PERIO - Periodontal Practice Today 4 (2007), No. 3 (19.09.2007)
Non-surgical treatment of gingival overgrowth induced by cyclosporin: a case report
Zanatta, Fabricio Batistin / Antoniazzi, Raquel Pippi / Oppermann, Rui Vicente / Rösing, Cassiano Kuchenbecker
Gingival overgrowth induced by cyclosporin is frequently treated surgically. A case report of gingival overgrowth induced by cyclosporin associated with severe chronic periodontitis is described. This clinical case report describes an impressively positive treatment response following non-surgical periodontal therapy. A 47-year-old male, with a generalised gingival overgrowth associated with tooth migration, large overjet and tooth mobility was treated. The medical history revealed a renal transplant, hypertensive state, and a family history of periodontitis. The patient was under a regimen of 200 mg cyclosporin and 100 mg captopril daily. The diagnosis was severe chronic periodontitis. Probing pocket depths of >= 8 mm were found in all teeth present. Treatment consisted in non-surgical therapy and reduction of the cyclosporin dosage. After 6 months of non-surgical treatment, clinical parameters demonstrated a great improvement with 90% of sites with 1-3 mm and 6% with 4-5 mm of probing depth, and absence of bleeding on probing. Tooth realignment and overjet reduction occurred spontaneously and the patient was totally satisfied with the treatment. Surgical corrections were not considered necessary. Supportive periodontal care was given every 3 months. A cause-related approach working closely with the nephrologist could be adequate for treatment of cyclosporin-associated gingival overgrowth and periodontitis and should precede surgical treatment. The reduction in cyclosporin dosage may account for at least part of the obtained clinical results.
Keywords: cyclosporin, dental plaque, gingival overgrowth, non-surgical periodontal therapy, periodontitis