Abstract

Background: The prevalence of gingival overgrowth in renal transplant recipients maintained on cyclosporine
A remains as essential and still unexplained problem for the patient, physician and periodontist.
Clinically significant gingival overgrowth may be associated with inflammation, pain, tooth migration, mastication and cosmetic disorders and it may cause physiological and psychological morbidity. Tacrolimus is a new immunosuppressant, a therapeutic alternative to CsA and has no adverse effect on the gingival tissues.
Case Report: We reported on a case of five patients after renal transplantation with severe CsA – induced
gingival overgrowth and different treatment modalities. Two of them underwent periodontal
therapy and surgical treatment - gingivectomy. The next three patients were converted from CsA to tacrolimus. Hygiene instructions to all patients were given. After 2 years in surgery treated patients gingival overgrowth, degree and inflammation level were lower but still present. In patients converted to tacrolimus treatment almost complete regression of the gingival overgrowth without surgical intervention were observed.
Conclusions: Both periodontist and patient have an important role to play in improving oral hygiene and
gingival health. Cyclosporine-induced gingival overgrowth is effectively ameliorated by conversion
from CsA to tacrolimus while surgical intervention provides only temporary remedy.

Keywords: Cyclosporine A, Gingival Overgrowth, Tacrolimus, periodontal treatment, Gingivectomy