Thomason J M, Seymour R A, Ellis J S, Kelly P J, Parry G, Dark J, Idle J R
Department of Restorative Dentistry, University of Newcastle, Newcastle upon Tyne, U.K.
J Periodontol. 1995 Aug;66(8):742-6. doi: 10.1902/jop.1995.66.8.742.
It is well established that both cyclosporin and nifedipine are associated with gingival overgrowth. Although both drugs are widely used in the management of organ transplant patients, there is little information on the prevalence and severity of this unwanted effect in cardiac transplant patients. This study evaluated the gingival health of 94 dentate cardiac transplant patients, all of whom were medicated with cyclosporin as a component of their immunosuppressive therapy. Sixty-three (63) of the patients were also medicated with nifedipine. Significantly higher gingival overgrowth scores (P < 0.0001) and periodontal probing depths (P = 0.001) were observed in patients medicated with the combination of cyclosporin and nifedipine than those medicated with cyclosporin alone. Likewise, there was a significantly greater need to carry out gingival surgery on patients taking the combination (62%), than those medicated with cyclosporin alone (25.8%) (P = 0.001). Patient's age, sex, duration of therapy, gingival bleeding index, and nifedipine therapy were important determinants for both the expression of gingival overgrowth and the need for surgery. Significant sequestration of nifedipine in the gingival crevicular fluid (GCF) was observed. The concentration of nifedipine in GCF did not relate to either the gingival changes or plasma concentration of the drug. Cardiac transplant patients are at risk of developing gingival overgrowth and approximately 50% require surgical intervention. This risk increases significantly when patients are medicated concomitantly with nifedipine.
众所周知，环孢素和硝苯地平都与牙龈增生有关。尽管这两种药物都广泛用于器官移植患者的治疗，但关于心脏移植患者中这种不良影响的发生率和严重程度的信息却很少。本研究评估了94例有牙的心脏移植患者的牙龈健康状况，所有患者均接受环孢素作为免疫抑制治疗的一部分。其中63例患者还服用了硝苯地平。与单独服用环孢素的患者相比，同时服用环孢素和硝苯地平的患者牙龈增生评分显著更高（P < 0.0001），牙周探诊深度也显著更深（P = 0.001）。同样，与单独服用环孢素的患者（25.8%）相比，同时服用这两种药物的患者进行牙龈手术的需求显著更高（62%）（P = 0.001）。患者的年龄、性别、治疗持续时间、牙龈出血指数和硝苯地平治疗是牙龈增生表现和手术需求的重要决定因素。观察到硝苯地平在龈沟液（GCF）中有显著的潴留。龈沟液中硝苯地平的浓度与牙龈变化或药物血浆浓度均无关。心脏移植患者有发生牙龈增生的风险，约50%的患者需要手术干预。当患者同时服用硝苯地平时，这种风险会显著增加。
