肾移植受者牙龈增生：一项 44 个月随访研究。

Gingival overgrowth in renal transplant subjects: a 44-month follow-up study.

机构信息

1 Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. 2 Department of Dentistry, Periodontics Research Division, University of Taubaté, Taubaté, São Paulo, Brazil. 3 Address correspondence to: Fernando Oliveira Costa, B.D.S., M.Sc., Ph.D., Associate Professor, Department of Periodontology, School of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, P.O. Box 359, Belo Horizonte, MG, Brazil 31270-901.

出版信息

Transplantation. 2013 Nov 27;96(10):890-6. doi: 10.1097/TP.0b013e3182a1cd0c.

DOI:10.1097/TP.0b013e3182a1cd0c

PMID:23903015

Abstract

BACKGROUND

To assess changes in gingival status of renal transplant subjects under immunosuppressive regimens based on cyclosporine (CsA), tacrolimus (Tcr), and sirolimus (Sir).

METHODS

From a sample of 135 subjects (baseline examination [BE]), 89 without periodontal treatment, who maintained the immunosuppressive regimen based on the same main agent (CsA=23, Tcr=31, and Sir=35), were reexamined after 44 months (follow-up examination [FE]). Demographic, pharmacologic, and periodontal variables were collected and gingival overgrowth (GO) was assessed by visual examination.

RESULTS

In Tcr and CsA groups, although not significant, occurrence of GO decreased (CsA [BE=56.5% and FE=34.8%; P=0.063] and Tcr [BE=19.4% and FE=12.9%; P=0.500]). In addition, the severity of GO decreased significantly in CsA group (mean score BE=10.29 ± 7.70 and mean score FE=0.78 ± 1.38; P=0.003). In Sir group, GO decreased from 17.1% (BE) to 0.0% (FE) (P=not applicable). In total sample, GO was associated with papillary bleeding index (P=0.001) and concomitant use of calcium channel blockers (P=0.029); in CsA and Tcr groups, GO was associated with papillary bleeding index (P=0.029 and 0.033, respectively).

CONCLUSIONS

There was no incidence of GO, and a decrease in the occurrence and severity of GO was significant in total sample. This decrease can be attributed to changes in pharmacologic and periodontal variables over this period of time.

摘要

背景

评估基于环孢素（CsA）、他克莫司（Tcr）和西罗莫司（Sir）的免疫抑制方案下肾移植受者牙龈状况的变化。

方法

从 135 名受试者（基线检查[BE]）中抽取 89 名未经牙周治疗且维持相同主要药物（CsA=23、Tcr=31 和 Sir=35）免疫抑制方案的患者，在 44 个月后进行复查（随访检查[FE]）。收集人口统计学、药理学和牙周变量，并通过视觉检查评估牙龈增生（GO）。

结果

在 Tcr 和 CsA 组中，尽管无统计学意义，但 GO 的发生率降低（CsA [BE=56.5%和 FE=34.8%；P=0.063] 和 Tcr [BE=19.4%和 FE=12.9%；P=0.500]）。此外，CsA 组的 GO 严重程度显著降低（BE 平均评分 10.29 ± 7.70，FE 平均评分 0.78 ± 1.38；P=0.003）。在 Sir 组中，GO 从 17.1%（BE）降至 0.0%（FE）（P=不适用）。在总样本中，GO 与乳突出血指数（P=0.001）和钙通道阻滞剂的联合使用相关（P=0.029）；在 CsA 和 Tcr 组中，GO 与乳突出血指数相关（P=0.029 和 0.033）。