Is periodontal health a predictor of drug-induced gingival overgrowth? A cross-sectional study

Gingival overgrowth is a common side-effect of amlodipine regimen on the oral cavity. There is controversy regarding the cause and effect relationship of periodontal health and drug induced gingival overgrowth. Therefore, this study was conducted to investigate and to assess the relationship between the periodontal health and the onset and severity of gingival overgrowth in hypertensive patients receiving amlodipine. A total of 99 known hypertensive patients on amlodipine regimen were included in this study. Probing pocket depth (PPD) and clinical attachment loss (CAL) were noted on four sites of maxillary and mandibular anterior teeth. Gingival enlargement scores were assessed for each patient by employing the hyperplastic index. Oral hygiene status was evaluated using the calculus index (CI). Patients were divided into H, E and L groups based on their periodontal status and responders and non-responders based on their hyperplastic index scores. Differences in means of different periodontal variables in different groups were tested for significance by using ANOVA and unpaired Student t-test. Pearson's correlation coefficient was calculated to assess the correlation between different variables. For all analyses, P < 0.05 was considered to be significant. All the periodontal parameters were statistically highly significant (P = 0.00) amongst H, E and L groups and between responders and non-responders. Statistically highly significant Pearson correlation coefficients were found between mean PPD and mean hyperplastic score, mean CAL and mean hyperplastic score and mean calculus and mean hyperplastic score. The results of this study indicated a definite association between periodontal health and development and severity of amlodipine-induced gingival overgrowth.