Gingival overgrowth in subjects under immunosuppressive regimens based on cyclosporine, tacrolimus, or sirolimus.
OBJECTIVE
To assess the prevalence and variables associated with gingival overgrowth (GO) in renal transplant recipients medicated with cyclosporine (CsA), tacrolimus (Tcr), or sirolimus (Sir).


METHODS
One hundred and thirty-five eligible subjects were divided in CsA, Tcr, and Sir groups comprising 45 subjects each. GO was visually assessed and subjects were assigned as GO+ or GO- in a post hoc definition. Saliva samples were collected and the presence of periodontal pathogens was assessed through polymerase chain reaction. Variables of interest were compared between GO+ and GO- subjects through univariate and multivariate analysis.


RESULTS
Prevalence of GO was of 60.0% for CsA, 28.9% for Tcr, and 15.6% for Sir groups. Within the CsA group, GO was associated with papillary bleeding index (p=0.001); within the Tcr group, GO was associated with CsA previous use (p=0.013), and calcium channel blockers (CCB) use (p=0.003); within the Sir group, GO was associated with papillary bleeding index (p=0.018), and CCB use (p=0.020). A higher frequency of Tannerella forsythia was observed among GO+ subjects medicated with Tcr.


CONCLUSIONS
Pharmacological and periodontal variables were associated with GO in different immunosuppressive regimens. Integration between the medical and the dental team may be an important approach in the post-transplant maintenance routine.
Cota
Luís Otávio Miranda
LO
Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Aquino
Davi Romeiro
DR
Franco
Gilson César Nobre
GC
Cortelli
José Roberto
JR
Cortelli
Sheila Cavalca
SC
Costa
Fernando Oliveira
FO
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D012463:Saliva / Q000382:microbiology; D020123:Sirolimus / Q000009:adverse effects*; D018709:Statistics, Nonparametric; D016559:Tacrolimus / Q000009:adverse effects*; D055815:Young Adult
D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D020123:Sirolimus; D016559:Tacrolimus