Salivary phenytoin levels in institutionalized epileptics

Risk factors for drug‐induced gingival overgrowth

“…As with serum concentrations there is no clear picture. For phenytoin, some studies have reported that salivary concentrations are positively correlated with gingival overgrowth (Babcock & Nelson 1964, Conard et al 1974, Hassell et al 1983), whilst others have failed to confirm such a relationship (Ball et al 1996, Dahllof & Modeer 1986, Modeer & Dahllof 1987. It is possible that the concentration of phenytoin or its major metabolite (HPPH) present in saliva are not representative of those present at the site of action, that is, the gingival tissue itself.…”

Plasma and Gingival Crevicular Fluid Phenytoin Concentrations as Risk Factors for Gingival Overgrowth

“…As mentioned before, drug‐induced gingival overgrowth is thought to be a multifactorial model. Inflammatory cytokines, growth factors, pharmacokinetic variables, periodontal variables, and genetic factors might have possible roles in this model 10‐26 . Thus, newer molecular approaches are needed to clearly establish the pathogenesis of drug‐induced gingival enlargement.…”

“…Inflammatory cytokines, growth factors, pharmacokinetic variables, periodontal variables, and genetic factors might have possible roles in this model. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Thus, newer molecular approaches are needed to clearly establish the pathogenesis of druginduced gingival enlargement.…”

“…On the other hand, many studies 19‐26 have investigated the relationship between the extent and severity of gingival overgrowth and drug variables, such as dose, duration, serum, and salivary concentrations. Gingival crevicular fluid (GCF) is a complex mixture of substances derived from serum, leukocytes, structural cells of the periodontium, and oral bacteria 27 .…”

“…It was speculated that various growth factors were targets for these drugs, and their activation may be important in the pathogenesis of druginduced gingival overgrowth. 7 On the other hand, many studies [19][20][21][22][23][24][25][26] have investigated the relationship between the extent and severity of gingival overgrowth and drug variables, such as dose, duration, serum, and salivary concentrations. Gingival crevicular fluid (GCF) is a complex mixture of substances derived from serum, leukocytes, structural cells of the periodontium, and oral bacteria.…”