Thomason J M, Seymour R A, Ellis J
Department of Restorative Dentistry, Dental School, University of Newcastle upon Tyne, England.
Ren Fail. 1994 Nov;16(6):731-45. doi: 10.3109/08860229409044903.
This review considers the periodontal problems of renal transplant patients with particular reference to their drug therapy and the pretransplant uremia. It would appear that either disease- or drug-induced immunosuppression affords the renal transplant patient a degree of "protection" against periodontal breakdown. However, of more significance to the periodontologist is the problem of drug-induced gingival overgrowth with reference to both cyclosporin and nifedipine. Approximately 30% of dentate renal transplant patients medicated with cyclosporin alone experience significant gingival overgrowth which requires surgical excision. This figure increases to 40% when patients are medicated with both drugs. The pathogenesis of this unwanted effect is uncertain and the relationship between the expression of gingival overgrowth and various periodontal or pharmacokinetic variables remains a contentious issue. Clinical measures to prevent the occurrence of either cyclosporin- or nifedipine-induced gingival overgrowth are unsatisfactory.
本综述探讨肾移植患者的牙周问题，特别提及他们的药物治疗和移植前的尿毒症。似乎疾病或药物引起的免疫抑制为肾移植患者提供了一定程度的抵御牙周破坏的“保护”。然而，对牙周病医生来说更重要的是环孢素和硝苯地平引起的药物性牙龈增生问题。仅使用环孢素治疗的有牙肾移植患者中，约30%会出现明显的牙龈增生，需要手术切除。当患者同时使用这两种药物时，这一比例增至40%。这种不良效应的发病机制尚不确定，牙龈增生的表现与各种牙周或药代动力学变量之间的关系仍是一个有争议的问题。预防环孢素或硝苯地平引起的牙龈增生的临床措施并不令人满意。
