title: Prevalence of gingival overgrowth in transplant patients immunosuppressed with tacrolimus.
abstract: OBJECTIVE
  The study aims to determine the prevalence and severity of gingival overgrowth in a group of adult organ transplant recipients immunosuppressed with tacrolimus in comparison with ciclosporin, and to examine various risk factors for the development of gingival overgrowth.
  
  
  METHODS
  Forty patients taking tacrolimus were compared with 197 ciclosporin patients. Demographic, pharmacological and periodontal data were recorded for all patients. Comparison between the groups was made using independent sample t-tests, chi2 statistic or Mann-Whitney test. The effects of risk variables on overgrowth severity were examined using forward and backward stepwise regression analysis.
  
  
  RESULTS
  Those taking tacrolimus had a significantly lower mean gingival overgrowth score (14.1%) compared with ciclosporin (22.4%). Fifteen percent of the tacrolimus group had clinically significant gingival overgrowth compared with 30% in the ciclosporin group (p=0.053).
  
  
  CONCLUSIONS
  The prevalence and severity of gingival overgrowth is less in adult transplant patients taking tacrolimus compared with ciclosporin. Concomitant use of calcium channel blockers and previous medication with ciclosporin are significant risk factors for the presence and severity of gingival overgrowth. Patients who have alteration of their immunosuppressant from ciclosporin to tacrolimus may persist in demonstrating gingival overgrowth attributable to their ongoing therapy with calcium channel blockers.
authors.affiliation: School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4BW, UK. j.s.ellis@ncl.ac.uk
authors.forename: J S
authors.initials: JS
authors.lastname: Ellis
authors.forename: R A
authors.initials: RA
authors.lastname: Seymour
authors.forename: J J
authors.initials: JJ
authors.lastname: Taylor
authors.forename: J M
authors.initials: JM
authors.lastname: Thomason
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016009:Chi-Square Distribution; D016572:Cyclosporine / Q000627:therapeutic use; D004347:Drug Interactions; D005260:Female; D019214:Gingival Overgrowth / Q000139:chemically induced*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D011239:Prednisolone / Q000627:therapeutic use; D012044:Regression Analysis; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D002121:Calcium Channel Blockers; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D001379:Azathioprine; D016559:Tacrolimus