Tacrolimus, on the other hand, is less toxic than cyclosporin, causing less severe gingival overgrowth, hepatic and renal toxicity. Management
If gingival overgrowth becomes a legitimate concern, initial management would be proper oral hygiene habits as it is the least invasive option to alleviate overgrowth. Otherwise, it may also be advisable to cease medication, although this should only be done with the patients’ medical practitioners’ consent, and complete resorption may still take up to 8 weeks. In cases where medication cannot be paused, patients’ medical practitioners or consultants should be consulted to discuss treatment options. Replacement drugs may be suggested. For example, vigabatrin may substitute phenytoin as anticonvulsant. However, this method may be ineffective for long-standing overgrowth. Another option is the surgical removal of excess tissue via gingivectomy. This method is widely successful, although recurrence has been reported for certain drugs. Nonetheless, the procedure is associated with risk of hemorrhage in the highly inflamed and vascularized gingiva. As such, CO2 laser or ND:YAG laser has been suggested for accurate, cauterized, and sterilized incisions. Other nonsurgical interventions such as fast mimicking diet regime and nonsurgical periodontal therapy has also been suggested for alleviating gingival overgrowth, thus reducing the need for surgical intervention. However, they could not prevent or fully resolve gingival overgrowth alone. == References ==
Clindamycin/tretinoin is a topical gel used in the treatment of acne. The two active ingredients are the antibiotic clindamycin phosphate (1.2%) and tretinoin (0.025%), a retinoid. The two active ingredients perform different functions, the clindamycin is active against gram-positive bacteria, including streptococci and penicillin-resistant staphylococci. The Tretinoin element acts to reduce the amount of oil released by oil glands in skin as well as encouraging skin cell replenishment. The topical treatment is stored in 2, 30, and 60 gram tubes and should be stored at 25°C (77°F), with the tube tightly shut away from light. Side effects may include peeling, redness, dryness, itching and photosensitivity. Also, topical clindamycin may rarely cause diarrhea or colitis. Sun exposure while using this preparation can cause skin irritation. Citations
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