Diphenylhydantoin Gingival Hyperplasia in <i>Macaca arctoides:</i> Prevention by Inhibition of Dental Plaque Deposition

Staple, P. H.; Reed, Michael J.; Mashimo, Paul A.; Sedransk, Nell; Umemoto, Toshihiko

doi:10.1902/jop.1978.49.6.310

Cited by 20 publications

(11 citation statements)

References 3 publications

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“…However, Aas (1963) found no statistically significant relationship between IQ and level of oral hygiene, but reported a statistically significant correlation between severity of inflammation and severity of gum overgrowth, a finding corroborated by the present investigation. Glickman & Lewitus stated in 1941 that focal irritation is a secondary phenomenon; in the interim, well controlled experiments in tnan, in monkeys and in cats have demonstrated that in the absence of the frank irritation and ensuing inflammation caused by plaque, PHT induced gingival overgrowth can be minimized (Hall 1969, Nuki & Cooper 1972, King et al 1976, Staple & Reed 1976, Pihistrom et al 1980, Steinberg & Steinberg 1982. Furthermore, patients without teeth, and thus without gingival sulci which harbor plaque, almost never develop the lesions (Glickman & Lewitus 1941, Ziskin et al 1941, Aas 1963).…”

Section: Discussionmentioning

confidence: 99%

Phenytoin induced gingival overgrowth in institutionalized epileptics

Hassell

O'Donnell

Pearlman

et al. 1984

J Clinic Periodontology

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In a cross-sectional, epidemiological study of phenytoin induced gingival overgrowth in 77 institutionalized persons with epilepsy, the severity of the gum lesions was quantified by means of a precise new technique. Lesion severity was then compared statistically to other clinical and laboratory parameters. Positive correlations were detected between overgrowth severity and gingival inflammation, probing depths, calculus accumulation, plaque score and the measurement gingival margin to mucogingival junction (GM-MGJ). No correlation was observed between lesion severity and patients age, daily drug dosage, plasma or saliva phenytoin level, or salivary concentration of the major phenytoin metabolite.

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Section: Discussionmentioning

confidence: 99%

Phenytoin induced gingival overgrowth in institutionalized epileptics

Hassell

O'Donnell

Pearlman

et al. 1984

J Clinic Periodontology

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“…The pathogenesis of the lesion remains unclear, although the occurrence has been related to the daily dose level (Frankel 1940), age of the patient (Babcock & Nelson 1964), and a genetically determined inabihty of a host to deal effectively with chronic doses of the drug (Hassell & Page 1978, Bressmann, Robinson & Bemveniste 1982. In humans, this gingival overgrowth has been associated with chronic gingival infiammation (Angelopoulos 1975, Steinberg & Steinberg 1982 and was also observed in ferrets (King & Gimson 1947), in monkeys (Staple et al 1978), in cats (Ishikawa & Glickman 1961) but not in rats (Conard et al 1975). Nevertheless, Yamada, Sato and Miake (1977) showed a localized gingival hyperplasia associated with plaque accumulation in rats receiving dilantin.…”

Section: Introductionmentioning

confidence: 88%

Interaction of phenytoin and inflammation induces gingival overgrowth in rats

Nascimento

Barreto

Bozzo

et al. 1985

J of Periodontal Research

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In adult male Wistar rats {Rattus norvegicus albinus) gingival irritation provided by means of wire silk ligatures around the cervix of first left lower molars, for a duration of 77 days, caused gingival inflammatory changes. In the rats receiving also daily one i.p. injection of sodium 5,5diphenylhydantoinate (phenytoin)., during 70 days, there was no macroscopical change of the gingiva of non-ligated first right lower molars. However, in the first left lower molars, the association of silk ligature-plus-phenytoin administration elicited gingival overgrowth. The rat was seen as a satisfactory animal model for studies of phenytoin-induced gingival changes.

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“…Patients are rarely seen in this geographic area with Class III gingival overgrowth who are not mentally handicapped and institutionalized, A high proportion of Actinomyces was found in plaque from monkeys with phenytoin induced gingiva! overgrowth (Staple et a!, 1978). The present data suggest that increased Actinomyces probably is not associated with mature gingiva!…”

Section: Discussionmentioning

confidence: 99%

“…Therapy, such as the above, has not proven useful with subjects already having gingival overgrowth. However, antiplaque treatment begun with the start of phenytoin therapy may reduce gingival overgrowth as demonstrated with monkeys receiving both phenytoin and chiorhexidine (Staple et al 1978),…”

Section: Introductionmentioning

confidence: 99%

“…but to suppress growth of Streptococci, in human plaque (Javed et al 1980). A high proportion of Actinomyces, fusifortn bacteria, and rods were found in plaque from monkeys with phenytoin associated gingival overgrowth (Staple et al 1978). Phenytoin associated gingival overgrowth is more prevalent and severe in the anterior regions (Esterberg & White 1945, Panuska et al 1960, Aas 1963, However, comparisons between plaque microbe composition and clinical parameters of anterior and posterior teeth of patients with gingiva!…”

Section: Introductionmentioning

confidence: 99%

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Microbial flora and clinical parameters in phenytoin associated gingival overgrowth

Smith

Wilson

Germaine

et al. 1983

J of Periodontal Research

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The effect of phenytoin therapy on periodontal indices, plaque microbiology, and gingival overgrowth was studied. Plaque, gingivitis, and calculus indices and pocket depth were recorded for anterior and posterior teeth of 89 subjects partitioned into 5 groups, a control group, and 4 groups of patients receiving phenytoin therapy with differing severity of gingival overgrowth. A survey of the major oral microorganisms present in marginal plaque was also done. The clinical indices increased with increasing severity of overgrowth. Patients with no or minimal overgrowth had clinical indices equal to or less than those of controls. The proportions of the major oral genera in marginal plaque samples from the groups were similar except for the patients with the most severe gingival overgrowth (mentally retarded and institutionalized). The microbe proportions from neither anterior nor posterior sites had a distinct relationship to severity of gingival overgrowth. Furthermore, no differences were found between clinical parameters or plaque microbiology at the anterior sites of patients who had greater anterior than posterior overgrowth. More frequent Correlations occurred among clinical parameters than among microbial percentages or between microbial percentages and clinical indices. This study does not support a specific marginal plaque etiology for phenytoin associated gingival overgrowth.

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Diphenylhydantoin Gingival Hyperplasia in Macaca arctoides: Prevention by Inhibition of Dental Plaque Deposition

Cited by 20 publications

References 3 publications

Phenytoin induced gingival overgrowth in institutionalized epileptics

Phenytoin induced gingival overgrowth in institutionalized epileptics

Interaction of phenytoin and inflammation induces gingival overgrowth in rats

Microbial flora and clinical parameters in phenytoin associated gingival overgrowth

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