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Drug-Induced Gingival Overgrowth — NDEB AFK MCQ

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ModeratePeriodontologyDrug-Induced Gingival OvergrowthNDEB AFK

A patient presents with generalised gingival enlargement that is firm, stippled, and non-haemorrhagic. The patient takes phenytoin for epilepsy. Which of the following best describes the pathogenesis of this condition?

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Correct answer: E — Drug-induced fibroblast proliferation and collagen accumulation

Phenytoin (diphenylhydantoin) causes gingival overgrowth by stimulating fibroblast proliferation and collagen synthesis. The exact mechanism involves altered calcium ion flux in fibroblasts and upregulation of connective tissue growth factors. Plaque acts as a co-factor that worsens the condition. Other drugs causing gingival overgrowth include cyclosporine and calcium channel blockers (nifedipine). Meticulous oral hygiene reduces severity.

Reference: Newman – Newman and Carranza's Clinical Periodontology, 13th ed., 2019