CYCLOSPORINE-A-INDUCED GINGIVAL OVERGROWTH IN HEART-TRANSPLANT PATIENTS - A CROSS-SECTIONAL STUDY

The incidence of gingival overgrowth secondary to the administration o f cyclosporine A (CsA) is widely reported in renal transplant recipien ts, while there is no information about periodontal conditions in hear t transplant patients. In the present cross-sectional investigation th e relationship between clinical periodontal conditions and pharmacolog ical profiles of CsA was determined in 39 patients (31 male and 8 fema le, aged 18-63 years, mean 45.6+/-15.2 years) who possessed their 6 up per and 6 lower anterior teeth. All patients had been on a CsA-based i mmunosoppression regimen for at least 6 months (6-101, mean 39.3+/-30. 1). 2 periodontal parameters (recorded on the 12 anterior teeth only) relating to gingival overgrowth were considered: hyperplastic index an d % of sites with probing depth >3 mm. These parameters were always re corded by the same observer at first appointment and 2 months after an oral hygiene programme. Both non parametric statistical analysis (Kru skal-Wallis one-way analysis by rank, Wilcoxon signed rank-test and Ma nn Whitney U-test) and parametric analysis (stepwise multiple regressi on analysis, one-sample and two-sample t-test) were used to investigat e the relationship between the periodontal parameters (dependent varia bles) and a series of independent variables: age, sex, plaque index (P I), gingival index (GI), CsA dose, CsA blood level, duration of therap y (months since allograft). Results failed to demonstrate any signific ant correlation between gingival overgrowth and age, sex, CsA dose or CsA blood level, PI. A positive significant correlation was found betw een periodontal conditions and GI and a significant inverse correlatio n between periodontal conditions and duration of therapy, suggesting t hat the relation between CsA therapy and gingival overgrowth in heart- transplant patients could be time-related and the negative influence o f the drug on the periodontal status could spontaneously decrease over time.