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The effect of a plaque control program on the development of phenytoin-induced gingival overgrowth. A 2-year
Insights
A plaque control program did not prevent phenytoin (PHT)-induced gingival overgrowth in epileptic children. Despite oral hygiene efforts, gingival enlargement occurred, showing the limitations of plaque control in managing this side effect.
Area of Science:
- Pharmacology
- Pediatric Dentistry
- Periodontology
Background:
- Phenytoin (PHT) is an anticonvulsant medication known to cause gingival overgrowth.
- Gingival overgrowth can lead to various oral health complications.
- Effective management strategies for PHT-induced gingival overgrowth are crucial.
Purpose of the Study:
- To investigate the efficacy of a plaque control program in preventing phenytoin (PHT)-induced gingival overgrowth in epileptic children.
- To assess the longitudinal effects of PHT medication on gingival health parameters.
Main Methods:
- A 2-year longitudinal study involving 16 epileptic children (8-16 years old) receiving PHT medication.
- Implementation of a preventive plaque control program including oral hygiene instruction and professional cleaning.
- Monitoring of visible plaque index (VPI), gingival bleeding index (GBI), probing depth, and gingival overgrowth.
Main Results:
- No patients developed pseudopockets (≥4 mm) after 2 years of PHT therapy.
- A statistically significant increase in marginal gingival thickness was observed in all patients within 1 month.
- Gingival enlargement did not significantly increase after the first year and was not correlated with PHT plasma concentration.
Conclusions:
- The implemented plaque control program was ineffective in preventing PHT-induced gingival overgrowth.
- Gingival enlargement is an early and consistent side effect of PHT medication in children.
- Further research is needed to explore alternative prevention and management strategies.
Abstract:
The effect of a plaque control program on the development of phenytoin(PHT)-induced gingival overgrowth was studied in 16 epileptic children, 8-16 years of age during a 2-year longitudinal study. The parameters studied were: visible plaque index (VPI), gingival bleeding index (GBI), probing depth and gingival overgrowth. A preventive program was instituted before the start of the PHT-medication and included oral hygiene instruction and frequent professional tooth cleaning during the observation period. When gingival overgrowth was evaluated on the basis of probing depth, no patients on PHT therapy for 2 years developed pseudopockets (greater than or equal to 4 mm). During the 2-year observation period, there was a statistically significant increase (p less than 0.01) in the thickness of the marginal gingiva bucco-lingually in all patients. This gingival enlargement was already evident (p less than 0.01) after 1 month. The degree of gingival enlargement in this patient group did not increase significantly after the 1st year of PHT-medication and was not significantly correlated to the plasma concentration of PHT. The results of this study show that the development of PHT-induced gingival overgrowth could not be prevented by this specific plaque control program.