A longitudinal study was conducted during the first 6 months following transplant surgery in 100 heart, liver, or kidney transplant patients to assess the incidence and severity of cyclosporin-induced gingival overgrowth, as well as the most important associated factors. Gingival overgrowth, plaque, and gingivitis indices, in addition to cyclosporin blood concentration, were assessed monthly. Statistical analysis was applied to evaluate the relationship between gingival overgrowth and other study variables and to test the influence of age, sex, time, and transplant type. Forty-three percent (43%) of the patients developed gingival overgrowth. Gingival overgrowth increased significantly during the study, while plaque and gingivitis, subject to an oral hygiene training and motivation program, decreased significantly. The findings from this study would suggest that the basic factor influencing gingival overgrowth is cyclosporin blood concentration, followed by plaque/gingivitis level. The significant differences observed among transplant types, as well as among age groups, might be attributed to the differences in cyclosporin concentrations. An oral hygiene program prior to the transplant surgery is recommended.

Enamel pearls are one of a number of different enamel structures that can be found on the roots of deciduous and permanent teeth. They have a distinct predilection for the furcation areas of molar teeth, particularly the maxillary third and second molars. They can consist primarily of enamel, but in most instances, a core of dentin is contained within them. On rare occasions, even pulpal tissues can be found. Enamel pearls usually occur singularly, but up to 4 enamel pearls have been observed on the same tooth. Depending on the study, enamel pearls on permanent molar teeth have an incidence rate of between 1.1%-9.7% with distinct differences among racial and national groups. The incidence of enamel pearls increases greatly in histological studies, suggesting that they are often obscured by a covering of cementum.

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