Connective tissue metabolism and gingival overgrowth.
Gingival overgrowth occurs mainly as a result of certain anti-seizure, immunosuppressive, or antihypertensive drug therapies. Excess gingival tissues impede oral function and are disfiguring. Effective oral hygiene is compromised in the presence of gingival overgrowth, and it is now recognized that this may have negative implications for the systemic health of affected patients. Recent studies indicate that cytokine balances are abnormal in drug-induced forms of gingival overgrowth. Data supporting molecular and cellular characteristics that distinguish different forms of gingival overgrowth are summarized, and aspects of gingival fibroblast extracellular matrix metabolism that are unique to gingival tissues and cells are reviewed. Abnormal cytokine balances derived principally from lymphocytes and macrophages, and unique aspects of gingival extracellular matrix metabolism, are elements of a working model presented to facilitate our gaining a better understanding of mechanisms and of the tissue specificity of gingival overgrowth.
Trackman
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PC
Boston University Goldman School of Dental Medicine, Department of Periodontology and Oral Biology, Division of Oral Biology, Boston, MA 02118, USA. trackman@bu.edu
Kantarci
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A
D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000009:adverse effects; D003238:Connective Tissue / Q000187:drug effects / Q000378:metabolism*; D055513:Connective Tissue Growth Factor; D016572:Cyclosporine / Q000009:adverse effects; D005109:Extracellular Matrix / Q000378:metabolism; D005347:Fibroblasts / Q000187:drug effects / Q000378:metabolism; D019214:Gingival Overgrowth / Q000139:chemically induced / Q000235:genetics / Q000378:metabolism*; D006133:Growth Substances / Q000378:metabolism; D006801:Humans; D017874:Immediate-Early Proteins / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000009:adverse effects; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D009543:Nifedipine / Q000009:adverse effects; D010587:Phagocytosis / Q000187:drug effects; D010672:Phenytoin / Q000009:adverse effects
D000927:Anticonvulsants; D000959:Antihypertensive Agents; C526317:CCN2 protein, human; D006133:Growth Substances; D017874:Immediate-Early Proteins; D007166:Immunosuppressive Agents; D036341:Intercellular Signaling Peptides and Proteins; D055513:Connective Tissue Growth Factor; D010672:Phenytoin; D016572:Cyclosporine; D009543:Nifedipine