Periodontal Changes in Liver Cirrhosis and Post‐Transplantation Patients. I: Clinical Findings

Oettinger‐Barak, Orit; Barak, Shlomi; Machtei, Eli E.; Ardekian, Leon; Baruch, Yaacov; Peled, Micha

doi:10.1902/jop.2000.72.9.1236

Cited by 34 publications

(76 citation statements)

References 28 publications

(35 reference statements)

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“…These findings agree with other reports . We observed that 56% of the LTCs presented periodontitis, which is in line with the results of other studies with cirrhotic subjects conducted in Brazil, which observed 52% and 68% prevalence of periodontitis, respectively.…”

Section: Discussionsupporting

confidence: 93%

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Periodontal status of liver transplant candidates and healthy controls

Profio

Inoue

Marui

et al. 2018

Journal of Periodontology

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Section: Discussionsupporting

confidence: 93%

“…Poor oral hygiene might be an explanation for higher prevalence, extent, and severity of periodontitis in cirrhotic patients . Further, other risk factors for periodontal disease, such as sociodemographic characteristics, might also explain the poor periodontal condition of LTCs.…”

Section: Discussionmentioning

confidence: 99%

Periodontal status of liver transplant candidates and healthy controls

Profio

Inoue

Marui

et al. 2018

Journal of Periodontology

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“…Clinical data have demonstrated that tacrolimus does not induce gingival overgrowth (James et al , 2001; McKaig et al , 2002; Spolidorio et al , 2006) or have suggested that the severity of gingival overgrowth seen in patients taking tacrolimus is less than that with CsA (Bader et al , 1998; James et al , 2000). Prevalence studies are limited and the methods used for assessing overgrowth and severity vary from study to study (Oettinger‐Barak et al , 2001; Wondimu et al , 2001). On the other hand, there is agreement in the literature with regard to the ‘risk factors’ of gingival overgrowth.…”

Section: Discussionmentioning

confidence: 99%

The effects of up to 240 days of tacrolimus therapy on the gingival tissues of rats – a morphological evaluation

Nassar

Andia

et al. 2007

Oral Diseases

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“…described tacrolimus associated gingival overgrowth as less extensive than that seen with cyclosporin, and suggested that the overgrowth seen could not be entirely attributed to concomitant calcium channel blocker drug therapy [64]. Despite several studies observing the outcomes of immunosuppression with tacrolimus [64][65][66][67][68][69][70][71][72], there is little evidence of why the variation in the pathogenesis of tacrolimus in respect to gingival overgrowth occurs.…”

Section: Tacrolimusmentioning

confidence: 99%

Cyclosporin‐induced gingival overgrowth in children

Wright¹,

Welbury²,

Hosey³

2005

Int J Paed Dentistry

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Cyclosporin is a potent immunosuppressant drug commonly used to prevent organ transplant rejection. In recent years, there has been a widening of its therapeutic use and an increase in the number of patients undergoing transplantation. Gingival overgrowth is one of several oral side-effects of cyclosporin, with a quoted prevalence of between 8% and 100%. There is continued debate over the factors which modify the degree of overgrowth, including individual sensitivity, age, dose of drug, duration of drug therapy and the presence of dental plaque. The exact mechanism of gingival overgrowth is still being debated, but appears to be caused by a combination of the proliferation of fibroblasts within the gingival tissue, an increase in the deposition of collagen and extracellular matrix, and a decrease in phagocytosis with a net gain in gingival tissue mass. A number of treatment options are utilized in the treatment of gingival overgrowth, including CO2 laser surgery, improved oral hygiene, the use of antibiotics such as metronidazole and azithromycin, and surgical intervention. In the clinical application of cyclosporin, there is little correlation between cyclosporin dose, serum trough levels and total exposure to the drug, making it difficult to achieve the desired therapeutic response. These problems were previously further complicated by the variability of absorption of the drug via the gastrointestinal tract. The original cyclosporin formulation, Sandimmune, was replaced by a new formulation, Neoral, which has a more reliable absorption, and gives a closer correlation between trough concentration levels and individual bioavailability. There is a conflict of opinion over whether or not the side-effect profile of Neoral varies from its precursor Sandimmune. It has yet to be seen whether the increased bioavailability of Neoral will result in an increased severity and prevalence of gingival overgrowth. An alternative immunosuppressant drug, tacrolimus, which is a macrolide antibiotic with a different side-effect profile, has emerged as a substitute for cyclosporin in organ transplantation. However, there have been conflicting reports of its side-effects and its capacity to cause gingival overgrowth.

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Periodontal Changes in Liver Cirrhosis and Post‐Transplantation Patients. I: Clinical Findings

Cited by 34 publications

References 28 publications

Periodontal status of liver transplant candidates and healthy controls

Periodontal status of liver transplant candidates and healthy controls

The effects of up to 240 days of tacrolimus therapy on the gingival tissues of rats – a morphological evaluation

Cyclosporin‐induced gingival overgrowth in children

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