title: Severe phenytoin-induced gingival enlargement associated with periodontitis.
abstract: The potential of phenytoin to induce gingival hyperplasia has been well-established. High levels of dental plaque and calculus have been reported as a critical co-factor for the development and severity of phenytoin-induced gingival hyperplasia. This article documents a severe gingival enlargement associated with periodontitis (in a patient under combined anti-epileptic therapy) and provides a rational model for its clinical management. Initially, full-mouth scaling and root planing, oral hygiene instructions, and phenytoin withdrawal were performed; however, clinical results demonstrated partial resolution of maxillary gingival hyperplasia. Subsequently, surgical therapy was indicated for the maxillary teeth. Complete reduction of gingival enlargement and improvement of clinical periodontal parameters were observed after the surgical therapy. This case report clearly describes the challenges that oral and medical health practitioners face when developing appropriate prevention and treatment programs for epileptic patients, particularly those with periodontal disease.
authors.affiliation: Department of Periodontics, Dental Research Division, Guarulhos University, Sao Paulo, Brazil.
authors.forename: Juliana Antico
authors.initials: JA
authors.lastname: Lucchesi
authors.forename: Shelia Cavalka
authors.initials: SC
authors.lastname: Cortelli
authors.forename: Jose Augusto
authors.initials: JA
authors.lastname: Rodrigues
authors.forename: Poliana Mendes
authors.initials: PM
authors.lastname: Duarte
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D012534:Dental Scaling; D005260:Female; D005885:Gingival Hyperplasia / Q000139:chemically induced / Q000150:complications* / Q000628:therapy; D005890:Gingivectomy / Q000379:methods*; D006801:Humans; D008437:Maxilla; D010518:Periodontitis / Q000150:complications* / Q000628:therapy; D010672:Phenytoin / Q000009:adverse effects*; D016745:Root Planing; D014085:Tooth Migration / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin