title: Risk factors for gingival overgrowth in patients medicated with ciclosporin in the absence of calcium channel blockers.
abstract: OBJECTIVE
  This study investigates the effect of a range of potential risk factors on the severity of gingival overgrowth in transplant patients medicated with ciclosporin in the absence of any calcium channel blockers.
  
  
  METHODS
  One hundred dentate solid organ transplants medicated with ciclosporin (but not calcium channel blockers or phenytoin) were recruited for the study. Demographic, pharmacological and periodontal data were recorded and gingival overgrowth assessed from stone models.
  
  
  RESULTS
  Univariate analysis identified the duration of transplant, papilla bleeding index, creatinine serum concentration, azathioprine and prednisolone dosage as risk factors for overgrowth severity. Multivariate modelling, excluding the periodontal parameters, gave a predictive model that included dosages of ciclosporin, azathioprine, prednisolone and weight (p<0.0001, adjusted-R2=19%). Adding the periodontal variables strengthened the model (p<0.0001, adjusted-R2=34.5%).
  
  
  CONCLUSIONS
  The explanatory models in this study contain a number of variables that moderate inflammation (azathioprine and prednisolone) or are markers of it (papilla bleeding index). Dosage of each of the three immunosuppressants was identified as a risk factor for the severity of gingival change. This observation appears to have been masked by the effects of the calcium channel blockers in earlier studies.
authors.affiliation: School of Dental Sciences, University of Newcastle upon Tyne, UK. j.m.thomason@ncl.ac.uk
authors.forename: J Mark
authors.initials: JM
authors.lastname: Thomason
authors.forename: Robin A
authors.initials: RA
authors.lastname: Seymour
authors.forename: Janice S
authors.initials: JS
authors.lastname: Ellis
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001379:Azathioprine / Q000008:administration & dosage; D001835:Body Weight; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects*; D003774:Dental Plaque Index; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced*; D005938:Glucocorticoids / Q000008:administration & dosage; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D011239:Prednisolone / Q000008:administration & dosage; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D003404:Creatinine; D001379:Azathioprine