Effect of periodontal treatment in renal transplant recipients.

Medical Principals and Practice 2014; 23 149-153.

Aims
To investigate the incidence and severity of gingival overgrowth (GO) due to immunosuppressants and to assess periodontal therapy in cyclosporine-induced GO in renal transplant recipients.

Interventions
Patients were randomised before they developed GO. In the two randomised groups, patients received periodontal treatment consisting of non surgical scaling and root planning and were instructed to maintain good oral hygiene by using chlorhexidine oral rinses. The other group of patients did not receive any periodontal treatment.

Participants
25 renal transplant recipients receiving immunosuppressive therapy with cyclosporine A.

Outcomes
The outcomes included plaque score, gingival index and GO measured in millimetres.

Follow-up
1 year.

CET Conclusions
This paper reports a small trial of periodontal therapy in renal transplant patients taking cyclosporine A. The authors demonstrate a significant reduction in gingival overgrowth at 12 months in the group of patients undergoing periodontal treatment, compared to those that did not, confirming the importance of good dental care and oral hygiene in preventing this potential complication of cyclosporine A use. Whilst this may have limited impact in most European and US transplant centres using tacrolimus-based immunosuppression, there are still many transplant centres worldwide using cyclosporine as primary immunosuppression. It should be noted that the study is very small (just 25 patients) with no a piori sample size calculation given. There is also a slightly worrying statement in the methods that the patients in the control group “…did not receive any periodontal treatment because they did not respond to the appeal for preventive treatment of periodontal disease.” This statement casts some doubt on the randomised nature of the trial, especially as no randomisation method is given.

Jadad score
1

Data analysis
Per protocol analysis

Allocation concealment
No

Trial registration
Not reported.

Funding source
Not reported