 non-periodontitis (NP) patients underwent clinical periodontal examination at baseline. Plaque index (PI), gingival index (GI), periodontal pocket depth (PPD), and clinical attachment loss (CAL) were measured. Scaling and polishing was performed and blood samples were taken for IgG and IgM anti-CL antibodies analysis. Re-evaluationwas performed four weeks after initial therapy. CP patients were re-examined, all periodontal parameters were recorded and blood samples were taken for reassessment of IgG and IgM anti-CL antibodies. Results: Significant difference means of PI(p=0.001), GI (p=0.000), PPD (p=0.000) and, CAL (p=0.000) were found between CP and NP groups. All periodontal parameters were significantly reduced (p≤0.05) after four weeks of therapy. The mean levels of IgG and IgM anti-CL antibodies at baseline were significantly higher in CP than NP group (IgG=4.46 vs 3.22, p=0.002; IgM=3.28 vs 2.57, p=0.019). No significant difference of the median levels of IgG (p=0.82) and IgM anti-CL antibodies (p=0.35) following therapy. Conclusion: All periodontal parameters were significantly reduced following periodontal therapy. Higher level of Anti-CL antibodies in CP indicates stimulation of autoantibodies production by periodontal infection. Nonetheless no significant changes of this anti-CL antibodies levels despite significant reduction of the clinical parameters after periodontal therapy.
Assessment of Gingival Status and Gingival Overgrowth among Immunosuppressed Patients in Universiti Sains Malaysia Hospital Wan Mohamad, Wan Majdiah; Mat Zaid, Syamimi Izzati; Taib, Haslina
Journal of Dentistry Indonesia Vol. 28, No. 1
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Drug-induced gingival overgrowth (DIGO) is defined as an abnormal growth of the gingiva due to adverse effect of some drugs such as immunosuppressant, calcium channel blocker, and anticonvulsant. Immunosuppressive drugs play an important role in controlling organ transplant rejection and were widely used to treat different diseases. Objective: Immunosuppressive drugs are used for prevention of transplant rejection and management of autoimmune disease. Drug-induced gingival overgrowth (GO) is abnormal growth of gingiva due to adverse effect of these drugs. This study aimed to assess the gingival status, the prevalence of gingival overgrowth and its associated factors among immunosuppressed patients. Methods: A total of 33 patients had participated in this cross-sectional study. Patients’ data such as age, race, gender, type of medication, and dosage were retrieved from patients’ medical record. Clinical oral examination was performed to assess the periodontal parameters: oral hygiene index, bleeding index and clinical gingival overgrowth index. Data were analysed using SPSS version 24.0. Results: The prevalence of gingival overgrowth among immunosuppressed patients is 57.6% at 95% confidence interval (40%,75%). Clinical index of gingival overgrowth shows 45.5% in grade 1 and 15.2% in grade 2. Oral hygiene status is significantly associated with gingival overgrowth based on plaque score (p= 0.01) and bleeding index score (p=0.05). Conclusion: The presence of gingival overgrowth among immunosuppressed patients is quite evidenced which could be contributed by poor oral hygiene.
Salivary IgA Depression in Drug-Influenced Gingival Enlargement among Hypertensive Patients Sabarudin, Muhammad Annurdin; Taib, Haslina; Wan Mohamad, Wan Majdiah; Zainuddin, Siti Lailatul Akmar; Wan Ghazali, Wan Syamimee; Misran, Ahmad Azhar
Journal of Dentistry Indonesia Vol. 29, No. 1
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Drug-influenced gingival enlargement (DIGE) among hypertensive patients is commonly associated with antihypertensive drugs such as calcium channel blockers (CCBs). Immune response alteration is one of the proposed mechanisms for DIGE. Immunoglobulin A (IgA) in saliva which involves in defense mechanism was shown to be affected in patients with DIGE. Objective: This study aimed to determine the association of salivary IgA level with DIGE. Methods: This cross-sectional study comprised 47 hypertensive patients who had consumed antihypertensive drugs for at least 3 months. Twenty-one (44.7%) males and 26 (55.3%) females had participated in this study. Data was analyzed using SPSS version 26.0. The p-value of less than 0.05 at a 95% confidence interval is considered statistically significant. Results: Eighty-three percent and 17.0% of hypertensive patients were on CCBs and non- CCBs respectively. Amlodipine was found to be the most common (55.3%) antihypertensive drug consumed. Twenty- one (44.7%) patients presented with DIGE. The salivary IgA level was significantly decreased (p=0.03) among hypertensive patients with DIGE [Median 4.9 ng/mL (IQR 5.268)] compared to those without DIGE [median 15.03 ng/mL (IQR 32.246)]. Conclusion: This data indicates the level of salivary IgA was significantly affected in patients with DIGE which may compromise the defense mechanism of saliva.