Topically Applied Phenytoin Gel as Adjunctive Treatment in Periodontitis Patients

Ibrahim, Ibrahim Hammad; Abd Rabbouh Ali, Abdullah Ibrahim; Soltan Zayed, Gamal Mohamed; Badr, Bahaa Mohammed

doi:10.21608/aadj.2024.355429

Topically Applied Phenytoin Gel as Adjunctive Treatment in Periodontitis Patients

Document Type : Original Article

Authors

¹ Department of Oral Medicine, Periodontology, Oral Diagnosis and Dental Radiology, Faculty of Dental Medicine, Al-Azhar University, Assiut branch, Egypt.

² Department of Oral Medicine, Periodontology, Oral Diagnosis and Dental Radiology, Faculty of Dental Medicine, Al-Azhar University, Assiut branch, Egyp

³ Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Al-Azhar University, Assiut branch, Egypt

⁴ Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa, Jordan Department of Medical Microbiology and Immunology, Faculty of Medicine, Al-Azhar University (Assiut branch), Assiut, Egypt.

10.21608/aadj.2024.355429

Abstract

Aim: The aim of this work was to evaluate efficacy of topically applied
1% phenytoin as an adjunctive treatment in stage II grade A periodontitis.
Subjects and methods: The current study was designed as a randomized controlled
clinical trial performed on 60 patients of both sexes, aged from (30-52) years with
stage II grade A periodontitis. Patients sites were classified into the following groups:
Group I: included 30 patients treated by scaling and root planning. Group II: included
30 patients treated by scaling and root planning combined with 1% phenytoin gel
application. Clinical parameters were measured at baseline, 3 and 6 months. The effect
of phenytoin on vascular endothelial growth factor (VEGF) and platelet-derived growth
factor (PDGF-BB) expression in gingival crevicular fluid (GCF) was investigated at
baseline, 1, 2, 3 and 4 weeks. Results: The clinical parameters PPD and CAL showed a
significant reduction in phenytoin treated sites compared with control and this reduction
was considered significant at 3 months. Although phenytoin (PHT) significantly
upregulated levels of PDGF-BB and VEGF in GCF than control sites within the first
and second week, growth factors level decreased to nearly the base line value at 3 weeks
and this reduction still to 4 weeks. Conclusion: It can be concluded that adjunctive use
of 1% phenytoin gel showed a positive impact on clinical periodontal parameters in the
form of probing depth reduction and attachment level gain.

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