Gingival overgrowth in subjects under immunosuppressive regimens based on cyclosporine, tacrolimus, or sirolimus (original) (raw)

2010, Journal of Clinical Periodontology

nephrotoxicity, hypertension, diabetes, dyslipidemia, neurotoxicity, osteopenia and oral changes such as gingival overgrowth [13,14]. Many studies have shown that gingival overgrowth is commonly found in immunosuppressive regimens based on Cyclosporine A. Several factors other than cyclosporine use, such as the use of prednisone, azathioprine, and calcium channel blockers (CCB), as well as gingival inflammation, appears to have an influence on the occurrence and severity of this event [15,16]. Tacrolimus has been used successfully to prevent acute rejection of renal transplantation. It inhibits calcineurin, a Ca 2+ calmodulindependent phosphatase, which results in reduced expression of interleukin-2 by T lymphocytes [17]. Tacrolimus has been associated with many side effects including nephrotoxicity, neurotoxicity and the induction of a diabetic state. Unlike cyclosporine A, studies that evaluated immunosuppressive agents based on tacrolimus failed to demonstrate gingival overgrowth within tacrolimus-based therapies [16,18], while others demonstrated a lower prevalence and severity of gingival overgrowth when compared with cyclosporine A-based therapies [15,19]. There is scarce data among Sudanese population related to comparisons of prevalence and severity of gingival overgrowth within