Gingival Status of Brazilian Renal Transplant Recipients Under Sirolimus-Based Regimens

Abstract

Background: Although the prevalence of gingival over-growth (GO) in calcineurin-inhibitor (CNI) immunosuppressive regimens has been well documented, to the best of our knowledge data from sirolimus (SIR) regimens have not been described. We sought to investigate the gingival status of renal transplant recipients under SIR-based regimens with regard to the prevalence and potential risk variables associated with GO. Methods: A cross-sectional study was conducted at a public hospital in Belo Horizonte, MG, Brazil. Of 886 transplant recipients, an eligible sample of 144 subjects was selected. Medical, pharmacologic, and periodontal variables were recorded for each subject. GO was assessed through visual inspection and was evaluated in relation to variables of interest by univariate and multivariate analyses. Results: Although not clinically significant, 20.8% of the samples had GO, with a mean GO score of 5.0% 3.98% (range, 0% to 19%) and mean GO score per papilla of 0.378 0.361 (range, 0.1 to 1.9); the percentage of papilla affected by GO was 14.35% 9.86% (range, 5% to 45%). The multivariate final model, excluding periodontal variables, showed that the concomitant use of calcium channel blockers (P = 0.033) and the interaction between time since transplant and previous CNI use (P < 0.001) were associated with GO. Adding periodontal variables to the model improved its accuracy and retained papillary bleeding index as being strongly associated with GO (P < 0.001). Conclusions: GO was observed in a considerable number of subjects under SIR-based immunosuppressive regimens, although the relationship was not clinically significant. Findings point to the importance of cooperation between medical and dental health care personnel in the maintenance of renal transplant recipients under SIR-based immunosuppressive regimens. J Periodontol 2008; 79:2060-2068.