ML McFadyen, MPMajola, R Nair*, M Govender*, H Laher*
DSU & Pharmacology Department and *Faculty of Dentistry, University of Durban-Westville, Private Bag X54001, Durban 4000
The aims of this study were to ascertain the prevalence and severity of phenytoin-induced gingival hyperplasia in patients who attend the Epilepsy Clinic at Prince Mshiyeni Memorial Hospital and to study the influence of oral hygiene, folic acid levels and phenytoin concentrations on the severity.
All patients on phenytoin who attended the Clinic in February were invited to participate. They were requested to undergo a dental examination and have blood taken for phenytoin and folic acid concentrations. The assessment of 6 teeth for gingival hyperplasia consisted of a 4 point score as follows:
0 = no observable hyperplasia;
1 = restricted to interdental papilla;
2 = increased size of interdental papilla and gingival margin;
3 = encroachment of gingiva onto clinical crown.
The average score for the 6 teeth was taken as the score for the patient and categorised as follows:
0 = no evidence of gingival hyperplasia
0.1-1.0 = mild
1.1-2.0 = moderate
2.1-3.0 = severe
Of the 135 dentate patients examined, 4% had severe, 52% moderate, 36% mild and only 8% no gingival hyperplasia. Twenty-seven patients were excluded from further concentration effect analysis because their serum levels were either below the assay sensitivity (25 patients) or suspiciously low on high doses.
A preliminary analysis showed that the concentration ranges for the different categories overlapped completely (No hyperplasia: 3.3-24.8mg/L; mild: 2.0-45.9mg/L; moderate: 2.7-40.0mg/L; severe: 8.5-24.6mg/L). However, the median value for severe gingival hyperplasia was substantially higher than that for moderate hyperplasia (21.33mg/L versus 13.18mg/L). The median concentrations for no gingival hyperplasia and mild hyperplasia were 10.3 and 10.8mg/l, respectively.
Reference: PAGE 5 () Abstr 580 [www.page-meeting.org/?abstract=580]
Poster: poster