Abstract
The authors experienced cases of dental treatment for two children with liver transplants from living donors. The first case was a girl who had received the transplant from her mother, the third case in Japan, and the longest surving case after this operation.
The patient visited the Special Patient Clinic of Matsumoto Dental College Hospital at 10 years of age. She had been prescribed 100 mg of cyclosporin A and 1.5 mg of predonisolone daily, extending over a long period of time. She looked rather small but healthy, and went to school every day. Her laboratory examination data did not reveal any remarkable deviation from the normal limits.
The chief complaint was a marked gingiva swelling covering the upper central incisors. After consultation with the surgeons, we removed the enlarged gingiva to help the eruption of the teeth. The excised gingiva was examined histopathologically. Pathologists diagnosed it as an eruption cyst, and did not find any remarkable increase of the dense collagen bundles. The central incisors soon erupted satisfactorily.
We recalled her every three months to treat early caries and to give instructions on plaque control. More than two years since the initial treatment, good dental health has been maintained. No gingival hypertrophy is manifest.
The second case was a boy who underwent the transplantation operation at 6 years of age. However, his recovery was not so very satisfactory and he also had suffered from hepatitis C.
The patient visited our clinic at 8 years of age. He had been prescribed 150mg of cyclosporin A and other drugs. He looked small and not very well. While obvious edema and jaundice were manifested on his face. There was also considerable liver dysfunction and prolonged prothrombin time.
At the first visit, he suffered from bleeding from enlarged gingiva. There were many dental caries and gingivitis. The most careful medical management was required for him, and also behavior management was not so easy since he had become a very fearful child.
We treated the dental diseases gradually with the surgeon's consultation. In the end result,4 deciduous teeth were removed and 10 teeth were restored without complication. He is now checked periodically under our recall system. We are striving for controlling the enlargement of the gingiva through vigorous brushing.
