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Case Reports
. 2021 Sep 21:2021:4120148.
doi: 10.1155/2021/4120148. eCollection 2021.

Necrotizing Ulcerative Gingivitis, a Rare Manifestation as a Sequel of Drug-Induced Gingival Overgrowth: A Case Report

Marah Damdoum  1 , Sudhir Rama Varma  1   2 , Mohamed A Jaber  1   2 , Manjusha Nambiar  3
Affiliations
Case Reports

Necrotizing Ulcerative Gingivitis, a Rare Manifestation as a Sequel of Drug-Induced Gingival Overgrowth: A Case Report

Marah Damdoum et al. Case Rep Dent. .

Abstract

Purpose: The purpose of this case report is to present a rare case of amlodipine-induced gingival overgrowth with a secondary formation of necrotizing ulcerative gingivitis involving the upper and lower arches of a 68-year-old female patient with a chief complaint of "swollen gums and pain on mastication which has been recurring for the past 5 years."

Materials and methods: The treatment plan of this case was divided according to quadrants of the mouth. Each week, one quadrant was surgically excised, and the remaining quadrants were observed for any changes. The gingival overgrowths were excised using a 15 blade, and debris/plaque was removed with Gracey curettes.

Results: Although full-mouth exodontia was performed, the patient unfortunately suffered with recurrences in GO. These results are suggestive of idiopathic causes of GO.

Conclusion: Careful examination, physician referrals, and biopsy to rule out any specific anomalies and to assist in proper diagnosis are followed by sequential management of the case results in productive outcomes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Fibrous, nodular, hard gingival overgrowths extending to most of the clinical crown in the anterior and posterior parts of the mandibular arch.
Figure 2
Figure 2
Yellowish-white pseudomembranous slough was found covering the interdental papilla in the mandibular left area.
Figure 3
Figure 3
Panoramic radiograph presenting bone loss around teeth and lower 4-unit implant-retained bridge.
Figure 4
Figure 4
External bevel incision gingivectomy of the lower left quadrant and exodontia of #33, #34, and #35.
Figure 5
Figure 5
Gingiva removed from the lower left quadrant and extracted teeth (#33, #34, and #35).
Figure 6
Figure 6
1 week after surgical excision of the lower left quadrant.
Figure 7
Figure 7
External bevel gingivectomy of the upper right quadrant.
Figure 8
Figure 8
Gingiva removed from the upper left quadrant and extracted teeth (#11 and #21).
Figure 9
Figure 9
External bevel gingivectomy of the upper left quadrant.
Figure 10
Figure 10
Recall after 2 weeks of surgical intervention of maxillary arch. Pus and exudates were observed around teeth and sutures. Full exodontia was done for the remaining teeth in the upper arch.
Figure 11
Figure 11
1 month recall after surgical intervention of the mandibular arch. Recurrence was presented, and full-mouth exodontia was done for the lower arch.
Figure 12
Figure 12
Histopathological slide of gingival biopsy revealed squamous epithelium hyperplasia with underlying chronic inflammation.
Figure 13
Figure 13
Histopathological slide of gingival biopsy revealed squamous epithelium hyperplasia with underlying chronic inflammation.
See this image and copyright information in PMC

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