The status of dental and jaw bones in children and adolescents after kidney and liver transplantation

Ann Transplant. 2012 Dec 31;17(4):72-81. doi: 10.12659/aot.883697.

Abstract

Background: Systemic complications in patients after renal or liver transplantation may be localized in the oral cavity. Calcium-phosphate disturbances may affect the structure and metabolism of mandible bones, promote calcification of dental pulp, and in children may cause developmental defects of teeth. The aim of this study was to evaluate the incidence of dental and bone abnormalities in children and adolescents after kidney and liver transplantation with respect to the type of the transplanted organ and maintenance immunosuppression.

Material/methods: Overall, 23 kidney and 25 liver recipients (mean age: 13.95±4.2 yrs) were evaluated. Twenty patients received ciclosporin A (CsA) and 28 tacrolimus (TAC). Twenty-one kidney and 14 liver recipients were treated with steroids. Mean time after transplantation was 3.62±2.98 years.

Results: The severity of caries and percentage of odontogenic abnormalities (76.0% vs. 60.86%) was higher in liver transplant recipients. Positive correlations were found between discoloration of the deciduous teeth and liver transplantation, between enamel hypoplasia and kidney transplantation, and between treatment with CsA and its dose and blood concentration (p<0.05). Pulp stones were present in 13.04% of kidney vs. 8.0% in liver recipients, more often in those treated with CsA than with TAC. Jaw bone abnormalities were present in 30.43% kidney recipients vs. 12% liver recipients.

Conclusions: Both kidney and liver recipients present dental and bone abnormalities. The incidence of specific types of oral lesions is different in renal and liver graft recipients; however, it is also correlated with specific immunosuppression.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cyclosporine / adverse effects
  • Cyclosporine / therapeutic use
  • Dental Caries / etiology
  • Dental Enamel Hypoplasia / etiology
  • Dental Pulp Calcification / etiology
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Graft Rejection / prevention & control
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Jaw Diseases / epidemiology
  • Jaw Diseases / etiology*
  • Kidney Transplantation* / immunology
  • Liver Transplantation* / immunology
  • Postoperative Complications* / epidemiology
  • Retrospective Studies
  • Tacrolimus / adverse effects
  • Tacrolimus / therapeutic use
  • Tooth Discoloration / etiology
  • Tooth Diseases / epidemiology
  • Tooth Diseases / etiology*

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclosporine
  • Tacrolimus