Effectiveness of periodontal therapy in patients with drug-induced gingival overgrowth. Long-term results

Background: Drug-induced gingival overgrowth (DGO) is one of the well-recog nized side effects of cyclosporin A (CsA) or nifedipine (Ni). After surgica l periodontal therapy, the incidence of DGO recurrence is not known. The ai m of this study was to evaluate the results of surgical periodontal therapy in patients receiving CsA or Ni and who exhibit severe long-term DGO. In a ddition, the relationship between various variables and the recurrence of s evere DGO after periodontal surgery was investigated. Methods: A total of 38 patients, 22 with CsA-induced DGO and 16 with Ni-ind uced DGO, were included in this study. At baseline, patients received initi al periodontal therapy, after which either the upper or lower anterior segm ent in each patient was surgically treated. Surgical periodontal therapy co nsisted of the flap technique with a 90 degrees gingivectomy incision. Foll owing surgery, patients were placed on a maintenance therapy recall program and were monitored for 18 months. Patients were seen once a month for the first 3 months and once every 3 months for the following 15 months, Plaque index (PI), papilla bleeding index (PBI) and DGO scores in the treated segm ents were recorded at each recall appointment. Attendance at recall appoint ments was also noted for each patient. Results: Recurrence of severe DGO was observed in 13 of the 38 patients (34 %) 18 months following periodontal surgery. Multiple regression analysis in dicated that age, gingival inflammation, and attendance at recall appointme nts were significant determinants of the recurrence of severe DGO. Conclusions: This study suggests that regular re-motivation and professiona l care at frequent recall appointments after periodontal surgery are of gre at importance in patients receiving CsA or Ni. By maintaining periodontal h ealth, the life quality of these patients may be raised.