Oral health status, oral microflora, and non-surgical periodontal treatment of renal transplant patients receiving cyclosporin A and FK506.
OBJECTIVE
To determine the oral health status, oral microflora and the effect of non-surgical periodontal treatment on gingival overgrowth of renal allograft recipients receiving either cyclosporin A (CsA) or FK506 (Tacrolimus) as an immunosuppressant.


METHODS
A total of 47 patients receiving CsA (mean age 43.1 years) and 10 receiving FK506 (mean age 40.1 years) were included in the study. Stone casts were taken for measurement of gingival overgrowth. An oral rinse technique was used to investigate the prevalence of yeasts, and aerobic and facultatively anaerobic Gram-negative rods (AGNR).


RESULTS
The CsA and FK506 patients exhibited a Gingival Overgrowth Index (GOI) of 45.2%, and 25.1%, respectively (p < 0.05). The CsA patients had a GOI of 15.2% after one year of non-surgical periodontal treatment. The difference between pre- and postoperative gingival overgrowth indices was significant (p < 0.0001). Candida albicans and Klebsiella pneumoniae were the most notable yeast and AGRN found.


CONCLUSIONS
Renal transplant patients, being immunocompromised, constitute a high-risk group for gingival overgrowth. However, the FK506 regime appeared to ameliorate this effect, compared with CsA. Non-surgical periodontal treatment was effective in reducing established gingival overgrowth in both CsA and FK506 patients (p < 0.05). Adequate pre- and post-transplant oral health care is recommended, for these patients, irrespective of the drug regime.
Chu
F C
FC
Faculty of Dentistry, University of Hong Kong, Hong Kong.
Tsang
P C
PC
Chan
A W
AW
Leung
W K
WK
Samaranayake
L P
LP
Chan
T M
TM
D000328:Adult; D000368:Aged; D002175:Candida / Q000145:classification; D015331:Cohort Studies; D016572:Cyclosporine / Q000627:therapeutic use*; D004245:DMF Index; D004755:Enterobacteriaceae / Q000145:classification; D005500:Follow-Up Studies; D019214:Gingival Overgrowth / Q000139:chemically induced* / Q000145:classification; D016946:Gram-Negative Aerobic Rods and Cocci / Q000145:classification; D006092:Gram-Negative Facultatively Anaerobic Rods / Q000145:classification; D006304:Health Status; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D009909:Oral Health; D010510:Periodontal Diseases / Q000628:therapy*; D010512:Periodontal Index; D012307:Risk Factors; D013223:Statistics as Topic; D016559:Tacrolimus / Q000627:therapeutic use*; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus