Non-surgical periodontal treatment of cyclosporin A-induced gingival overgrowth: immunohistochemical results.
OBJECTIVE
The present study was planned to analyze the effects of a 12-month non-surgical periodontal treatment on histologic and immunohistochemical features of cyclosporin A (CsA)-induced gingival overgrowth (GO).


METHODS
Gingival samples were collected from 21 liver transplant subjects exhibiting CsA-induced GO prior to, and 12 months after non-surgical periodontal therapy including oral hygiene instructions, scaling and 2-month recall appointments, and also from 18 healthy control subjects. Gingival biopsy specimens were stained with hematoxylin-eosin and monoclonal antibodies for vimentin, CD3 (T-lymphocytes), CD20 (B-lymphocytes), CD34 (endothelium) and Ki-67 (fibroblasts proliferation rate), using a streptavidin-biotin-peroxidase complex method.


RESULTS
Total inflammatory cells, gingival vessels and fibroblast proliferation rate demonstrated significant reduction after non-surgical periodontal treatment (P < 0.0001) in overgrown gingiva, while B- and T-lymphocytes remained nearly unchanged (P = 0.61 and 0.33, respectively). At the 12-month evaluation no significant differences were found when comparing the gingival biopsies from CsA-treated patients and those from healthy controls (P > 0.05).


CONCLUSIONS
Control of clinical inflammation by means of non-surgical periodontal treatment results both in lowering of inflammatory infiltrate and in changes in connective tissue composition. Thus, plaque-induced inflammation would seem to modulate the drug-gingival tissue interaction.


CONCLUSIONS
A strict plaque control program play a pivotal role in the management of transplant patients exhibiting cyclosporin A-GO.
Aimetti
M
M
Section of Periodontology, Department of Medical Sciences and Human Oncology, University of Torino, Torino, Italy. mario.aimetti@unito.it
Romano
F
F
Marsico
A
A
Navone
R
R
D000328:Adult; D018951:Antigens, CD20 / Q000032:analysis; D018952:Antigens, CD34 / Q000032:analysis; D017252:CD3 Complex / Q000032:analysis; D016022:Case-Control Studies; D016572:Cyclosporine / Q000009:adverse effects*; D003773:Dental Plaque / Q000150:complications / Q000628:therapy; D012534:Dental Scaling; D005260:Female; D005881:Gingiva / Q000737:chemistry / Q000276:immunology; D019214:Gingival Overgrowth / Q000139:chemically induced / Q000276:immunology* / Q000628:therapy*; D005891:Gingivitis / Q000209:etiology / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D019394:Ki-67 Antigen / Q000032:analysis; D016031:Liver Transplantation; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D014746:Vimentin / Q000032:analysis
D018951:Antigens, CD20; D018952:Antigens, CD34; D017252:CD3 Complex; D007166:Immunosuppressive Agents; D019394:Ki-67 Antigen; D014746:Vimentin; D016572:Cyclosporine