PERIO - Periodontal Practice Today 5 (2008), No. 2 (12.09.2008)
Ciclosporin A-induced gingival enlargement. Clinical and microbiological modifications after conversion to the medication tacrolimus: an account of ten patient cases
Purschwitz, Regina / Schmidt, Hannelore / Jentsch, Holger
The objective of the investigation was to assess changes of periodontal variables, particularly the gingival width, hyperplasia index and the subgingival flora, after changing medication from ciclosporin A to tacrolimus. Ten patients with gingival enlargement were included in the study. Plaque index, gingival index and hyperplasia index together with papillary and marginal gingival width were measured immediately after the change-over as well as after 4, 8 and 26 weeks. At the beginning and end of the investigations, probing depths were determined and subgingival plaque samples were assessed using polymerase chain reactions to Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Eikenella corrodens, Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia, Treponema denticola and Capnocytophaga. Significant improvements were found in the probing depth, the hyperplasia index and the papillary gingival width after 8 and 26 weeks as well as in the marginal gingival width after 8 weeks. T. forsythia was significantly reduced at the end of the study into subgingival plaque. The change in medication from ciclosporin A to tacrolimus had positive effects on clinical variables and the subgingival biofilm.
Keywords: ciclosporin A, gingival enlargement, subgingival biofilm, tacrolimus