{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:05:20Z","timestamp":1777860320347,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Risk &amp; Safety in Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Drug-induced gingival overgrowth (DIGO) is a common adverse effect of anticonvulsants, calcium channel blockers (CCBs), and immunosuppressants like cyclosporine, with nifedipine being the most frequently implicated CCB. In contrast, mycophenolate mofetil (MMF)-induced DIGO is rare due to its antifibrotic properties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>We report a case of a 26-year-old female with systemic sclerosis (SSc), receiving nifedipine and MMF for Raynaud\u2019s phenomenon and interstitial lung disease, who presented with grade I gingival hyperplasia confined to interdental papillae. Despite good oral hygiene, gingival inflammation, microstomia, and plaque accumulation contributed to DIGO. Nifedipine was substituted with tadalafil, and MMF was replaced with nintedanib due to worsening interstitial lung disease. The pathogenesis of DIGO involves TGF-\u03b2-mediated fibroblast proliferation and extracellular matrix deposition, mechanisms also implicated in SSc-related fibrosis. Genetic polymorphisms in TGF-\u03b2 and fibroblast regulatory genes further increase susceptibility. Effective management includes drug substitution, meticulous oral hygiene, and surgical excision for persistent cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This report highlights the need for vigilant pharmacovigilance in SSc patients, emphasizing early detection, genetic risk assessment, and preventive dental care to mitigate DIGO progression. Personalized risk stratification based on genetic profiling may enhance DIGO prevention and therapeutic strategies in high-risk individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09246479251389217","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T16:34:47Z","timestamp":1762360487000},"page":"144-147","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Nifedipine and mycophenolate mofetil-induced gingival hyperplasia in a patient with systemic sclerosis: Role of concomitant therapy and pharmacovigilance aspects"],"prefix":"10.1177","volume":"37","author":[{"given":"Shreya K","family":"Gowda","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bevan","family":"Priyadarshan","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biswanath","family":"Behera","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishal","family":"Thakur","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"issue":"20","key":"e_1_3_3_2_2","first-page":"S68","article-title":"Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of periodontal and Peri-Implant Diseases and Conditions","volume":"45","author":"Chapple ILC","year":"2018","unstructured":"Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018; 45(Suppl 20): S68\u2013S77.","journal-title":"J Clin Periodontol"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.06.025"},{"issue":"7","key":"e_1_3_3_4_2","first-page":"e65195","article-title":"Idiopathic gingival enlargement: a case report","volume":"16","author":"Shraddha Kashinath M","year":"2024","unstructured":"Shraddha Kashinath M, Kumar Kendole R. Idiopathic gingival enlargement: a case report. Cureus 2024; 16(7): e65195.","journal-title":"Cureus"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/2229411220150309"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022034515571265"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12398"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2010.01574.x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2004.04.010"},{"issue":"5","key":"e_1_3_3_10_2","first-page":"276","article-title":"Drug-induced gingival enlargement: a review of diagnosis and current treatment strategies","volume":"43","author":"Barsoum F","year":"2022","unstructured":"Barsoum F, Prete BRJ, Ouanounou A. Drug-induced gingival enlargement: a review of diagnosis and current treatment strategies. 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