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Phenytoin as a risk factor in gingival hyperplasia
F Perlík1, M Kolínová, J Zvárová
1First Department of Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Therapeutic Drug Monitoring
|October 1, 1995
Summary
Phenytoin use in epilepsy patients can lead to gingival hyperplasia, particularly with higher doses and longer treatment durations. Over 75% of patients studied showed mild or no gum overgrowth, but severity correlated with drug levels.
Area of Science:
- Pharmacology
- Neurology
- Oral Medicine
Background:
- Epilepsy is a common neurological disorder managed with antiepileptic drugs.
- Phenytoin is a widely used antiepileptic medication.
- Gingival hyperplasia is a known side effect of phenytoin therapy.
Purpose of the Study:
- To investigate the prevalence and severity of gingival hyperplasia in epilepsy patients on long-term phenytoin treatment.
- To determine the correlation between gingival hyperplasia and phenytoin dosage, serum concentrations, and other clinical factors.
Main Methods:
- A cross-sectional study involving 54 out-patients with epilepsy on phenytoin for over one year.
- Clinical examination for gingival hyperplasia.
- Statistical analysis comparing lesion severity with phenytoin dosage, total and free drug concentrations, and other parameters.
Main Results:
- Approximately 76% of patients exhibited mild or no gingival hyperplasia.
- A positive correlation was observed between gingival hypertrophy and increasing phenytoin dosage per unit of body weight.
- Higher total and free phenytoin concentrations were significantly associated with a progressive trend of increasing gingival hyperplasia.
Conclusions:
- Long-term phenytoin use is associated with gingival hyperplasia in epilepsy patients.
- Phenytoin dosage, duration of treatment, and serum drug concentrations are key factors influencing the development and severity of gingival hyperplasia.