Cyclosporine (an immunosuppressant used after organ transplants) can cause which oral complication?

Correct answer: D. Gingival hyperplasia (similar to phenytoin and calcium channel blockers)

• A. Periapical abscess is from pulpal pathology — not a drug effect of cyclosporine.
• B. Oral candidiasis occurs from corticosteroids and immunosuppression generally — not specifically from cyclosporine's gingival effect.
• C. Xerostomia is from anticholinergics, antihistamines, antidepressants, diuretics — not cyclosporine.
• D. Correct. GINGIVAL HYPERPLASIA is a well-recognized oral side effect of cyclosporine. The mechanism involves increased fibroblast proliferation and decreased collagenase activity, leading to excess collagen accumulation in the gingival connective tissue. It occurs in 25-30% of patients on cyclosporine and is worsened by poor oral hygiene. The 'Big 3' causes of drug-induced gingival hyperplasia: Phenytoin (anticonvulsant), Calcium channel blockers (amlodipine, nifedipine), Cyclosporine (immunosuppressant).