Gingival overgrowth in renal transplant subjects medicated with tacrolimus in the absence of calcium channel blockers.
BACKGROUND
The results from reports analyzing the occurrence of gingival overgrowth (GO) induced by tacrolimus are controversial. In addition, the role of pharmacological and periodontal variables on the development and severity of GO have not been well-established. Therefore, the aim of the present study was to determine the effect of potential risk variables for GO in a Brazilian population comprising renal transplant recipients medicated with tacrolimus in the absence of calcium channel blockers.


METHODS
Demographic, pharmacological, and periodontal data, recorded from 125 subjects selected to participate in the study, was analyzed with the use of the independent sample t test, the chi-squared statistic, or Mann-Whitney test. The effects of risk variables on GO scores were subsequently examined using multivariate regression analysis and general linear model.


RESULTS
The prevalence of clinically significant GO (> or =30%) in the study population was of 7.25%. These subjects showed greater averages of plaque scores (P=0.0043) as well as papillary bleeding index (P=0.0026) when compared to subjects with GO <30%. Papillary bleeding index, time since transplant and azathioprine dosage were significant in the univariate and multivariate models (adjusted R=43.8%), whereas plaque index was significant only in the univariate model.


CONCLUSIONS
This study revealed that, in the absence of calcium channel blockers, gingival inflammation, represented by the papillary bleeding index, was a variable associated with Tcr-induced GO, indicating the importance of periodontal maintenance of subjects under Tcr immunosuppressive regimens.
Cezário
Erika S
ES
Department of Periodontology, Pontifical Catholic University of Minas Gerais, Horizonte, Brazil.
Cota
Luís O M
LO
Ferreira
Sérgio D
SD
Siqueira
Fernanda M
FM
Soares
Rodrigo V
RV
Zenóbio
Elton G
EG
Costa
Fernando O
FO
D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D002121:Calcium Channel Blockers; D016009:Chi-Square Distribution; D003773:Dental Plaque / Q000473:pathology; D005260:Female; D005881:Gingiva / Q000187:drug effects / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012044:Regression Analysis; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use*; D013997:Time Factors
D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine; D016559:Tacrolimus