Efficacy of AZM therapy in patients with gingival overgrowth induced by Cyclosporine A: a systematic review

Clementini, Marco; Vittorini, Gianluca; Crea, Alessandro; Gualano, Maria Rosaria; Macrì, Ludovica Antonella; Deli, Giorgio; Torre, Giuseppe La

doi:10.1186/1472-6831-8-34

Cited by 15 publications

(9 citation statements)

References 49 publications

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“…A systematic review done in 2008 on the efficacy of AZM on cyclosporine A-induced gingival enlargement revealed that a 5-day course of Azithromycin with Scaling and Root Planning reduces the degree of gingival overgrowth. 22 The present study revealed a similar result that azithromycin has a significant effect on the reduction of gingival enlargement on patients with cyclosporine A-induced gingival enlargement. It showed the pooled effect in terms of mean difference of 1.58(95%CI: 0.77-2.39).…”

Section: Discussionsupporting

confidence: 86%

“…The previous study didn't show the pooled effect of azithromycin on cyclosporine-induced gingival enlargement due to limited studies. 22 Meanwhile, Azithromycin has a statistically significant effect of reducing bleeding on probing tendencies in patients with cyclosporine-induced gingival enlargement with a mean difference of 1.32(95% CI: 0.39-2.24).…”

Section: Discussionmentioning

confidence: 99%

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The efficacy of azithromycin on cyclosporine-induced gingival enlargement: Systematic review and meta-analysis

Teshome

Girma

Aniley

2020

Journal of Oral Biology and Craniofacial Research

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Background: Cyclosporine is one of the powerful immunosuppressant drugs commonly used to avoid transplant rejection and autoimmune condition management. However, this drug has many side effects, such as nephrotoxicity, hepatotoxicity, hypertension, and gingival overgrowth. Gingival enlargement is one of the most commonly reported adverse drug outcome in patients with long term usage of the drug with the exclusion of other confounding factors. Hence, this systematic review and Meta-analysis was planned to investigate the effect of azithromycin on cyclosporine A-induced gingival enlargement.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

The efficacy of azithromycin on cyclosporine-induced gingival enlargement: Systematic review and meta-analysis

Teshome

Girma

Aniley

2020

Journal of Oral Biology and Craniofacial Research

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“…nifedipine) have been associated with gingival enlargement (7). The prevalence of this side‐effect varies from 5% to 50% in adults (79). For cyclosporine, the highest prevalence of gingival overgrowth was observed in children (191) and decreased with increasing patient age (152).…”

Section: Epidemiologymentioning

confidence: 99%

Principles of periodontology

Dentino¹,

Lee²,

Mailhot³

et al. 2012

Periodontology 2000

177

156

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Periodontal diseases are among the most common diseases affecting humans. Dental biofilm is a contributor to the etiology of most periodontal diseases. It is also widely accepted that immunological and inflammatory responses to biofilm components are manifested by signs and symptoms of periodontal disease. The outcome of such interaction is modulated by risk factors (modifiers), either inherent (genetic) or acquired (environmental), significantly affecting the initiation and progression of different periodontal disease phenotypes. While definitive genetic determinants responsible for either susceptibility or resistance to periodontal disease have yet to be identified, many factors affecting the pathogenesis have been described, including smoking, diabetes, obesity, medications, and nutrition. Currently, periodontal diseases are classified based upon clinical disease traits using radiographs and clinical examination. Advances in genomics, molecular biology, and personalized medicine may result in new guidelines for unambiguous disease definition and diagnosis in the future. Recent studies have implied relationships between periodontal diseases and systemic conditions. Answering critical questions regarding host-parasite interactions in periodontal diseases may provide new insight in the pathogenesis of other biomedical disorders. Therapeutic efforts have focused on the microbial nature of the infection, as active treatment centers on biofilm disruption by non-surgical mechanical debridement with antimicrobial and sometimes anti-inflammatory adjuncts. The surgical treatment aims at gaining access to periodontal lesions and correcting unfavorable gingival/osseous contours to achieve a periodontal architecture that will provide for more effective oral hygiene and periodontal maintenance. In addition, advances in tissue engineering have provided innovative means to regenerate/repair periodontal defects, based upon principles of guided tissue regeneration and utilization of growth factors/biologic mediators. To maintain periodontal stability, these treatments need to be supplemented with long-term maintenance (supportive periodontal therapy) programs.

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“…Wahlstrom et al 13 described two cases of gingival hyperplasia that improved after treatment with azithromycin. A systematic review revealed that a short course of azithromycin or metronidazole along with proper regular oral hygiene is helpful in reducing the degree of gingival overgrowth 14. There is a general agreement that an initial threshold serum concentration of the offending drug (phenytoin) is required to initiate gum hypertrophy and it has been suggested that the higher the serum concentration the quicker gum hypertrophy develops 15…”

Section: Discussionmentioning

confidence: 99%

A well known and important adverse effect of phenytoin in a neurosurgical patient

Tomar¹,

Saxena

Kumar

et al. 2015

BMJ Case Reports

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Efficacy of AZM therapy in patients with gingival overgrowth induced by Cyclosporine A: a systematic review

Cited by 15 publications

References 49 publications

The efficacy of azithromycin on cyclosporine-induced gingival enlargement: Systematic review and meta-analysis

The efficacy of azithromycin on cyclosporine-induced gingival enlargement: Systematic review and meta-analysis

Principles of periodontology

A well known and important adverse effect of phenytoin in a neurosurgical patient

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