title: Reduction in gingival overgrowth associated with conversion from cyclosporin A to tacrolimus.
abstract: BACKGROUND
  Unsightly gingival overgrowth affects many individuals immunosuppressed with cyclosporin A (CsA). Current management involves repeated periodontal surgery and intensive hygienist support. Tacrolimus is an effective alternative immunosuppressive agent for renal transplantation which does not appear to produce gingival enlargement.
  
  
  OBJECTIVE
  The purpose of the present study was to monitor the gingival response of 4 renal transplant patients (RTPs), with clinically significant CsA-induced gingival overgrowth, after their immunosuppressive therapy was switched to tacrolimus.
  
  
  METHODS
  Intra-oral photographs and alginate impressions were taken both prior to the drug conversion and again, 6 to 9 months later. Gingival overgrowth scores were determined, from plaster models on both these occasions.
  
  
  RESULTS
  All of the RTPs experienced significant resolution of their gingival enlargement within the time period studied; however, only one had complete regression.
  
  
  CONCLUSIONS
  It is concluded that conversion of RTPs with gingival overgrowth from CsA to tacrolimus may provide an effective management strategy for this clinical problem.
authors.affiliation: Turner Dental School, University of Manchester, UK. jamesj@fsl.den.man.ac.uk
authors.forename: J A
authors.initials: JA
authors.lastname: James
authors.forename: S
authors.initials: S
authors.lastname: Boomer
authors.forename: A P
authors.initials: AP
authors.lastname: Maxwell
authors.forename: P S
authors.initials: PS
authors.lastname: Hull
authors.forename: C D
authors.initials: CD
authors.lastname: Short
authors.forename: B A
authors.initials: BA
authors.lastname: Campbell
authors.forename: R W
authors.initials: RW
authors.lastname: Johnson
authors.forename: C R
authors.initials: CR
authors.lastname: Irwin
authors.forename: J J
authors.initials: JJ
authors.lastname: Marley
authors.forename: H
authors.initials: H
authors.lastname: Spratt
authors.forename: G J
authors.initials: GJ
authors.lastname: Linden
mesh_terms: D000293:Adolescent; D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D016559:Tacrolimus / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus