Abstract: Objective: To analyze the clinical features of gingival enlargement in the diabetic patients caused by nifedipine, and to provide the evidences for the diagnosis and treatment of drug-induced gingival enlargements with systemic diseases. Methods: The clinical materials of one diabetic patient with nifedipine-induced gingival enlargement were collected and the relative literatures were reviewed to summarize the etiology, clinical characteristics and treatment methods of the drug-induced gingival enlargement with system disease. Results: The patient, male, aged 67 years old, admitted hospital because of recurrence after 2 years of resection of gingival swelling. The patient had a history of diabetes and hypertension,as well as the use of nifedipine to control hypertension. Oral examination revealed poor oral hygiene, dark red gums,and bleeding during probing. The swelling of the gingiva exceeded 2/3 of the tooth, and there were varying degrees of mobility in many teeth. The clinical diagnosis was drug-induced gingival enlargement. First the blood pressure and blood glucose were controlled to the clinically operable range, oral hygiene education was performed,the periodontal basic therapy was done to eliminate inflammation, and gum swelling was significantly reduced. Gingival resection and gingivalplasty were used to restore the normal shape of the gums at the sites where the hyperplasia was still apparent after basic treatment. The plaque was strictly controlled throughout the procedure, no antihypertensive drugs were replaced, and there was no relapse within one year. Conclusion: The etiology of drug-induced gingival enlargement with systemic diseases is complex and easy to relapse. Initial periodontal therapy should be performed under the condition of controlling the systemic diseases. Surgery can be used if necessary,and long-term effective plaque control is a powerful measure to prevent the occurrence and recurrence of drug-induced gingival enlargement.

Key words: nifedipine, drug-induced gingival enlargement, diabetes mellitus, initial periodontal therapy, periodontal surgery