Cyclosporin is
a medication used to prevent tissue rejection when doing organ transplants. It
is reported that 30% of those taking cyclosporin will develop gingival
hyperplasia (Seymour, et al., 1987).
The following
case represents a patient who was experiencing rejection of his transplanted
kidney. Consequently, his cyclosporin dose was doubled with rapid onset of
gingival hyperplasia. His hyperplasia was so severe that his gingiva was growing
over the occlusal surfaces of his teeth and he could not bite down all the way.
Two
weeks after the excess tissue was removed, new hyperplastic tissue was noted
between several of his teeth. This was resolved by removing isolated areas of
excess tissue and getting the patient to use a Braun Interclean
interdental cleaner. Note: Braun discontinued this product fall
2000 :-(
The
use of the Braun Interclean seems to make a big difference in this type
of case, since the hyperplastic tissue usually starts to grow between the teeth
where people do not routinely floss.
Patients that
have this reaction to cyclosporin should be on a three-month preiodontal
maintenance schedule with constant reinforcement of their home care.
It is
important to realize that this is an example of a severe tissue reaction. Most
periodontal diseases have minimal or no obvious symptoms. It is often a
"silent disease." In most cases of periodontal disease, it is
necessary to measure the spaces, called pockets, around the teeth and correlate
them with X-rays to determine the extent of the disease process.
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Copyright © 2002 Dale R. Johnstone, DDS