Gingival Overgrowth in Renal Transplant Subjects: A 44-Month Follow-Up Study

Abstract

Background. To assess changes in gingival status of renal transplant subjects under immunosuppressive regimens based on cyclosporine (CsA), tacrolimus (Tcr), and sirolimus (Sir). Methods. From a sample of 135 subjects (baseline examination [BE]), 89 without periodontal treatment, who maintained the immunosuppressive regimen based on the same main agent (CsA=23, Tcr=31, and Sir=35), were reexamined after 44 months (follow-up examination [FE]). Demographic, pharmacologic, and periodontal variables were collected and gingival overgrowth (GO) was assessed by visual examination. Results. In Tcr and CsA groups, although not significant, occurrence of GO decreased (CsA [BE=56.5% and FE=34.8%; P=0.063] and Tcr [BE=19.4% and FE=12.9%; P=0.500]). In addition, the severity of GO decreased significantly in CsA group (mean score BE=10.29-7.70 and mean score FE=0.78-1.38; P=0.003). In Sir group, GO decreased from 17.1% (BE) to 0.0% (FE) (P=not applicable). In total sample, GO was associated with papillary bleeding index (P=0.001) and concomitant use of calcium channel blockers (P=0.029); in CsA and Tcr groups, GO was associated with papillary bleeding index (P=0.029 and 0.033, respectively). Conclusions. There was no incidence of GO, and a decrease in the occurrence and severity of GO was significant in total sample. This decrease can be attributed to changes in pharmacologic and periodontal variables over this period of time.