Low prevalence of gingival overgrowth associated to new imunossupressive protocols with cyclosporin

Abstract

Gingival overgrowth (GO) is a frequent finding in patients treated with cyclosporine (CsA). This study investigated the prevalence and severity of GO in patients who received kidney transplant and CsA therapy, as well as associations with pharmacological and clinical factors. This cross-sectional study included 63 kidney transplant recipients who were treated with CsA in a university hospital. Demographic, pharmacological, and periodontal data were collected. The primary variable was GO. Independent sample t-and chi-square tests were used to compare means in groups with versus without GO. The response rate was 86.3%. Overall, 40% of patients had some degree of GO. Eleven individuals presented GO scores > 10%, and 5 individuals reached 30%. The mean GO percentage was low (6.79 ± 15.83). Patients that were concurrently under nifedipine treatment showed a non-significant trend toward a greater prevalence of GO. Mean CsA dosage and serum levels were 3.20 ± 0.94 mg/kg/d and 156.12 ± 162.75 ng/mL, respectively. There were no statistically significant differences between patients with versus without GO nor between the groups receiving nifedipine, no drug, or verapamil. The GO prevalence and severity rates were lower than those reported in previous studies and seemed to be independent of drug interactions.

Epidemiology of periodontal diseases in adults from Latin America

“…Other risk factors/indicators, including psychosocial factors , metabolic syndrome , osteoporosis/osteopenia , arthritis , use of cyclosporine and alcohol consumption , have also been investigated in Latin American studies, with mixed results obtained.…”

Drug-induced gingival overgrowth: The nemesis of gingiva unravelled

“…[19] However, cyclosporin may have damaging side effects, such as nephrotoxicity, hepatotoxicity, hypertension, and gingival overgrowth. [29] The first time gingival overgrowth with cyclosporin therapy was described in the dental literature in 1983 by both Rateitschak-Plüss et al ., and Wysocki et al . [5] Recently, Greenberg et al .,[30] studied a sample of 115 patients that underwent kidney transplants and found a gingival overgrowth prevalence of 53% among those who were treated with cyclosporin.…”

Agrandamiento gingival farmacoinducido: Serie de casos

“…Por el contrario, el agrandamiento gingival inducido por inmunosupresores como las ciclosporinas, altamente utilizadas en casos de trasplantes de órganos, tiene una prevalencia de 40%. Se ha encontrado que el efecto de este fármaco depende de la dosis que ingiere el paciente, a menor dosis, menor efecto (7) . La fenitoína, uno de los fármacos más comúnmente utilizado para el tratamiento de pacientes epilépticos debido a su bajo costo y familiaridad, dentro de este grupo de medicamentos es el más…”

“…Dentro de los grupos farmacológicos más asociados al AGFI se encuentran los antihipertensivos de tipo bloqueadores de canales de calcio (6) , inmunosupresores de tipo ciclosporina o azatioprina (7) y entre los anticonvulsivantes principalmente la fenitoína (8) . Una vez identificado el agente asociado al AGFI debe evaluarse la posibilidad de disminución de la dosis empleada o el reemplazo de la medicación de acuerdo a las necesidades y beneficios del paciente; sin embargo, al tratarse de medicamentos para enfermedades de carácter crónico, ésta estrategia se encuentra limitada y puede ocurrir que incluso después de disminuir su dosis se mantenga el agrandamiento gingival y se requiera complementar con medidas de higiene oral adecuadas, iniciar con una fase higiénica exhaustiva para lograr una disminución de la colonización bacteriana y del edema tisular previo a la realización de intervenciones quirúrgicas como gingivectomía del sitio comprometido (8) .…”