Management of Drug Induced Gingival Overgrowth (Digo) in a Patient with Cerebral Palsy Type Spastic Quadriplegia: A Case Report

https://doi.org/10.33860/jik.v18i1.3912

Authors

  • Anggun Tri Sari Oral and Maxillofacial Surgery Departement, Faculty of Dentistry, Universitas Padjadjaran, RSUP Dr. Hasan Sadikin Bandung, Indonesia
  • Melita Sylvyana Oral and Maxillofacial Surgery Departement, Faculty of Dentistry, Universitas Padjadjaran, RSUP Dr. Hasan Sadikin Bandung, Indonesia
  • Harmas Yazid Yusuf Oral and Maxillofacial Surgery Departement, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia

Keywords:

Gingival Hyperplasia, Gingival Enlargement, Epilepsy, Cerebral palsy

Abstract

Drug Induced Gingival Overgrowth (DIGO) can be defined as local or general enlargement of the gingival tissue that occurs as a side effect of certain drugs such as immunosuppressive drugs, anticonvulsants and calcium channel blockers. Epilepsy is known to be closely related to cerebral palsy; 15-60% of children with cerebral palsy report having epilepsy requiring anticonvulsant drugs as routine therapy. When gingival enlargement occurs, it interferes with normal oral hygiene practices and can interfere with masticatory function. Gingival hyperplasia can be treated by stopping or changing drugs. In more severe cases, surgical treatment is required. A 6 year old boy patient with a history of epilepsy and cerebral palsy came with complaints of lumps in the gums of the right and left lower jaw. The patient started taking epilepsy medication about 3 years after being diagnosed with epilepsy. After about 1.5 years of taking epilepsy drugs, the patient experienced enlargement of all of his maxillary and mandibular gingiva. The patient was consulted to the Oral and Maxillofacial Surgery Department of Hasan Sadikin General Hospital, on intra-oral examination we found there was gingival enlargement that covered almost the entire tooth surface, the treatment plan was carried out by a surgical procedure in stages under general anesthesia. The results obtained after surgery showed that the shape of the gingiva was normal and the patient's masticatory function had improved. In cases where there is overgrowth of the gingiva to cover the entire tooth surface, surgical procedure is a standard procedure to restore the normal shape of the gingiva.

References

Swaiman KF, Ashwal S. Pediatric Neurology, Principles, and Practice (3rd Ed ), Mosby, St. Louis, 2014: 312-22.

Ratanawongsa B. Cerebral palsy. Dalam : e-Medicine Journal, 2015, Volume 2, No.2.

Aneja S, Ahuja B, Taluja B, Bhatia VK. Epilepsy in children with cerebral palsy. Indian Journal of Pediatrics, 2017, February : 68 (2): 111-5

Marshall RI, Bartold PM. Medication induced gingival overgrowth. Oral Dis. 2018 Jun;4(2):130-51.

Sander, J, and S. D. Shorvon. Epidemiology of the epilepsies. Journal of Neurology Neurosurgery and Psychiatry. 2015; 61(5), 433–443,

Camargo PM, Melnick PR, Pirih FQ, Lagos R, Takei HH. Treatment of drug-induced gingival enlargement: aesthetic and functional considerations. Periodontol 2000. 2017;27:131-8.

Berker N, Yalcin S. The help guide to cerebral palsy. 2nd Edition. Washington: Merril Corporation; 2015.

Sadowska, M.; Sarecka-Hujar, B.; Kopyta, I. Evaluation of Risk Factors for Epilepsy in Pediatric Patients with Cerebral Palsy. Brain Sci. 2020, 10, 481. [CrossRef]

Walter BH. Treatment of Gingival Enlargement. In: William P. Lundergan. Critical Decisions in Periodontology. 4th Ed. BC Decker Inc: Hamilton London 2016; 58, 138- 40.

Newman MG., Takei HH., Carranza FA.Clinical Periodontology 11th 9th edition. 2014.Philadelphia: WB Saunders Co.p . 74- 94

Dongari-Bagtzoglou A., Research, Science and Therapy Committee, American Academy of Periodontology. Drug-associated gingival enlargement. J Periodontol. 2014 Oct;75(10):1424-31.

Guncu, F. Cxaglayan, A. Dincxel, A. Bozkurt, S. Sayg, and E. Karabulut.Plasma and gingival crevicular fluid phenytoin concentrations as risk factors for gingival overgrowth.Journal of Periodontology.2015; 77

Suzuki, A. Yoshimura, Y. Ozaki, T. Kaneko, and Y. Hara. Cyclosporin A and phenytoin modulate inflammatory responses. Journal of Dental Research. 2016; 88( 12), 1131–1136.

Greenberg KV, Armitage GC, Shiboski CH. Gingival enlargement among renal transplant recipients in the era of new-generation immunosuppressants. J Periodontol. 2018 Mar;79(3):453-60.

Seymour RA, Thomason JM, Ellis JS. The pathogenesis of drug-induced gingival overgrowth. J Clin Periodontol. 2016 Mar;23(3 Pt 1):165-75.

Patel D., Neelakantan M., Pandher K., & Merrick J. Celebral Palsy in Children: a clinical overview. Translational Pediatrics, 2020 Feb; 9(1); S125-S135.

Alfira NI, Andriati, Irwanto, & Prastiya IG. Assessment Quality of Life in Children with Cerebral Palsy, Ages 2–18 Years. Jurnal Epidemiologi, 2021; 9(2): 166-174.

Muhammad RF. Understand the design of qualitative research methods. Humanika, 2021; 21(1): 33-54.

Milya S., & Asmendri. Library Research in Science Education Research. Natural Science, 2020; 6(1): 41-53.

Ulfah Z, Umi BR, & Inten H. Case Study: Physiotherapy Program For Ataxia Cerebral Palsy Case In Pediatric Physiotherapy Diamond Clinic, 2022; 2(3): 16-20.

Nahdiah P., Wartun WR, & Nurhikmawaty H. The Relationship Between Gross Motor Skills And Quality Of Life In Children With Cerebral Palsy. Jurnal Keperawatan dan Fisioterapi, 2022; 5(1): 139-146.

Dedi I. Children With Cerebral Palsy Can Run. Indonesian Journal Of Education Teaching and Learning (IJETL), 2021; 1(1): 16-20.

Sujata T, & Arati GP. Drug-Induced Gingival Overgrowth. StatPearls, 2022.

Agenieszka D, & Marek D. Drug-Induced Gingival Overgrowth—Molecular Aspects of Drug Actions. MDPI, 2023; 24(6).

Sudip P., Anjuman N, Mrinalini B., & Ajaya. A Review on Recent Advances of Cerebral Palsy. Oxid Med cell Longev, 2022.

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Published

2024-05-31

How to Cite

Sari, A. T., Sylvyana, M., & Yazid Yusuf, H. (2024). Management of Drug Induced Gingival Overgrowth (Digo) in a Patient with Cerebral Palsy Type Spastic Quadriplegia: A Case Report. Poltekita: Jurnal Ilmu Kesehatan, 18(1), 116–122. https://doi.org/10.33860/jik.v18i1.3912

Issue

Vol. 18 No. 1 (2024)

Section

Case Study Article

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