Epidemiological analysis of nifedipine and phenytoin-induced gingival overgrowth in users of the Primary Health Care System

Análise epidemiológica do aumento gengival induzido por nifedipina e fenitoína em usuários da Atenção Primária à Saúde

Luciara Viana Leão Fonseca^I; Hercílio Martelli Júnior^II; Patrícia Furtado Gonçalves^I; Fillipe Mateus Castro de Carvalho^I; Ricardo Della Coletta^III; Paulo Rogério Ferreti Bonan^II

^IDepartment of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, MG, Brazil
^IIDepartment of Dentistry, State University of Montes Claros, Montes Claros, MG, Brazil ]]> ^IIIDepartment of Dentistry, State University of Campinas, Piracicaba, SP, Brazil

Correspondence

ABSTRACT

PURPOSES: The aim of this study was to evaluate the prevalence of drug-induced gingival overgrowth (DIGO) in Brazilian users of nifedipine and/or phenytoin and to determine the presence of predisposing/modifying factors.
METHODS: Demographic, pharmacological, and periodontal data were obtained from 100 users of the Brazilian Primary Health Care System in Diamantina, Jequitinhonha Valley, Minas Gerais state, Brazil, who were taking nifedipine and/or phenytoin. Clinical evaluations including gingival overgrowth analysis were carried out by a single calibrated examiner. Bivariate analysis (Chi-square test or Student's t-test) were used to identify demographic, periodontal and drug-related significant factors associated with gingival overgrowth severity. Multivariate analysis (Poisson regression) was used to assess confounding factors.
RESULTS: The prevalence of DIGO was high (86%), but its severity was predominately mild. The prevalence of DIGO was significantly higher in phenytoin users than in nifedipine users (p=0.01). There was no association between DIGO and demographic, pharmacological or periodontal variables.
CONCLUSION: The high occurrence of DIGO among users of nifedipine and phenytoin emphasizes the importance of the dentist as part of the public health team to provide the prevention, early diagnostic, and control of this alteration.

Key words: Nifedipine; phenytoin; gingival overgrowth; primary health care

OBJETIVO: Avaliar a prevalência dos aumentos gengivais medicamentosos em usuários brasileiros de nifedipina e fenitoína e determinar a presença de fatores preditores/modificadores.
METODOLOGIA: Dados demográficos, farmacológicos e periodontais foram obtidos de 100 pacientes usuários da Atenção Primária no Vale do Jequitinhonha que usavam nifedipina e/ou fenitoína. Avaliações clínicas, incluindo a análise do aumento gengival, foram feitas por um avaliador calibrado. Análises bivariadas (teste do qui-quadrado ou teste t de Student) foram usadas para identificar fatores demográficos, periodontais e medicamentosos que apresentassem associação com a severidade do aumento gengival. Foi utilizada análise multivariada (regressão de Poisson) para estimar a razão de prevalência e intervalo de 95% de confiança para identificar os fatores de risco associados ao desenvolvimento do AG.
RESULTADOS: A prevalência do aumento gengival foi elevada (86%), mas a gravidade mais comumente observada foi a leve. A prevalência foi maior em usuários de fenitoína do que de nifedipina (P=0.01). Não houve associação entre aumento gengival e as variáveis demográficas, farmacológicas e periodontais.
CONCLUSÃO: A alta prevalência do aumento gengival medicamentoso entre os usuários de nifedipina e fenitoína enfatiza a importância do cirurgião dentista no diagnóstico, prevenção e controle dessa alteração.

Palavras-chave: Nifedipina; fenitoína; hiperplasia gengival; atenção primária em saúde

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Acknowledgments

This study received financial support from FAPEMIG - Foundation of Research Support of Minas Gerais State, Brazil.

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Correspondence: ]]> Luciara Leão Viana Fonseca
Rua da Glória, 187, Centro
Diamantina, MG - Brasil 39100-000
E-mail: luciaraleao@hotmail.com

Received: January 29, 2010
Accepted: April 9, 2010

Conflict of Interest Statement: The authors state that there are no financial and personal conflicts of interest that could have inappropriately influenced their work.