Cyclosporin‐ and nifedipine‐induced gingival overgrowth in renal transplant patients: correlations with periodontal and pharmacological parameters, and HLA‐antigens

Margiotta, Valerio; Pizzo, Ignazio; Pizzo, Giuseppe; Barbaro, Adele

doi:10.1111/j.1600-0714.1996.tb00207.x

Cited by 57 publications

(55 citation statements)

References 26 publications

(32 reference statements)

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“…The prevalence of DIGO has been reported to be between 20% and 85% [20][21][22][23]. In agreement with the literature, our baseline evaluation found that 65% of our study population had DIGO.…”

Section: Discussionsupporting

confidence: 91%

Sonic tooth brushing reduces gingival overgrowth in renal transplant recipients

et al. 2006

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Cyclosporine (CSA) is a commonly used immunosuppressive medication in pediatric transplantation. Drug-induced gingival overgrowth (DIGO) is a frequent side effect associated with CSA use and can impair the patient's ability to achieve good oral hygiene. This study tested the hypothesis that sonic tooth brushing and oral hygiene instruction can reduce the occurrence or severity of DIGO in CSA-treated pediatric renal transplant recipients. Twenty-three pediatric renal transplant patients with DIGO were randomly allocated to treatment or control groups. The treatment group received oral hygiene instruction and use of a sonic toothbrush, while the control group continued their usual home care with manual brushes. Dental impressions and photographs of all subjects were taken at baseline and every 3 months for a year. The casts and photographs were evaluated by a dental panel to compare the DIGO levels from baseline until the end of the study. After 12 months the control group had significantly more severe DIGO than did the sonic tooth brushing and oral hygiene instruction group (OR=4.5, 95%CI=1.2-16.0, P=0.03). Of the risk factors considered, only male gender was significantly associated with worse outcome (OR=6.1, 95%CI=2.3-16.1, P=0.03). The use of a powered toothbrush, together with oral hygiene instruction, may be an important component of health maintenance for pediatric transplant patients on CSA.

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Section: Discussionsupporting

confidence: 91%

Sonic tooth brushing reduces gingival overgrowth in renal transplant recipients

et al. 2006

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“…They concluded that local factors and pharmacological p a r a m e t e rs were unrelated to ove r gr owth and indicated a trend for HLA A19-positive patients to show signs of gingival overgrowth, suggesting an underlying genetic susceptibility. 101 Further studies of renal and cardiac transplant patients have suggested that while the incidence of clinically significant gi n gi val ove r gr owth may be s i m i l a r , the seve rity of ove r gr owth appears to be significantly greater in those receiving both Cs and nifedipine. 102 Patients taking both drugs had significantly higher gingival overgrowth scores, probing depths and a greater need for surgery.…”

Section: Combinations Of Medications Associated With Gingival O Vergrmentioning

confidence: 99%

A clinical review of drug‐induced gingival overgrowths

Marshall

Bartold

1999

Australian Dental Journal

124

139

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There is an increasing number of medications associated with gingival overgrowth. These medications are used to treat a number of common conditions in the Australian population and as such dentists can expect to manage a number of patients with medication-related gingival overgrowth. This review highlights the clinical features and management of the common overgrowths associated with anticonvulsants, immunosuppressants and the calcium channel blockers.

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“…The prominent side-effect of CsA therapy in oral tissue is gingival overgrowth (GO; Bennet and Christian 1982;Wysocki et al 1983) with a prevalence ranging from 2% to 70% (Margiotta et al 1996). However, the precise molecular mechanisms underlying this development are still not elucidated.…”

Section: Introductionmentioning

confidence: 98%

Elevated gene expression of MMP-1, MMP-10, and TIMP-1 reveal changes of molecules involved in turn-over of extracellular matrix in cyclosporine-induced gingival overgrowth

et al. 2006

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In humans, pathogenesis in cyclosporine A (CsA)-induced gingival overgrowth (GO) includes the accumulation of extracellular matrix (ECM) constituents, viz., collagen type-1 and type-3 and proteoglycans, in subgingival connective tissue. However, whether this increase is associated with alterations of molecules pivotal for the turn-over of collagens and proteoglycans remains unclear. The present study explores the status of matrix metalloproteinase MMP-1 and MMP-10, which are important for fibrillar collagen and proteoglycan turn-over, and their tissue inhibitor TIMP-1, on their gene expression and protein levels in frozen sections derived from GO and matched normal tissue. In situ hybridization (ISH) revealed elevated levels of MMP-1 gene expression in the connective tissue of GO compared with normal tissue. This elevation also applied to MMP-10 and TIMP-1, the latter exhibiting the strongest gene transcription in the deep connective tissue. These differences detected by ISH were corroborated by quantitative reverse transcription/polymerase chain reaction; relative gene expression analysis indicated a 1.9-fold increase for MMP-1, a 2.3-fold increase for MMP-10, and a 4.8-fold increase for TIMP-1. Detection of the protein by indirect immunofluorescence showed that normal gingival tissue was devoid of all three proteins, although they were detectable in GO tissue, with emphasis on TIMP-1. Analysis of our data indicates elevated levels of MMP-1 and-10, and particularly TIMP-1. With respect to TIMP-1, this elevation may in turn lead to alterations in ECM turn-over by abrogating MMP-1 and MMP-10, thereby contributing to ECM accumulation associated with GO.

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Cyclosporin‐ and nifedipine‐induced gingival overgrowth in renal transplant patients: correlations with periodontal and pharmacological parameters, and HLA‐antigens

Cited by 57 publications

References 26 publications

Sonic tooth brushing reduces gingival overgrowth in renal transplant recipients

Sonic tooth brushing reduces gingival overgrowth in renal transplant recipients

A clinical review of drug‐induced gingival overgrowths

Elevated gene expression of MMP-1, MMP-10, and TIMP-1 reveal changes of molecules involved in turn-over of extracellular matrix in cyclosporine-induced gingival overgrowth

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