• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.14-23
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• 1995

Cyclosporin A is a powerful immunosuppressive agent commonly used for patients receiving organ transplants. Like phenytoin and the calcium channel blockers, the drug is associated with gingival overgrowth. The purpose of this study was to compare the correlation with gingival overgrowth score and clinical indices(i.e, : plaque index, papillary bleeding index, probing depth) and correlation with gingival overgrowth score and microorganism distribution in use of phase contrast microscope. After renal tranplant, taking cyclosporin A 40 patients participating in this investigation. Post - transplatation cyclosporin medication period was average $17.53{\pm}15.75$ months. In previous study reported that gingival overgrowth is an adverse side - effects seen in about 25-81% of patient taking cyclosporin A. The results were as follows : 1. Gingival overgrowth prevalence in taking cyclosporin A patients was 77.5%. Prevalence rate of region was anterior region(26 teeth, 55.3%), molar region(14 teeth, 29.8%), premolar region(7 teeth, 14.8%) in turns. Gingival overgrowth score by Angelopoulos & Goaz method was molar region($1.56{\pm}0.81$), anterior region($1.52{\pm}0.75$), premolar region($1.14{\pm}0.90$) in turns. 2. Medication period was not correlation with gingival overgrowth score. 3. Clinical indices and gingival overgrowth score were as follows. 1) Plaque index and gingival overgrowth score was significantly correlated(p

• Journal of Korean Dental Science
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• v.5 no.1
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• pp.1-6
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• 2012

Patients with gingival overgrowth are easily seen in dental clinics. Cyclosporin-A (CsA), a widely prescribed immunosuppressant induces gingival overgrowth in up to 35% of patients with medical history of organ transplantation. The immunosuppressant CsA can transform genetic expression of gingival fibroblasts, resulting in gingival overgrowth. Meticulous plaque control is recommended for treatment of gingival overgrowth. Substitution of the drug or surgical procedures such as gingivectomy and periodontal flaps should be considered after re-evaluation. Azithromycin is often recommended as a supplementary drug to reduce this side effect. Recent studies show that tacrolimus can be a more economic, efficient and safe substitute for CsA.

• Journal of Genetic Medicine
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• v.15 no.2
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• pp.64-71
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• 2018

Purpose: Overgrowth syndromes are conditions that involve generalized or localized areas of excess growth. In this study, the clinical, molecular, and genetic characteristics of Korean patients with overgrowth syndrome were analyzed. Materials and Methods: We recruited 13 patients who presented with overgrowth syndrome. All patients fulfilled inclusion criteria of overgrowth syndrome. Analysis of the clinical and molecular investigations of patients with overgrowth syndrome was performed retrospectively. Results: Among the 13 patients with overgrowth syndrome, 9 patients (69.2%) were found to have molecular and genetic causes. Among the seven patients with Sotos syndrome (SS), two had a 5q35microdeletion that was confirmed by fluorescent in situ hybridization. In two patients with SS, intragenic mutations including a novel mutation, c.5993T>A (p.M1998L), were found by Sanger sequencing. One patient had one copy deletion of NDS1 gene which was confirmed by multiplex ligation-dependent probe amplification. Among five patients with Beckwith-Wiedemann syndrome, three had aberrant imprinting control regions; 2 hypermethylation of the differentially methylated region of H19, 1 hypomethylation of the differentially methylated region of Kv. In one patient displaying overlapping clinical features of SS, a de novo heterozygous deletion in the chromosomal region 7q22.1-22.3 was found by single nucleotide polymorphism-based microarray. Conclusion: Considering high detection rate of molecular and genetic abnormalities in this study, rigorous investigations of overgrowth syndrome may be an important tool for the early diagnosis and genetic counseling. A detailed molecular analysis of the rearranged regions may supply the clues for the identification of genes involved in growth regulation.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.242-250
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• 2004

In general, the skeletal class III has the characteristics of mandibular overgrowth with a normal maxillary growth or maxillary undergrowth with a normal mandibular growth And clinical and radiographic evaluations of the patient are needed. However, the treatment plan is not dependent on these evaluations alone, because patient's general condition and hope for aesthetics varies. The aim of this report is to consider the treatment of a medically compromised patient with an anterior open bite and skeletal class III, which showed a severe mandibular overgrowth. In 2003, a 17-year-old boy with epilepsy, mental retardation presented at our clinic complaining of concave profile. A clinical examination showed severe mandibular prognathism with an anterior open bite. The radiographic examination revealed a short cranial base, a moderate maxillary overgrowth, severe mandibular overgrowth and skeletal open bite tendency. In 2004, he was verified to have no potential of growth by hand-and-wrist radiographs and an endocrine examination. He completed the preoperative orthodontic treatment and orthognathic surgery (sagittal split ramus osteotomy, genioplasty). He was evaluated on the first visit, the preoperative period and the postoperative period with a clinical and radiographic examination. At the first visit, the patient showed moderate overgrowth of the maxilla, severe overgrowth of the mandible, and a subsequential skeletal open bite. After the preoperative orthodontic treatment (preoperative period), the patient showed the same skeletal problem as before and a decompensated dentition for orthognathic surgery. After orthognathic surgery, his profile had improved, but he had still a skeletal openbite tendency because the maxillary orthognathic surgery was not performed. Severe mandibular prognathism with a maxillary overgrowth and anterior open bite should be treated by bimaxillary orthognathic surgery. However, one-jaw orthognathic surgery on the remaining the skeletal open bite tendency was performed for his medical problem and facial esthetics. This subsequential open bite should be resolved with a postoperative orthodontic treatment.

• Journal of Oral Medicine and Pain
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• v.42 no.1
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• pp.20-24
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• 2017

Drug-induced gingival overgrowth (DIGO) is an adverse drug reaction mainly described with three types of commonly prescribed drugs, namely, calcium channel blockers (CCBs) (nifedipine, diltiazem, and verapamil), anti-convulsants (phenytoin), and immunosuppressive agents (cyclosporine). Numerous reports have associated gingival overgrowth with the newer generation of immunosuppressive agents (tacrolimus, sirolimus, and everolimus), and CCBs (amlodipine, felodipine, nicardipine, and manidipine). Especially, patients concomitantly medicated with an immunosuppressive agent and CCB have a higher DIGO chance. Dentists need to be aware of drugs that induce gingival overgrowth, the possibility of DIGO, and risk factors, and also prevent the progression of DIGO by early detection of DIGO, consultation about the drug change, and the maintenance of strict dental hygiene regimes.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.591-596
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• 2005

Amlodipine, nifedipine, and felodipine are calcium channel blocking agents, which are cause of unwanted gingival overgrowth around natural teeth. Many studies has been performed about this unwanted effects. However, the exact etiology remains uncertain.Few reports and investigations can be found in the literature on drug-induced gingival overgrowth around dental implants. The present case reports that amlodipine-induced gingival overgrowth occurred in peri-implant sites, confirms clinical and histological features in hyperplastic peri-implant tissues. Clinical and histological features of amlodipine-induced gingival overgrowth around dental implants were similar to that of tissue around natural teeth.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.5
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• pp.438-445
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• 2005

Cyclosporine A(CsA) is a powerful immunossuppresive agent used to prevent graft rejection of organ and treat autoimmune disease. One of the major side effects associated with CsA treatment is the development of gingival overgrowth. The purpose of this study was to evaluate the expression and association of the several growth factors in gingival overgrowth induced CsA using by immunohistochemical technique. Normal tissues as control were obtained from healthy normal gingivae and overgrowth gingival tissues as experiments were obtained from the patients taken the CsA. The expressions of the MMP-1, TIMP-1, TGF$\beta$-1, p21, p53, PCNA were evaluated by immunohistochemical technique. The more overgrowth was detected at the epithelial and connective tissue area in experimental group. The MMP-1, TGF$\beta$-1, p21, p53, PCNA expressions were significantly increased in experimental group. The TIMP-1 expressions was not significantly increased in experimental group. We could conclude that the gingival overgrowth induced CsA was related with the collagen matabolism in connective tissue and also the production of the growth factor from epithelial tissue.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.14 no.2
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• pp.92-96
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• 2018

Drug-induced gingival overgrowth is an abnormal increase of gingival tissues caused as a side effect of systemic medication. This report presents a severe case of valproate-induced gingival overgrowth combined with ulcerative and hemorrhagic lesions in a patient with Lennox-Gastaut syndrome. Considering the patient's limited cooperative ability, gingivectomy and excisional biopsy under general anesthesia were performed. The lesions were successfully treated without recurrence. When gingival enlargement does not subside with nonsurgical treatments, surgical procedure and excisional biopsy are to be performed. Postoperative management of oral hygiene is critical to prevent recurrence.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5535-5538
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• 2012

Background: There have been case reports of oral squamous cell carcinoma arising from gingival overgrowth induced by phenytoin - an antiepileptic drug. However, a detailed analysis for the presence of mutations in p53 and ras genes, which are the two most frequently mutated genes in cancers, in phenytoin induced gingival overgrowth tissues has hitherto not been performed. Methods: Cellular DNA isolated from twenty gingival overgrowth tissues collected from patients undergoing phenytoin therapy were amplified using primers for p53 (exons 5-8) and H-ras (exons 1-2) genes. The PCR amplicons were then gel purified and subjected to direct sequencing analysis to screen for mutations. Results: Direct sequencing of twenty samples of phenytoin induced gingival growth did not identify mutations in any of the exons of p53 and H-ras genes that were analyzed. Conclusion: Our result indicates that mutational alteration of p53 and H-ras genes is infrequent in phenytoin induced gingival growth, which thus suggests a non malignant nature of this pathology. The findings in the present study are clinically significant as a large number of epileptic patients are treated with phenytoin.

• The Journal of the Petrological Society of Korea
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• v.22 no.4
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• pp.291-298
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• 2013

We identified well developed overgrowth rims from several zircon grains separated from the Gyemyeongsan metavolcanics of the Okcheon Metamorphic Belt. Such overgrowth rims reveal generally quite low Th/U ratios indicating formation during the metamorphism. We were able to conduct SHRIMP U-Pb spot analyses from the relatively wide overgrowth rims and determined a concordia age of $259.7{\pm}3.3Ma$ (n=8, $2{\sigma}$), which indicates timing of the regional metamorphism occurred in the Gyemyeongsan Formation.