Changes in extracellular matrix macromolecules in human gingiva after treatment with drugs inducing gingival overgrowth

It is generally agreed that gingival overgrowth results from an increase in the levels of gingival extracellular macromolecules infiltrated with various numbers of inflammatory cells. The relative amounts of extracellular matrix macromolecules observed in 12 cases of gingival hyperplasia associated with the use of cyclosporin, hydantoin or nifedipine were compared with those obtained in a control group on the basis of histological and immunohistochemical investigations. From tissue sections, the quantification was by computerized morphometric analysis on a BFM 186 microcomputer to which were implemented the transformations of mathematical morphology. The area fractions (AA%) occupied by total collagen, type III and type IV collagen, vessels, fibroblasts, fibronectin and elastic fibres were estimated and compared. The overall histological aspects of drug-induced gingival overgrowth were similar, but quantification of different extracellular matrix components showed differences. In the nifedipine and cyclosporin groups, the area occupied by fibroblasts were not significantly greater than in healthy gingiva and chronic gingivitis. The area occupied by collagen was significantly greater in the nifedipine group than in the other pathological groups. Fibronectin was also strongly expressed in the nifedipine group, and the elastic fibre network was preserved in this group.