The periodontal condition of 40 adult epileptic subjects (mean age 51 years) receiving long-term therapy (mean 18 years) with phenytoin (PHT) or carbamazepine (CBZ) was studied. The subjects completed a questionnaire and underwent clinical and radiologic examination. Patients receiving PHT exhibited the same level of alveolar bone loss as those receiving CBZ. Patients receiving PHT exhibited more units with gingival overgrowth, reflected by the significantly higher number of gingival units with increased probing depth (p < 0.05). The results indicate that long-term PHT does not result in increased risk for alveolar bone loss as compared with CBZ.
The influence of the anticonvulsive drug phenytoin on the periodontal tissues during orthodontic tooth movement in the rat was studied. The experimental and the control group each consisted of 10 Sprague-Dawley rats. The test group was injected daily with phenytoin during the experimental period of 6 weeks. A fixed appliance for expansion was applied on the first molars in both groups after 2 weeks (day 15). At the end of the experiment (day 42), radiographic measurements revealed less tooth movement in the phenytoin-treated rats. Compared to the control group, significant histologic changes in the periodontal tissues such as increased density of fibroblasts, decreased number of osteoclasts in contact with alveolar bone wall of the pressure side and deeper layer of non-mineralized osteoid on the tension side were observed in the phenytoin group.
– Human mononuclear cells purified by Lymphoprep flotation were incubated with phenytoin (PHT) (20 μg/ml) or its metabolite p‐HPPH (2 μg/ml) in the presence of Concanaval‐in A (10 μg/ml) in vitro. The results indicate that phenytoin and its metabolite p‐HPPH induce the release of a mononuclear cell factor(s) that activates quiescent human gingival fibroblast to synthesize DNA.
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