Abstract
Introduction: Some systemic medications can affect the periodontal tissues, modifying their inflammatory response and promoting gingival growth, which causes gingival hyperplasia (GH). This can be intensified when two drugs are used synergistically, worsening the GH picture. Objective: It was to perform a systematic review on the incidence of gingival hyperplasia and its relation to the predictors of phenytoin, nifedipine and cyclosporine A. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. A systematic review of the incidence of gingival hyperplasia and its relationship to the predictor phenytoin, nifedipine and cyclosporine A. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results: According to the GRADE instrument, most studies presented homogeneous results, with X2=70.8% > 50%. A total of 62 articles were found and submitted for eligibility analysis, with 20 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 02 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2 standards. It was found that gingival growth in patients with kidney transplantation was associated with a significant increase in gingival hyperplasia (GH) and also with other pathologies leading to the use of drugs such as phenytoin, nifedipine and cyclosporin A. However, G H can be mistakenly mistaken for gingival hyperplasia. The name "gingival growth and / or gingival hypertrophy" is a function of histological study, the occurrence of increased extracellular matrix synthesis, mainly in collagen, and increase in the size and number of fibroblasts present in the tissue. Scientific research has shown that Ciclosporin A can modify the metabolism of the gingival and bone tissue and the composition of the oral biofilm, the flow and composition of the gingival fluid. Conclusion: The surgeon-dentist should be aware during the anamnesis to the cases of patients who use medications that induce gingival hyperplasia, such as anticonvulsants. It is imperative for the dentist to understand the general condition and the limitations of each patient, so that he can control and cure the most varied oral manifestations, in order to maintain a good quality of life in his patient.