The effect of a plaque control programme on the incidence and severity of cyclosporin‐induced gingival changes

Abstract

The efficacy of plaque control as a means of preventing cyclosporin-induced gingival overgrowth was assessed in 27 adult renal transplant patients. After baseline examination, patients were randomly allocated to receive intensive oral hygiene instructions, scaling and root planing (OH group) or no treatment (no treatment group). Gingival condition was assessed 6 months after baseline and changes in gingival form were related to various periodontal and pharmacokinetic measures. In both treatment groups, there was a significant increase (P less than 0.05) in gingival hyperplasia scores at 6 months. In the OH group, plaque scores were significantly lower (P less than 0.05) at 6 months, whereas in the no treatment group, a significant increase in plaque scores, gingival inflammation and probing depths was observed at 6 months. Dosages of cyclosporin, whole blood concentrations of cyclosporin, baseline gingival index, hyperplasia scores, and 6-month plaque index were not important determinants for the increase in gingival over-growth in both treatment groups. It is concluded that attention to plaque control and the removal of local irritants is of some benefit for the gingival health of cyclosporin-treated adult renal transplant patients, but these measures alone did not prevent gingival overgrowth. Pharmacokinetic variables of cyclosporin and various periodontal measures were not good predictors of cyclosporin-induced gingival changes.

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

“…Abundant plaque (PI ≥ 2 in 40% of the sites) was associated with a 5.4 times higher risk of GO. 3 However, according to Seymour and Smith, 7 optimal plaque control is insufficient to prevent GO. Our results showed low mean PI (0.88) and GI (0.84) values, and did not reveal any association between these parameters and the occurrence of GO.…”

“…Several authors have studied the etiology of GO in patients receiving kidney transplant surgery and immunosuppressive treatment. Studies have evaluated the association of GO with bacterial plaque, 7 periodontal disease, treatment dosage and duration, plasma concentrations, 5 concurrent use of calcium channel blockers (CCBs), 8 and genetic susceptibility. 9 Greenberg et al 3 recently studied a sample of 115 patients that underwent kidney transplants and found a GO prevalence of 53% among those who were treated with CsA.…”

Hiperplasia gingival por ciclosporina: A propósito de un caso

“…Si bien es aceptada su relación directa con fármacos y el factor genético, entre otros, el rol del biofilm bacteriano (placa dental) ha sido controvertido [5][6][7][8][9] .…”

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

“…Similarly, gingival hyperplasia is a common complication of posttransplant medication regimens, especially when they include cyclosporin A (CsA) and calcium channel blockers (209). In a small, randomized, controlled trial, posttransplant plaque control with intensive oral hygiene instruction, scaling and root planing had a beneficial effect on CsA-associated gingival hyperplasia (210). It has also been shown that pretrans- It is likely that influenza is more severe when it occurs in immunosuppressed renal transplant recipients (Table 30), although systematic studies documenting this are lacking.…”