The Clinical Analysis of Gingival Hyperplasia in Patients after Renal Transplantation_West China Medical Journal

Authors：

MA Xiaoping ¹ , LIU Yang ¹ , LI Yangbo ¹ ,  XU Yahong ¹ , LIN Tao ²

1. Department of Urology, The 452 Hospital of the People’s Liberation Army, Chengdu, Sichuan 610021, P. R. China; 2. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

XU Yahong, Email: mxp5612@sina.com

Keywords：

肾移植; 环孢素A; 牙龈增生; 口腔卫生

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

【摘要】　目的　探讨肾移植术后药物（环孢素A和钙离子拮抗剂）、口腔卫生与牙龈增生的关系。　方法　随访2003年1月—2010年3月间321例肾移植患者，记录患者术后药物使用和口腔卫生情况，观察牙龈增生程度。结果　〖HTSS〗口腔卫生水平与牙龈增生程度之间存在统计学相关性（rs=0.344，P=0.000），口腔卫生水平越差，牙龈增生越严重。服用环孢素A和钙离子拮抗剂患者（A组）牙龈增生发生率为62.15%，高于单纯服用环孢素A患者（B组）23.40%，二者比较，差异有统计学意义（χ2=39.220，P=0.000）。结论　〖HTSS〗肾移植术后环孢素A和钙离子拮抗剂联合应用明显增加了牙龈增生的发病率。口腔卫生水平与牙龈增生程度之间存在重要关联，口腔卫生差是牙龈增生的危险因素。
【Abstract】　Objective　 To investigate the correlation between drugs (cyclosporine A and calcium channel blocker), oral hygiene and gingival hyperplasia in patients after renal transplantation. 　Methods　 We continuously followed up 321 patients undergoing renal transplantation from January 2003 to July 2009 in our hospital. The levels of oral hygiene, medication and gingival hyperplasia were recorded. 　Results　 There was a close relationship between the level of oral hygiene and the degree of gingival hyperplasia (rs=0.344, P=0.000). Higher grades of gingival hyperplasia (grades Ⅱ and Ⅲ) were found exclusively in patients who did not have good oral hygiene. There was a higher tendency of developing gingival hyperplasia among patients who received cyclosporine A and calcium channel blocker than those who only received cyclosporine A (62.15% vs. 23.40%; χ2=39.220, P=0.000). 　Conclusion　 The prevalence of gingival hyperplasia is higher in renal transplant recipients taking cyclosporine A and calcium channel blockers. There is a significant relationship between the level of oral hygiene and the development of gingival hyperplasia. Poor oral hygiene is a risk factor of gingival hyperplasia.

Citation： MA Xiaoping,LIU Yang,LI Yangbo,XU Yahong,LIN Tao. The Clinical Analysis of Gingival Hyperplasia in Patients after Renal Transplantation. West China Medical Journal, 2011, 26(5): 695-697. doi: Copy

1.
2.	e transplanted patient[J]. Nephron, 1998, 80(3), 257-268.
3.	Butler RT, Kalkwarf KL, Kaldahl WB. Drug-induced gingival hyperplasia: phenytoin, cyclosporine, and nifedipine[J]. J Am Dent Assoc, 1987,114(1): 56-60.
4.	Garzini-Demo P, Carbone M, Carrozzo M, et al. An increase in gingival volume induced by drugs (phenytoin, cyclosporine and calcium antagonists). A review of the literature[J]. Minerva Stomatologica, 1998,47(9): 387-398.
5.	Spratt H, Boomer S, Irwin CR, et al. Cyclosporine associated gingival overgrowth in renal transplant recipients[J]. Oral Diseases, 1999,5(1): 27-31.
6.	Vescovi P, Savi A, Macaluso GM, et al. Gingival hypertrophy due to cyclosporine. A clinico-statistical study in 82 patients[J]. Minerva Stomatologica, 1997, 46(4): 155-164.
7.	O’Leary TJ, Drake RB, Naylord JE. The plaque control record[J]. J Periodontol, 1972, 43(1): 38.
8.	Silness J, Löe H. Periodontal disease in pregnancy. Ⅱ. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand, 1964, 22: 121-135.
9.	Rateitschak-Plüss EM, Hefti A, Lrtscher R, et al. Initial observation that cyclosporine-A induces gingival enlargement in man[J]. J Clin Periodontol, 1983, 10(3): 237-246.
10.	Wong W, Hodge MG, Lewis A, et al. Resolution of cyclosporine induced gingival hypertrophy with metronidazole[J]. Lancet, 1994, 343(8903): 986.
11.	Reali L, Zuliani E,Gabutti L,et al. Poor oral hygiene enhances gingival overgrowth caused by calcineurin inhibitors[J]. J Clin Pharm Ther, 2009, 34(3): 255-260.
12.	First MR, Neylan JF, Rocher LL, et al. Hypertension after renal transplantation[J]. J Am Soc Nephrol, 1994, 4(Suppl 8): s30-s36.
13.	Schwenger V, Zeier M, Ritz E, et al. Hypertension after renal transplantation[J]. Curr Hypertens Rep, 2001, 3(5): 434-439.
14.	Zeier M, Mandelbaum A, Ritz E, et al. Hypertension in th.
15.	Tutone VK, Mark PB, Stewart GA,et al. Hypertension, antihypertensive agents and outcomes following renal transplantation[J]. Clin Transplant, 2005, 19(2): 181-192.
16.	Morton RS, Dongari-Bagtzoglou AI. Regulation of gingival fibroblast interleukin-6 secretion by cyclosporine A[J]. J Periodontol, 1999, 70(12): 1464-1471.
17.	Trackman PC, Kantarci A. Connective tissue metabolism and gingival overgrowth[J]. Crit Rev Oral Biol Med, 2004, 15(3): 165-175.
18.	Bulut S, Ozdemir BH, Alaaddinoglu EE, et al. Effect of cyclosporin A on apoptosis and expression of p53 and bcl-2 proteins in the gingiva of renal transplant patients[J]. J Periodontol, 2005, 76(5): 691-695.
19.	郑恒, 刘东, 方淑贤,等. 肾移植患者术后牙龈增生与环孢素A浓度的相关性[J]. 中国医院药学杂志, 2004, 24(11): 677-678.
20.	Mustapha IZ, Debrey S, Oladubu M, et al. Markers of systemic bacterial exposure in periodontal disease and cardiovascular disease risk: a systematic review and meta-analysis[J]. J Periodontol, 2007, 78(12): 2289-2302.
21.	Harikrishnan P, Harden PN. Tacrolimus can resolve cyclosporine-induced gingival hyperplasia[J]. Nephrol Dial Transplant, 1999, 14(7): 1805-1806.
22.	James JA, Boomer S, Maxwell AP,et al. Reduction in gingival overgrowth associated with conversion from cyclosporin A to tacrolimus[J]. J Clin Periodontol, 2000, 27(2): 144-148.
23.	Margreiter R, European Tacrolimus vs Ciclosporin Microemulsion Renal Transplantation Study Group. Efficacy and safety of tacrolimus compared with cyclosporin microemulsion in renal ransplantation: a randomised multicentre study[J]. Lancet, 2002, 359(9308): 741-746.
24.	Somacarrera ML, Lucas M, Scully C, et al. Effectiveness of periodontal treatments on cyclosporin-induced gingival overgrowth in transplant patients[J]. Br Dent J, 1997, 183(3): 89-94.
25.	Kantarci A, Cebeci I, Tuncer O, et al. Clinical effects of periodontal therapy on the severity of cyclosporin A-induced gingivalhyperplasia[J]. J Periodontol, 1999, 70(6): 587-593.
26.	范连慧,吴雄飞,吴晓倩,等.甲硝唑、阿奇霉素治疗肾移植后环孢素致牙龈增生的疗效观察[J]. 重庆医学,2003,32(3):370-371.

1.
2. e transplanted patient[J]. Nephron, 1998, 80(3), 257-268.
3. 　Butler RT, Kalkwarf KL, Kaldahl WB. Drug-induced gingival hyperplasia: phenytoin, cyclosporine, and nifedipine[J]. J Am Dent Assoc, 1987,114(1): 56-60.
4. 　Garzini-Demo P, Carbone M, Carrozzo M, et al. An increase in gingival volume induced by drugs (phenytoin, cyclosporine and calcium antagonists). A review of the literature[J]. Minerva Stomatologica, 1998,47(9): 387-398.
5. 　Spratt H, Boomer S, Irwin CR, et al. Cyclosporine associated gingival overgrowth in renal transplant recipients[J]. Oral Diseases, 1999,5(1): 27-31.
6. 　Vescovi P, Savi A, Macaluso GM, et al. Gingival hypertrophy due to cyclosporine. A clinico-statistical study in 82 patients[J]. Minerva Stomatologica, 1997, 46(4): 155-164.
7. 　O’Leary TJ, Drake RB, Naylord JE. The plaque control record[J]. J Periodontol, 1972, 43(1): 38.
8. 　Silness J, Löe H. Periodontal disease in pregnancy. Ⅱ. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand, 1964, 22: 121-135.
9. 　Rateitschak-Plüss EM, Hefti A, Lrtscher R, et al. Initial observation that cyclosporine-A induces gingival enlargement in man[J]. J Clin Periodontol, 1983, 10(3): 237-246.
10. 　Wong W, Hodge MG, Lewis A, et al. Resolution of cyclosporine induced gingival hypertrophy with metronidazole[J]. Lancet, 1994, 343(8903): 986.
11. 　Reali L, Zuliani E,Gabutti L,et al. Poor oral hygiene enhances gingival overgrowth caused by calcineurin inhibitors[J]. J Clin Pharm Ther, 2009, 34(3): 255-260.
12. 　First MR, Neylan JF, Rocher LL, et al. Hypertension after renal transplantation[J]. J Am Soc Nephrol, 1994, 4(Suppl 8): s30-s36.
13. 　Schwenger V, Zeier M, Ritz E, et al. Hypertension after renal transplantation[J]. Curr Hypertens Rep, 2001, 3(5): 434-439.
14. 　Zeier M, Mandelbaum A, Ritz E, et al. Hypertension in th.
15. 　Tutone VK, Mark PB, Stewart GA,et al. Hypertension, antihypertensive agents and outcomes following renal transplantation[J]. Clin Transplant, 2005, 19(2): 181-192.
16. 　Morton RS, Dongari-Bagtzoglou AI. Regulation of gingival fibroblast interleukin-6 secretion by cyclosporine A[J]. J Periodontol, 1999, 70(12): 1464-1471.
17. 　Trackman PC, Kantarci A. Connective tissue metabolism and gingival overgrowth[J]. Crit Rev Oral Biol Med, 2004, 15(3): 165-175.
18. 　Bulut S, Ozdemir BH, Alaaddinoglu EE, et al. Effect of cyclosporin A on apoptosis and expression of p53 and bcl-2 proteins in the gingiva of renal transplant patients[J]. J Periodontol, 2005, 76(5): 691-695.
19. 　郑恒, 刘东, 方淑贤,等. 肾移植患者术后牙龈增生与环孢素A浓度的相关性[J]. 中国医院药学杂志, 2004, 24(11): 677-678.
20. 　Mustapha IZ, Debrey S, Oladubu M, et al. Markers of systemic bacterial exposure in periodontal disease and cardiovascular disease risk: a systematic review and meta-analysis[J]. J Periodontol, 2007, 78(12): 2289-2302.
21. 　Harikrishnan P, Harden PN. Tacrolimus can resolve cyclosporine-induced gingival hyperplasia[J]. Nephrol Dial Transplant, 1999, 14(7): 1805-1806.
22. 　James JA, Boomer S, Maxwell AP,et al. Reduction in gingival overgrowth associated with conversion from cyclosporin A to tacrolimus[J]. J Clin Periodontol, 2000, 27(2): 144-148.
23. 　Margreiter R, European Tacrolimus vs Ciclosporin Microemulsion Renal Transplantation Study Group. Efficacy and safety of tacrolimus compared with cyclosporin microemulsion in renal ransplantation: a randomised multicentre study[J]. Lancet, 2002, 359(9308): 741-746.
24. 　Somacarrera ML, Lucas M, Scully C, et al. Effectiveness of periodontal treatments on cyclosporin-induced gingival overgrowth in transplant patients[J]. Br Dent J, 1997, 183(3): 89-94.
25. 　Kantarci A, Cebeci I, Tuncer O, et al. Clinical effects of periodontal therapy on the severity of cyclosporin A-induced gingivalhyperplasia[J]. J Periodontol, 1999, 70(6): 587-593.
26. 　范连慧,吴雄飞,吴晓倩,等.甲硝唑、阿奇霉素治疗肾移植后环孢素致牙龈增生的疗效观察[J]. 重庆医学,2003,32(3):370-371.

West China Medical Journal

The Clinical Analysis of Gingival Hyperplasia in Patients after Renal Transplantation

Abstract Full text Figures/Tables Video References Cited by

Format

Content