Medico-Legal Update

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Phenytoin Induced Gingival overgrowth - a Case Report


Affiliations
1 Department of Periodontology, Rural Dental College, Loni, Maharashtra, India
2 Department of Pedodontics & Preventive Dentistry, Rural Dental College, Loni, Maharashtra, India
3 Department of Periodontics, A. B.Shetty Memorial Institute of Dental Sciences, Mangalore, India
4 Depatrment of Periodontics, Rural Dental College, Loni, Maharashtra, India
     

   Subscribe/Renew Journal


Gingival overgrowth is a rare disorder characterized by the proliferative fibrous over growth of the gingival tissue. It usually develops as an isolated disorder but can be a feature of a syndrome. Anticonvulsants, immune-suppressant drugs and calcium channel blockers have been known to produce similar gingival overgrowths in susceptible patients.

Phenytoin, an anti epileptic has been frequently used in the management of all forms of epilepsy except petit-mal. The potential of phenytoin to induce gingival hyperplasia has been well-established.

This article documents a severe gingival enlargement in a patient under anti-epileptic therapy and provides a rational model for its clinical management.

A case of 15 year old male is reported who presented a generalized severe gingival overgrowth, involving the maxillary and mandibular arches and covering all teeth. Treatment included phase 1 therapy, substitution of the drug, and surgical excision of the excessive gingival tissue, maintenance and supportive therapy resulting in excellent clinical outcome. Post surgical follow up demonstrated no recurrence.


Keywords

Phenytoin, Antiepileptic, Gingival Over Growth, Gingivectomy
Subscription Login to verify subscription
User
Notifications
Font Size


  • Bittencourt L.P, Campos V, Moliterno L.F, Ribeiro D.P. Herediatry gingival fibromatosis: review of the literature and a case report. Quint Int. 2000; 31:415-418.

  • Takada K, Sugiyama H, Umezawa K, Mega J, Hirasawa M. The subgin-gival microflora in phenytoin-induced gingival hyperplasia. J Periodontal Res 2003; 38:477-81

  • Kurzawski M., A. Drozdzik, E. Dembowska, A. Pawlik, J. Banach, M. Drozdzik Matrix Metalloproteinase-1 Gene Polymorphism in Renal Transplant Patients With and Without Gingival Enlargement. Journal of Periodontology September 2006, Vol. 77, No. 9: 1498-1502.

  • Nishikawa S., Nagata T., Morisaki I., Oka T., Ishida H., J. Periodontol., 67, 463—471 (1996). Yamasaki A., Rose G. G., Pinero G. J., Mahan C. J., J. Oral. Pathol.,

  • Academy report. Drug associated gingival enlargement. J.Periodontol 2004; 75:1424-31.

  • Brunet L, Miranda J,Roset P, Borini L,Forre M. Prevalence and the risk of gingival enlargement in patients treated with anticonvulsant drugs. Eur. J Clin Invest 2001; 31:781-8

  • Perucca E. An introduction to antiepileptic drugs. Epilepsia 2005; 46 Suppl 4:31-37.

  • Angelopoulos AP. Diphenylhydantoin gingival hyperplasia. A clinicopathological review. Incidence, clinical features and histopathology. J Can Dent Assoc 1975; 41:103-106.

  • Greenwood RS, Tennison MB, Maguire JH, Lewis DV, Hassell TM. Phenytoin-induced gingival overgrowth and antiepileptic co-administration. Epilepsia 1986; 27:640.

  • Maclean M, Mc Donald R. Multiple actions of phenytoin on mouse spinal cord neurons in cell culture. J Pharmacol Exp Ther 1983; 227:779-89.


Abstract Views: 609

PDF Views: 2




  • Phenytoin Induced Gingival overgrowth - a Case Report

Abstract Views: 609  |  PDF Views: 2

Authors

Gowri Pendyala
Department of Periodontology, Rural Dental College, Loni, Maharashtra, India
Sourabh Joshi
Department of Pedodontics & Preventive Dentistry, Rural Dental College, Loni, Maharashtra, India
Biju Thomas
Department of Periodontics, A. B.Shetty Memorial Institute of Dental Sciences, Mangalore, India
Avneesh Tejnani
Depatrment of Periodontics, Rural Dental College, Loni, Maharashtra, India

Abstract


Gingival overgrowth is a rare disorder characterized by the proliferative fibrous over growth of the gingival tissue. It usually develops as an isolated disorder but can be a feature of a syndrome. Anticonvulsants, immune-suppressant drugs and calcium channel blockers have been known to produce similar gingival overgrowths in susceptible patients.

Phenytoin, an anti epileptic has been frequently used in the management of all forms of epilepsy except petit-mal. The potential of phenytoin to induce gingival hyperplasia has been well-established.

This article documents a severe gingival enlargement in a patient under anti-epileptic therapy and provides a rational model for its clinical management.

A case of 15 year old male is reported who presented a generalized severe gingival overgrowth, involving the maxillary and mandibular arches and covering all teeth. Treatment included phase 1 therapy, substitution of the drug, and surgical excision of the excessive gingival tissue, maintenance and supportive therapy resulting in excellent clinical outcome. Post surgical follow up demonstrated no recurrence.


Keywords


Phenytoin, Antiepileptic, Gingival Over Growth, Gingivectomy

References