Gingival overgrowth in renal transplant recipients induced by pharmacological treatment. Review of the literature.
Patients who undergo a renal transplant also require a pharmacological immunosuppressor therapy with cyclosporine (CsA) as well as anti-hypertensive calcium channel-blockers (CCBs); the former suppresses interferon and interleukin-2 production thus interfering with T cell cell-mediated activity, while the latter are used in order to counteract the nephrotoxicity of CsA which causes the local release, of thromboxane A2 with vascular vasoconstriction in the kidney. The use of both these drugs, particularly if used in association, leads to the onset of a clinical picture of variable entity, characterized mainly by a hypertrophy originating usually at the level of interdental papillae, and more pronounced in the anterior maxillary areas and the vestibular surfaces of the teeth, in a more or less symptomatic manner. The therapy is above all preventive, with an appropriate oral hygiene program, both professionally as well as at home, and with the use of substitutive drugs that do not present such side effects.
Grassi
F R
FR
Unit of Periodontology II and Prosthesis I of Odontostomatology and Dentistry, University of Bari, Bari, Italy.
Pappalardo
S
S
Baglìo
O A
OA
Frateiacci
A
A
Scortichini
A
A
Papa
F
F
De Benedittis
M
M
Petruzzi
M
M
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D004347:Drug Interactions; D005886:Gingival Hypertrophy / Q000139:chemically induced* / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D007674:Kidney Diseases / Q000517:prevention & control; D016030:Kidney Transplantation; D009910:Oral Hygiene; D013928:Thromboxane A2 / Q000378:metabolism; D014661:Vasoconstriction / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents; D013928:Thromboxane A2; D016572:Cyclosporine