Anindita L., Aris Aji K.

Bagian Ilmu Penyakit Mulut, Kedokteran Gigi, Fakultas Kedokteran, Universitas Jenderal Soedirman

 Arcadia Sulistijo J.

Program Profesi Kedokteran Gigi, Kedokteran Gigi, Fakultas Kedokteran, Universitas Jenderal Soedirman

DOI: https://doi.org/10.19184/stoma.v17i2.25219

ABSTRACT 

Hypertension presents an increase in blood pressure following the oral manifestations, such as gingival enlargement. A 42-year-old woman came to the General Sudirman University Dental and Oral Hospital complaining of enlarged front gums seven years ago. The  patient  had  a  history  of  hypertension  and  regularly  consumed  drugs,  amlodipine  5  mg.  Extraoral  examination  revealed  no lymphadenopathy and no swelling of the head and neck area. Intraoral examination revealed a gingival enlargement involving the papilla to the gingival margin present on the entire upper and lower labial gingival surface. The patient's diagnosis was gingival enlargement caused by gingival enlargement due to the use of amlodipine. Gingival enlargement has been noted with long-term or high-dose  amlodipine  use.  The  mechanism  of  amlodipine  in  causing  gingival  enlargement is through  the  role  of fibroblasts  with abnormal susceptibility to the drug, resulting in increased levels of protein synthesis, especially collagen. The role of pro-inflammatory cytokines occurs through an increase in interleukin-1β (IL-1β) and IL-6 in the inflamed gingival tissue due to the gingival fibrogenic response to drugs. Therapies were DHE and scaling and root planning as phase I in periodontal treatment. Plaque elimination is vital to reduce gingival inflammation that may occur. Substitution of the drug amlodipine may be needed if there is no improvement. Based on case reports, hypertension patients who took amlodipine could have gingival enlargement. The therapy given was plaque elimination in the form of DHE and Scaling and regular check-ups with the dentist.