Does the Use of Tacrolimus Influence Alveolar Bone Metabolism?

Background: Tacrolimus is commonly used in the medical area to avoid the rejection of grafted organs. Some studies have suggested that tacrolimus is an immunosuppressor that increases bone turnover and the development of severe osteopenia. In dentistry this effect may interfere with oral treatments. Objectives: A systematic literature review to test the hypothesis that treatment with immunosuppressor tacrolimus may interfere with alveolar bone metabolism. Search Strategy: Research in the health science databases was performed and includes articles published up to August 2011. Selection Criteria: Studies in animals and humans using tacrolimus as an immunosuppressor and capable of interfering with alveolar bone metabolism were included. Data Collection and Analysis: The key words used were: tacrolimus and alveolar bone or tacrolimus and alveolar bone loss or FK506 and alveolar bone or FK506 and alveolar bone loss. The articles were initially selected by title and abstract and then potentially eligible articles were read and those that fulfilled the inclusion criteria were carefully analyzed and classified (A, B and C). Results: From a total of 745 references, only 6 articles fulfilled the eligibility criteria. Three articles were classified as A and 3 as C. In spite of the methodological differences in the 6 articles (3 animal and 3 human) tacrolimus was not found to cause damage to alveolar bone tissue. Conclusions: In humans the results are still not conclusive. In animals: tacrolimus does not produce alveolar bone loss, whereas in humans there is no evidence that this immunosuppressor produces alveolar bone loss.