The periodontium and periodontal disease activity can be affected by systemic drug therapy. Immunosuppressant drugs are one among such category. These drugs in common, influences the response of gingival and periodontal tissues to bacterial plaque. An extremely effective and most commonly used immunosuppressant drug for organ transplant procedures is cyclosporine A. The drug is also associated with various untoward effects, including gingival overgrowth. Corticosteroids are another major drug category, which may either exert its action as an immunosuppressant or as an anti-inflammatory agent. This review considers the pharmacokinetics, pharmacodynamics, and unwanted effects of immunosuppressants, on the gingival tissues.
Page, R. C. & Schroeder H. E. Pathogenesis of inflammatory periodontal disease. Laboratory Investigations; 1976, 33, 235- 248.
Page, R. C. & Schroeder, H. E. Current status of Ihe host response in chronic marginalgingivitis. Journal of Periodontology 1981; 52, 477-491.
Aws Alani& Robin Seymour; Systemic medication and the inflammatory cascade, periodontology 2000, vol. 64, 2014, 198–210.
Fu E, Hsieh YD, Nieh S, Wikesjo UM, Liu D. Effects of cyclosporine A on alveolar bone: an experimental study in therat. Journal of Periodontology 1999: 70: 189–194.
Gray DW. Mycophenolatemofetil for transplantation: new drug, old problems? Lancet 1995: 346: 390.
Rateitschak P, Hefti E M et al. Initial observation that cyclosporine-A induces gingival enlargement in man. Journal of Clinical Periodontology. 1983;10:237-46.
MacGraw T, Lam S et al. Cyclosporin induced gingival overgrowth: correlation with dental plaque scores, gingivitis scores and cyclosporine levels in serum and saliva. Oral Surgery Oral Med Oral Pathology 1987;64:293-7.
Peers SH, Smillie F, Elderfield AJ, Flower RJ. Glucocorticoid and non-glucocorticoid induction of lipocortins (annexins) 1 and 2 in rat peritoneal leucocytes in vivo. Br J Pharmacology 1993: 108: 66–72.
Newton R. Molecular mechanisms of glucocorticoid action: what is important? Thorax 2000: 55: 603–613.
Seymour RA, Heasman PA. Drugs and the periodontium. J Clin Periodontol 1988: 15: 1–16.
Ezzat BA. Validity of prevention of glucocorti coidinduce dalveolar bone loss in rat by either calcitonin or alendronate administration. Arch Oral Biol 2010: 55: 788–796.
Breivik T, Opstad PK, Gjermo P, Thrane PS. Effects of hypothalamic-pituitary-adrenal axis reactivity on periodontaltissue destruction in rats. Eur J Oral Sci 2000: 108:115–122.
Hilgert JB, Hugo FN, Bandeira DR, Bozzetti MC. Stress, cortisol, and periodontitis in a population aged 50 yearsand over. J Dent Res 2006: 85: 324–328.
Nicopoulou-Karayianni K, Tzoutzoukos P, Mitsea A, Karayiannis A, Tsiklakis K, Jacobs R, Lindh C, van der Stelt P, Allen P, Graham J, Horner K, Devlin H, Pavitt S, Yuan J. Tooth loss and osteoporosis: the OSTEODENT Study. J Clin Periodontol 2009: 36: 190–197.
