The effect of phenytoin medication on dentin apposition, root length, and caries progression in rat molars

To determine the effect of phenytoin (PHT) on dentin apposition and the rate of caries progression in dentin, 40 Wistar rats were treated daily for 35 days with intraperitoneal injections of 5,5-diphenylhydantoin. Twenty-eight controls received saline with pH adjusted to that of PHT. One PHT and one control group were fed a 43% sucrose diet, and the others a non-cariogenic pellet diet. Streptococcus sobrinus was inoculated to induce caries. Schiff staining was used to determine caries. The areas of dentin apposition and dentinal caries lesions were quantified after tetracycline staining. The root lengths were measured. PHT reduced slightly the dentin apposition and activated significantly the progression of the dentinal carious lesions. No difference in caries initiation was found. The high-sucrose diet reduced dentin apposition and increased the rate of progression of existing caries greatly. Our study suggests that both the high-sucrose diet and PHT have an effect on secreting odontoblasts, which can be seen as an alteration in dentin apposition and caries progression rates in dentin.