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      Agrandamiento gingival medicamentoso en pacientes que padecen hipertensión, cardiopatías y epilepsia Translated title: Medicated gingival enlargement in patients suffering from hypertension, heart disease and epilepsy

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          Abstract

          RESUMEN Introducción: el agrandamiento gingival medicamentoso es el efecto indeseado más extendido de la medicación sistémica sobre los tejidos periodontales, se implican con mayor frecuencia los medicamentos: fenitoína, ciclosporina y nifedipina, y no existe consenso respecto a las cifras exactas de prevalencia. Objetivo: caracterizar el agrandamiento gingival medicamentoso en pacientes que padecen hipertensión, cardiopatía y epilepsia del Consultorio del Médico de la Familia 21-8 del Policlínico “XX Aniversario”. Método: se realizó un estudio descriptivo observacional de corte transversal. Se seleccionaron los casos por muestreo no probabilístico intencional por criterios, la muestra quedó conformada por 46 personas. Se aplicaron métodos teóricos y empíricos que incluyeron la aplicación de índices epidemiológicos. La información se agrupó en tablas de contingencias y frecuencias. Resultados: la prevalencia de agrandamiento gingival fue de 4,3% sin distinción de edad ni sexo y afectó a los que padecen epilepsia. La fenitoína y la carbamazepina fueron los medicamentos que lo produjeron, se identificaron los factores de riesgo: edad, sexo, tiempo y dosis de consumo del fármaco, higiene bucal y estado periodontal. Conclusiones: la prevalencia de agrandamiento gingival fue baja, con severidad grado 2 y 3, exclusiva de pacientes epilépticos tratados con carbamazepina y fenitoína. Afectó por igual a jóvenes de ambos sexos. La higiene bucal deficiente y la enfermedad periodontal inflamatoria crónica estuvieron presentes.

          Translated abstract

          ABSTRACT Introduction: medicated gingival enlargement is the most widespread undesirable effect of systemic medication on periodontal tissues, the most frequently implicated drugs are phenytoin, cyclosporine and nifedipine, and there is no consensus on exact prevalence figures. Objective: to characterize medicinal gingival enlargement in patients suffering from hypertension, cardiopathy and epilepsy at the Family Physician's Office 21-8 of the “XX Aniversario” Polyclinic. Method: a cross-sectional, descriptive, observational study was conducted. Cases were selected by intentional non-probabilistic sampling by criteria, the sample was made up of 46 people. Theoretical and empirical methods were applied that included the application of epidemiological indices. The information was grouped in tables of contingencies and frequencies. Results: the prevalence of gingival enlargement was 4.3% without distinction of age or sex and it affected those who suffer from epilepsy. Phenytoin and carbamazepine were the drugs that produced it, risk factors were identified: age, sex, time and dose of drug consumption, oral hygiene and periodontal condition. Conclusions: prevalence of gingival enlargement was low, with severity grade 2 and 3, exclusive of epileptic patients treated with carbamazepine and phenytoin. It affected equally young people of both sexes. Poor oral hygiene and chronic inflammatory periodontal disease were present.

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          Most cited references20

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          2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8).

          Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes. There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years. There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in persons with CKD to improve kidney outcomes. Although this guideline provides evidence-based recommendations for the management of high BP and should meet the clinical needs of most patients, these recommendations are not a substitute for clinical judgment, and decisions about care must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient.
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            Anuario Estadístico de Salud 2017

            (2018)
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              Calcium channel blocker-induced gingival enlargement.

              Despite the popularity and wide acceptance of the calcium channel blockers (CCBs) by the medical community, their oral impact is rarely recognized or discussed. CCBs, as a group, have been frequently implicated as an etiologic factor for a common oral condition seen among patients seeking dental care: drug-induced gingival enlargement or overgrowth. This enlargement can be localized or generalized, and can range from mild to extremely severe, affecting patient's appearance and function. Treatment options for these patients include cessation of the offending drug and substitution with another class of antihypertensive medication to prevent recurrence of the lesions. In addition, depending on the severity of the gingival overgrowth, nonsurgical and surgical periodontal therapy may be required. The overall objective of this article is to review the etiology and known risk factors of these lesions, their clinical manifestations and periodontal management.
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                Author and article information

                Journal
                amdc
                Acta Médica del Centro
                Acta méd centro
                Hospital Provincial Clínico Quirúrgico Universitario Arnaldo Milián Castro (Santa Clara, , Cuba )
                2709-7927
                March 2021
                : 15
                : 1
                : 72-80
                Affiliations
                [1] Santa Clara Villa Clara orgnameUniversidad de Ciencias Médicas de Villa Clara Cuba
                Article
                S2709-79272021000100072 S2709-7927(21)01500100072
                ca107693-90a7-4896-aba6-399feaac4603

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 04 June 2020
                : 06 August 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 9
                Product

                SciELO Cuba


                gingival diseases,gingival enlargement,induced drug,gingival hyperplasia,enfermedades de las encías,hiperplasia gingival,agrandamiento gingival,fármaco inducido

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