| Summary: | 碩士 === 長庚大學 === 顱顏口腔醫學研究所 === 95 === Cyclosporine, a potent immunosuppressant agent discovered in 1972, has significantly reduced the morbidity and mortality associated with organ transplantations and improved the five-year success rate for solid organ transplants from 50% to 96%. The major side effect of this drug in the oral cavity is gingival overgrowth, especially in the transplant patients. Cyclosporine-induced gingival overgrowth was reported variable in between 10 and 30 % of the transplant patients, according to reports from different transplant centers, which were more for pediatric liver transplant patients.
The aims of this study were to investigate the effects of cyclosporine on the gingival tissues of liver transplant pediatric patients, to determine the prevalence and severity of gingival overgrowth in twenty-five cyclosporine-treated children, and to relate such changes to plaque scores, gingival inflammation and serum concentrations of the drug.
25 pediatric patients(15 males and 10 females), with end-stage of liver disease and receiving liver transplantation less than 4 years of age, were selected for this study. During the pre-transplantation period, these patients had the baseline data collection including the serum level of cyclosporine, gingival enlargement index, plague index and gingival bleeding index. After liver transplantation, these patients were received cyclosporine as an immunosuppressant agent. These children had the same data collections immediately, 3 months, 6 months and 12 months after liver transplantation.
The results showed that cyclosporine-induced gingival overgrowth of these children was not associated with their age, sex, gingival inflammation and the serum level of cyclosporine ( p > 0.05). Statistically, gingival overgrowth of these children was associated with dental plaque score in each time period until 12 months after liver transplantation ( p < 0.05). There was an increased tendency of gingival overgrowth ( > 80% ) in the children who received cyclosporine as an immunosuppressant agent during the immediate and 3 months after transplantation.
In summary, the major side effect of gingival overgrowth after receiving cyclosporine as an immunosuppressant agent in this study showed that gingival overgrowth was statistically more related to plaque scores than other factors, such as age, sex, gingival inflammation and the serum level of cyclosporine, suggesting that oral hygiene instruction is important during and after liver transplantation.
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