Gingival overgrowth among patients medicated with cyclosporin A and tacrolimus undergoing renal transplantation: a prospective study.
BACKGROUND
The aim of this study is to make a longitudinal evaluation of the incidence and severity of gingival overgrowth (GO) induced by immunosuppressive agents, such as tacrolimus (Tcr) and cyclosporin A (CsA), in the absence of calcium channel blockers in patients undergoing renal transplantation (RT).


METHODS
This longitudinal study is conducted in 49 patients with RT who were divided into a CsA group (n = 25) and Tcr group (n = 24). The individuals were assessed at four time intervals: before transplant and 30, 90, and 180 days after RTs. Demographic data and periodontal clinical parameters (plaque index, cemento-enamel junction to the gingival margin, probing depth, clinical attachment level, bleeding on probing [BOP], and GO) were collected at all time intervals.


RESULTS
The mean GO index was significantly lower in the Tcr group compared to the CsA group after 30 (P = 0.03), 90 (P = 0.004), and 180 (P = 0.01) days of immunosuppressive therapy. One hundred eighty days after RTs, a clinically significant GO was observed in 20.0% of individuals in the CsA group and 8.3% of individuals in the Tcr group. However, this difference was not statistically significant (P = 0.41). There was a reduction in periodontal clinical parameters regarding the time of immunosuppressive therapy for PI and BOP (P <0.001) in both groups.


CONCLUSIONS
Although there was no statistical difference in the incidences of clinically significant GO after 180 days of immunosuppressive therapy, it was observed that GO occurred later in the Tcr group, and the severity of GO in this group was lower than in patients who used CsA.
Paixão
Caroline G
CG
Dental School, Department of Stomatology, Division of Periodontics, University of São Paulo, SP, Brazil.
Sekiguchi
Ricardo T
RT
Saraiva
Luciana
L
Pannuti
Cláudio M
CM
Silva
Hélio T
HT
Medina-Pestana
José  O
J
Romito
Giuseppe A
GA
D000328:Adult; D000704:Analysis of Variance; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects / Q000276:immunology; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000276:immunology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016559:Tacrolimus / Q000009:adverse effects*; D055815:Young Adult
D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus