Conclusions

From the findings of the present study, we can conclude that:

1.    Cyclosporine A could induce gingival overgrowth.

2.    Azithromycin and metronidazole might induce regression or inhibition of Cyclosporine A induced gingival overgrowth.

3.    Azithromycin is more potent than metronidazole in the management of Cyclosporine A induced gingival overgrowth.

4.    Stimulation of  TGF-β and IL-6 might play an essential biological role in the development and progression of Cyclosporine A induced gingival overgrowth.

5.    Inhibition of MMP-1 might enhance development and progression of Cyclosporine A induced gingival overgrowth.

6.    The utilized treatment protocols could regress or inhibit Cyclosporine A induced gingival overgrowth through elimination of the negative effects of Cyclosporine A upon TGF-β, IL-6 and MMP-1 cytokines.

7.    Azithromycin-metronidazole combination protocol causes significant improvement and complete regression of Cyclosporine A induced gingival overgrowth.

8.    The therapeutic efficacy of Azithromycin and metronidazole combination is the best for treatment of Cyclosporine A induced gingival overgrowth when it is compared to the other pharmacological agents used in the studied groups.

Conclusions

From the findings of the present study, we can conclude that:

1.    Cyclosporine A could induce gingival overgrowth.

2.    Azithromycin and metronidazole might induce regression or inhibition of Cyclosporine A induced gingival overgrowth.

3.    Azithromycin is more potent than metronidazole in the management of Cyclosporine A induced gingival overgrowth.

4.    Stimulation of  TGF-β and IL-6 might play an essential biological role in the development and progression of Cyclosporine A induced gingival overgrowth.

5.    Inhibition of MMP-1 might enhance development and progression of Cyclosporine A induced gingival overgrowth.

6.    The utilized treatment protocols could regress or inhibit Cyclosporine A induced gingival overgrowth through elimination of the negative effects of Cyclosporine A upon TGF-β, IL-6 and MMP-1 cytokines.

7.    Azithromycin-metronidazole combination protocol causes significant improvement and complete regression of Cyclosporine A induced gingival overgrowth.

8.    The therapeutic efficacy of Azithromycin and metronidazole combination is the best for treatment of Cyclosporine A induced gingival overgrowth when it is compared to the other pharmacological agents used in the studied groups.