Clinical evaluation of marginal parodontium condition in patients after kidney graft treated with calcineurine inhibitors and calcium channel blockers

Abstract

Renal transplantation is a method of treating the chronic renal failure. Gingival overgrowth is a common side effect of immunosuppressive treatment with cyclosporine A. Calcium channel blockers also cause gingival overgrowth or intensify it. Tacrolimus is a new inhibitor of calcineurine used as an alternative to cyclosporine A. 124 patients were treated with cyclosporine A, and 38 patients were given tacrolimus. At the same time, patients were given calcium channel blockers. Impact of age, sex, calcineurine inhibitors dosage, sort of calcium channel blocker used as well as treatment duration on gingival overgrowth were studied. Also, periodontal status: oral cavity hygiene, gingivitis degree as well as extent and level of gingival overgrowth were evaluated. Gingival overgrowth of different degree was present in 58 patients (46.7%) treated with CsA and in none of the patients treated with tacrolimus. Hygiene and inflammation indices were significantly higher in the group of patients with gingival overgrowth as compared to the group without gingival overgrowth treated with CsA. In the group of patients treated with tacrolimus, these indices were the lowest, and the gingivae were sort of shrunk and paler. Patients with risk factors in gingival overgrowth and patients with severe overgrowth should be converted to tacrolimus treatment.