The rôle of time in reducing gingival overgrowth in heart-transplanted patients following cyclosporin therapy.
OBJECTIVE
In a previous cross-sectional study, the relevant rôle of time in reducing gingival overgrowth (GO) in heart-transplanted patients undergoing Cyclosporin A (CsA) therapy was hypothesized to explain the inverse relationship between GO and months since the graft.


METHODS
In the present study, the relationship between GO and time was investigated prospectively in a group of 21 heart transplanted patients who have been regularly followed up to 48 months.


RESULTS
6 months after beginning CsA therapy (1st appointment), 7 out of 21 patients (33%) had clinical GO as confirmed by a hyperplastic index (HI) >30. There was no significant difference between these values with respect to those detected during the 2nd appointment at 9 months. At this time, all patients underwent a regular oral hygiene program. Gingival and plaque indices significantly decreased at the 3rd appointment (12 months) both in the group of responders and in the group of non-responders and remained significantly unchanged with time; HI significantly decreased with time only in the group of responders, the decrease becoming significant 36 months after heart transplantation. As a consequence, the number of responders decreased from 7 at the 1st appointment to 5 after 12 months, 4 after 24 months, 2 after 36 months following heart transplantation.


CONCLUSIONS
The results suggest that GO necessarily develops in responders within 6 months from heart transplantation and in most subjects may be a time-related side-effect probably due to a progressive reduction in the sensitivity of the periodontum to CsA.
Montebugnoli
L
L
Clinica Odontoiatrica, Università di Bologna, Italy. lmonteb@tin.it
Servidio
D
D
Bernardi
F
F
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D016572:Cyclosporine / Q000009:adverse effects* / Q000097:blood; D003774:Dental Plaque Index; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000097:blood; D008297:Male; D010512:Periodontal Index; D012044:Regression Analysis; D012075:Remission, Spontaneous; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors
D007166:Immunosuppressive Agents; D016572:Cyclosporine