Gingival hyperplasia in renal allograft recipients receiving cyclosporin‐A and calcium antagonists

Abstract

Although it is established that the immunosuppressant cyclosporin-A (CsA) and calcium antagonists [Nifedipine (Nif) and Diltiazem (Dz)] can independently induce gingival enlargement, little has been documented on the significance of the salivary CsA levels and the combined effect of CsA and a calcium antagonist upon gingival tissues. In the present cross-sectional investigation, clinical periodontal parameters and the pharmacologic profiles of CsA, Nif, and Dz were determined for 66 renal transplant recipients. Subjects were divided into the following groups: Group (Gp) 1: CsA [n = 18]; Gp 2: CsA + Nif [n = 15]; Gp 3: CsA + Dz [n = 12] and a negative Control Gp 4: azathioprine [n = 21]. A gingival enlargement score was assessed for each patient from study models using a hyperplastic index (HI). Pharmacologic profiles included CsA whole blood and whole saliva levels as measured by fluorescence polarization immunoassay. The HI scores between Gp 1, 2 and 3 were not significantly different. However, when compared with controls (Gp 4), there was a significant difference in HI and all individual groups (Gp 1, 2, 3) (p < 0.05). Gingival hyperplasia was only weakly related to plaque and calculus but was unrelated to CsA dose (mg/kg/day), duration of CsA therapy (months), CsA blood or saliva levels (ng/ml), or the concurrent administration of a Nif or Dz. Gingival enlargement was found to occur in 49% of subjects who were either on CsA or CsA and a calcium antagonist. It is concluded that CsA alone or in combination with a calcium antagonist caused a significant increase in gingival enlargement compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Association of drug-induced gingival enlargement (calcium channel blockers) and local factors: Who is the culprit?

“…Any plaque-induced inflammatory changes within tissues will worsen the appearance of drug-induced gingival overgrowth. This finding suggests causality, with a patient's oral hygiene being a significant risk factor for both the growth and the expression of drug-induced gingival overgrowth, [11][12][13][14] although reports to the opposing have also been reported. [15] Most of the evidences supporting the association between bacterial plaque and drug-induced gingival overgrowth have been derived from cross-sectional studies, and in such studies, it is difficult to conclude whether plaque is a causative factor to or an outcome of the gingival changes.…”

Investigation of Oral Mucosal Lesions in Patients Attending Dermatology Outpatient Clinic: A Study of 1670 Cases

“…KKB ve CsA'nın jinjival hiperplaziye neden olduğu bilinmektedir. 53,54 Her ne kadar jinjival hiperplazi tanısı olan iki olguda da ilaç etyolojik faktör olarak görülse de, hasta sayısının az olması nedeniyle bu ilişki istatistiksel düzeyde anlamlı olarak sonuçlan-madı. Çalışmamızda ayrıca, araştırdığımız dermatolojik hastalıklar ve OML ilişkisinde istatistiksel düzeyde yalnızca akne grubu hastalıklar ile keilit gelişimi arasında anlamlılık tespit edildi, bu bulgunun da izotretinoin tedavisi alanlarda görülen ilaca bağlı keilit nedeniyle ortaya çıktığı düşüncesinde-yiz.…”

Agrandamiento gingival por bloqueantes de canales de calcio

“…Desde el primer informe de AG relacionado con fármacos en 1939 7 , se han realizado diversos estudios para reconocer la prevalencia de esta alteración, la cual puede estar exacerbada por ciertos factores locales y demográficos; en algunos estudios 2,8,9 mencionan que hay una posible influencia de la testosterona sobre el desarrollo del agrandamiento gingival y en otros 10,11,12 , sugieren que el fármaco aumenta la conversión de testosterona a su metabolito dihidrotestosterona, lo cual, puede influir en subpoblaciones de fibroblastos involucradas en el AG, por lo que los varones son significativamente más susceptibles a padecer de este efecto secundario. Además, Dayan D y cols.…”