Montebugnoli L, Bernardi F, Magelli C
Department of Dentistry, University of Bologna, Italy.
J Clin Periodontol. 1996 Sep;23(9):868-72. doi: 10.1111/j.1600-051x.1996.tb00625.x.
The incidence of gingival overgrowth secondary to the administration of cyclosporine A (CsA) is widely reported in renal transplant recipients, while there is no information about periodontal conditions in heart transplant patients. In the present cross-sectional investigation the relationship between clinical periodontal conditions and pharmacological profiles of CsA was determined in 39 patients (31 male and 8 female, aged 18-63 years, mean 45.6 +/- 15.2 years) who possessed their 6 upper and 6 lower anterior teeth. All patients had been on a CsA-based immunosoppression regimen for at least 6 months (6-101, mean 39.3 +/- 30.1). 2 periodontal parameters (recorded on the 12 anterior teeth only) relating to gingival overgrowth were considered: hyperplastic index and % of sites with probing depth > 3 mm. These parameters were always recorded by the same observer at first appointment and 2 months after an oral hygiene programme. Both non parametric statistical analysis (Kruskal-Wallis one-way analysis by rank, Wicoxon signed rank-test and Mann Whitney U-test) and parametric analysis (stepwise multiple regression analysis, one-sample and two-sample t-test) were used to investigate the relationship between the periodontal parameters (dependent variables) and a series of independent variables: age, sex, plaque index (PI), gingival index (GI), CsA dose, CsA blood level, duration of therapy (months since allograft). Results failed to demonstrate any significant correlation between gingival overgrowth and age, sex, CsA dose or CsA blood level, PI. A positive significant correlation was found between periodontal conditions and GI and a significant inverse correlation between periodontal conditions and duration of therapy, suggesting that the relation between CsA therapy and gingival overgrowth in heart-transplant patients could be time-related and the negative influence of the drug on the periodontal status could spontaneously decrease over time.
肾移植受者中，因服用环孢素A（CsA）继发牙龈增生的发生率已有广泛报道，而关于心脏移植患者牙周状况的信息却尚无报道。在本次横断面调查中，我们对39例患者（31例男性，8例女性，年龄18 - 63岁，平均45.6±15.2岁）进行了研究，这些患者均保留了上下各6颗前牙，旨在确定临床牙周状况与CsA药理特征之间的关系。所有患者均接受基于CsA的免疫抑制方案治疗至少6个月（6 - 101个月，平均39.3±30.1个月）。我们考虑了2个与牙龈增生相关的牙周参数（仅记录在12颗前牙上）：增生指数和探诊深度>3mm的部位百分比。这些参数始终由同一名观察者在首次就诊时以及口腔卫生计划实施2个月后记录。我们使用非参数统计分析（Kruskal - Wallis单向秩和分析、Wicoxon符号秩检验和Mann Whitney U检验）以及参数分析（逐步多元回归分析、单样本和两样本t检验）来研究牙周参数（因变量）与一系列自变量之间的关系：年龄、性别、菌斑指数（PI）、牙龈指数（GI）、CsA剂量、CsA血药浓度、治疗持续时间（移植后月数）。结果未能显示牙龈增生与年龄、性别、CsA剂量、CsA血药浓度或PI之间存在任何显著相关性。牙周状况与GI之间存在显著正相关，与治疗持续时间之间存在显著负相关，这表明心脏移植患者中CsA治疗与牙龈增生之间的关系可能与时间有关，并且该药物对牙周状况的负面影响可能会随着时间自发降低。
