• Zhila Nawroz Othman Board Candidate of Oral and Maxillofacial Medicine, Sulaimani Teaching Hospital, Kurdistan Region, Iraq.
  • Khadija Mohammed Ahmed Department of Oral Diagnosis, College of Dentistry University of Sulaimani, Kurdistan Region, Iraq.
  • Dana Ahmed Sharif Department of Medicine, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.




Renal transplant, Immunosuppression, Oral hygiene, Oral lesions



Renal transplant is the treatment of choice for patients with end-stage renal disease. To prevent graft rejection, recipients are receiving a combination of immunosuppressive medications. Among common side effects of the therapy, many oral manifestations are found either as a direct effect of the drugs or due to suppression of the immune system.


This study aimed to investigate oral problems and their relation to the oral hygiene status of the recipients.

Patients and methods

This cross-sectional study was performed on 150 renal transplant recipients in Sulaimani city, Kurdistan Region, Iraq, from December 2018 to June 2019. Any existing condition was diagnosed on a clinical basis. Additional data including a questionnaire of demographic, pharmacologic, and transplant duration were also collected. 


The 150 transplant recipients included 103 males and 47 females (mean age 40.5 years). A total of 22.1% had at least one oral lesion. The most common lesion was gingival hyperplasia in 16.7% of cases who received cyclosporine A as the primary immunosuppressive medication, followed by candida infection 4.7%, which were mostly in patients with a transplant duration of less than 3 months.


In this study, we reported a lower incidence of oral lesions compared to other studies published in the literature. Improvement of oral hygiene status of the recipients is associated with reduced oral manifestation specifically gingival hyperplasia. Also, using prophylactic antifungal and antiviral agents during the first few months of transplant has a direct effect on reducing the number and frequency of viral and fungal infections.


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