Gingival overgrowth in renal transplant patients administered cyclosporin A in mixture or in capsule form. A longitudinal study.

Cyclosporin A (CsA)-induced gingival overgrowth was longitudinally studied in 45 adult renal transplant patients randomly assigned to be administered CsA orally in mixture or in capsule form. After 1 year of CsA therapy, 37% of the mixture and 43% of the capsule patients exhibited gingival overgrowth. In mixture patients gingival overgrowth was present, already after 1 month of CsA therapy and, after 12 months, mixture patients exhibited an increased number of sites with gingival overgrowth in the regions of the upper front and lower molars compared to capsule patients. In addition, the relative increase in gingival width of the interdental papillae of the maxillary central incisors and the mandibular first molars, measured buccolingually on stone casts, was also higher in mixture patients than in capsule patients. In a stepwise multiple logistic regression analysis, the use of nifedipine and the total CsA dose administered during the first 6 posttransplant months were the predictors associated with gingival overgrowth. The study suggests that concomitant administration of nifedipine in renal transplant patients should be avoided and a change from the mixture form of CsA to the capsule form should be considered in order to minimize the development of CsA-induced gingival overgrowth.