Conversion from Cyclosporin A to Tacrolimus as a Non-Surgical Alternative to Reduce Gingival Enlargement: A Preliminary Case Series

  1. Dr. Gonzalo Hernández
  2. Lorenzo Arriba
  3. María Cruz Frías
  4. José Carlos de la Macorra García
  5. Enrique Moreno González
Journal of periodontology

ISSN: 0022-3492

Year of publication: 2003

Volume: 74

Issue: 12

Pages: 1816-1823

Type: Article

DOI: 10.1902/JOP.2003.74.12.1816 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Journal of periodontology


Cited by

  • Scopus Cited by: 37 (01-09-2023)
  • Web of Science Cited by: 28 (18-09-2023)
  • Dimensions Cited by: 29 (05-04-2023)

JCR (Journal Impact Factor)

  • Year 2003
  • Journal Impact Factor: 1.49
  • Journal Impact Factor without self cites: 1.103
  • Article influence score: 0.0
  • Best Quartile: Q1
  • Area: DENTISTRY, ORAL SURGERY & MEDICINE Quartile: Q1 Rank in area: 7/46 (Ranking edition: SCIE)

SCImago Journal Rank

  • Year 2003
  • SJR Journal Impact: 1.277
  • Best Quartile: Q1
  • Area: Periodontics Quartile: Q1 Rank in area: 1/7


(Data updated as of 05-04-2023)
  • Total citations: 29
  • Recent citations: 2
  • Relative Citation Ratio (RCR): 0.9
  • Field Citation Ratio (FCR): 6.67


Background: Gingival enlargement (GE) is a frequent side effect that occurs in organ transplant recipients (OTR) after the administration of cyclosporin A (CsA). The availability of new drugs used to suppress graft rejection in OTR offers an opportunity to manage GE non-surgically. This preliminary case series aimed to analyze the effect of CsA withdrawal and its substitution by another immunosuppressant in OTR with severe GE. Methods: Four organ transplant recipients who had received a liver or renal allograft were recruited for this study. All OTR had developed clinically severe CsA-induced GE. GE scores were assessed for each patient at baseline and at weeks 2, 4, 8, 12, 16, and 54 following conversion to tacrolimus. Scaling and root planing were initially performed and repeated monthly during the first 6 months. Careful polishing of the teeth was carried out once every 2 weeks until month 6 and then monthly until month 12. Hygiene instructions and reinforcement to optimize oral hygiene were maintained throughout the study. Results: The four patients showed a rapid decrease in their gingival symptoms and in the size of the gingivae. This change was clinically evident 8 weeks after conversion to tacrolimus. One year later, all the patients experienced GE regression, although some anatomic irregularities persisted in the interdental papillae of one of the patients. No adverse effects from tacrolimus were observed during the study except in one patient who presented headaches. Conclusion: It seems that CsA withdrawal and its conversion to tacrolimus in organ transplant recipients who develop severe gingival enlargement, together with an extensive plaque control program, provide an effective means to control/eliminate gingival hyperplasia, hyperplasia, with minimal risk of graft dysfunction.