Skip to main content
SpringerLink
Log in

Treatment of gingival hyperplasia induced by cyclosporine A

  • Research Article
  • Published:
Frontiers of Medicine in China Aims and scope Submit manuscript

Abstract

The clinical therapy for cyclosporine A (CsA)-induced gingival hyperplasia (GH) and the pathological changes in hyperplastic gingival tissues were investigated. Nine cases of CsA-induced GH after renal transplantation were subjected to periodontal non-surgical treatment and surgical treatment and were followed up. Gingival index (GI), dental plaque index (PLI) and GH degree (GHD) at different time points were measured. Under light and electron microscopy, the pathological changes in hyperplastic gingival tissues were observed. The CsA concentrations in gingival tissues and blood were determined by using fluorescence polarization immunoassay with TDxFLx monoclonal antibody. The results showed that GI, PLI and GHD in patients with GH declined after periodontal treatment. Two patients suffered from different degrees of GH during the 6 months to 54 months post-transplantation. Under transmission electron microscopy, fibroblasts in the hyperplastic gingival tissues were enlarged, cytoplasmic rough endoplasmic reticula were abundant and expanded slightly, and a few fibroblasts with early apoptotic changes were seen. The concentrations of CsA in hyperplastic gingival tissues were from 351.00 to 1345.47 ng/mL, which were significantly higher than in the blood of the same patients taken at the same time points. It was concluded that GI and PLI declined after periodontal treatment in combination with surgical treatment in patients taking CsA for a long time, but in some patients, GH recurred. The fact that the concentration of CsA in hyperplastic gingival tissues is higher than in blood awaits further studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mazza J E, Newman M G, Sims T N. Clinical and antimicrobial effect of stannous fluoride on periodontitis. J Clin Periodontol, 1981, 8(3): 203–212

    Article  PubMed  CAS  Google Scholar 

  2. Turesky S, Gilmore N D, Glickman I. Reduced plaque formation by the chloromethyl analogue of vitamin C. J Periodontol, 1970, 41(1): 41–43

    PubMed  CAS  Google Scholar 

  3. Cao Y G, Liu S W, Li M, Liu D G. Investgation of cyclosporine A-induced gingival overgrowth. Zhonghua Qi Guan Yi Zhi Za Zhi, 2003, 24(1): 31–32 (in Chinese)

    Google Scholar 

  4. Chae H J, Ha M S, Yun D H, Pae H O, Chung H T, Chae S W, Jung Y K, Kim H R. Mechanism of cyclosporine-induced overgrowth in gingiva. J Dent Res, 2006, 85(6): 515–519

    PubMed  Google Scholar 

  5. Schulz A, Lange D E, Hassell T M, Stone C E, Lison A E. Cyclosporine-induced gingival hyperplasia in renal transplant patients. Dtsch Zahnarztl Z, 1990, 45(7): 414–416

    PubMed  CAS  Google Scholar 

  6. Dongari-Bagtzoglou A; Research, Science and Therapy Committee, American Academy of Periodontology. Drugassociated gingival enlargement. J Periodontol, 2004, 75(10): 1424–1431

    Article  PubMed  Google Scholar 

  7. Harkonen M. Medically induced gingival hyperplasia. Mayo Clin Proc, 1999, 74(6): 742–743

    PubMed  CAS  Google Scholar 

  8. Mesa F L, Osuna A, Aneiros J, Gonzalez-Jaranay M, Bravo J, Junco P, Del Moral R G, O’Valle F. Antibiotic treatment of incipient drug-induced gingival overgrowth in adult renal transplant patients. J Periodontal Res, 2003, 38(2): 141–146

    Article  PubMed  CAS  Google Scholar 

  9. Ilgenli T, Atilla G, Baylas H. Effectiveness of periodontal therapy in patients with drug-induced gingival overgrowth. Long-term results. J Periodontol, 1999, 70(9): 967–972

    Article  PubMed  CAS  Google Scholar 

  10. Morisaki I, Fukui N, Fujimori Y, Murakami J, Daikoku H, Amano A. Effects of combined oral treatments with cyclosporine A and nifedipine or diltiazem on drug-induced gingival overgrowth in rats. J Periodontol, 2000, 71(3): 438–443

    Article  PubMed  CAS  Google Scholar 

  11. Haytac C M, Ustun Y, Essen E, Ozcelik O. Combined treatment approach of gingivectomy and CO2 laser for cyclosporine-induced gingival overgrowth. Quintessence Int, 2007, 38(1): 54–59

    Google Scholar 

  12. Ruhl S, Hamberger S, Betz R, Sukkar T, Schmalz G, Seymour R A, Hiller K A, Thomason J M. Salivary proteins and cytokines in drug-induced gingival overgrowth. J Dent Res, 2004, 83(3): 322–326

    PubMed  CAS  Google Scholar 

  13. Dannewitz B, Edrich C, Tomakidi P, Kohl A, Gabbert O, Staehle H J, Steinberg T. Elevated levels of gene expression for collagen and decorin in human gingival overgrowth. J Clin Periodontol, 2006, 33(7): 510–516

    Article  PubMed  Google Scholar 

  14. Thomas D W, Newcombe R G, Osborne G R. Risk factors in the development of cyclosporine-induced gingival overgrowth. Transplantation, 2000, 69(4): 522–526

    Article  PubMed  CAS  Google Scholar 

  15. Kantarci A, Augustin P, Firatli E, Sheff M C, Hasturk H, Graves D T, Trackman P C. Apoptosis in gingival overgrowth tissues. J Dent Res, 2007, 86(9): 888–892

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center of Stomatological Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Jingzhi Ma, Ming Li & Yingguang Cao

Authors
  1. Jingzhi Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ming Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yingguang Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yingguang Cao.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ma, J., Li, M. & Cao, Y. Treatment of gingival hyperplasia induced by cyclosporine A. Front. Med. China 2, 290–294 (2008). https://doi.org/10.1007/s11684-008-0055-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11684-008-0055-5

Keywords

Search

Navigation