PRETRANSPLANT GINGIVAL HYPERPLASIA PREDICTS SEVERE CYCLOSPORINE-INDUCED GINGIVAL OVERGROWTH IN RENAL-TRANSPLANT PATIENTS

The relationship between the pre-transplant periodontal status and the development of post-transplant gingival overgrowth was investigated i n a longitudinal study. The periodontal condition of 35 patients was e xamined on 2 occasions while they were on the transplant waiting list and then at 4-6, 10-12, 16 and 20 weeks post-transplant. At each visit the plaque index, the bleeding index and a pocket index (CPITN) were measured. Dental impressions were taken of the pre-and post-transplant gingival condition and used to make stone models which were used to s core the gingival overgrowth index (GOI). The patients divided into 3 distinct groups having severe (n=13), mild (n=16) or no post-transplan t gingival overgrowth (n=6). Only 1 of the patients had taken cyclospo rin prior to inclusion into the study. All the patients who developed severe overgrowth had evidence of gingival hyperplasia before the tran splant. There was no difference in the serum cyclosporin levels betwee n the three groups (chi(2)<2.28, p>0.319). Furthermore, there was no s tatistical difference for any of the periodontal indices. This study i ndicates that the hyperplastic gingival inflammatory response of some individuals appears to be potentiated by cyclosporin resulting in seve re posttransplant overgrowth. In other patients the same reaction may allow the fibroblastic activity to occur to an extent where it produce s a mild clinically apparent overgrowth.