1993 Volume 31 Issue 3 Pages 551-558
Since we have had an opportunity to observe the condition of the oral cavity of patient who had received Cyclosporine A (CsA) postoperatively following liver transplantation, we shall principally report on the dental and histopathological findings. The patient was 3 years 3 months old, the dose of CsA was 180 mg/d and the duration of therapy was 28 months.
Papillary gingival enlargement was found throughout the entire gingival of both the maxilla and mandible. The color of the hypertrophic gingiva was pink, and it was elastic hard. The pockets in the areas of the gingival enlargement were 1-4 mm deep, and there was no drange or hemorrhages. Discoloration of the teeth was observed. No particularly abnormal findings were detected on the radiograph.
Histopathologically, partial parakeratinized squamous epithelium, acantosis and elongation of epithelial projection were detected in the epithelium of the enlarged gingiva. In the deeper connective tissues, an increase of dense collagen bunddles was exhibited.
What is important in the oral management of this patient is the prevention of dental caries and infection originating in the area of the gingiva enlargement. Since gingivectomy cannot be employed to treat this disease, it is important to suppress the progression of gingival hypertrophy by proper brushing as well as aggressively to pursue caries control by topical application of fluoride, pit and fissure sealant, etc.
