Phenytoin Effects on Fibroblast Proliferation in Children and Adults

Objectives: PIGO is a common subsequent of consuming anti-epileptic drug. This side-effect may cause delayed eruption of teeth, and disturbances in speech, mastication, and aesthetic.² The most prevalence of gingival overgrowth has been reported in the anti-epileptic drugs group which is widely prescribed in cases of psychiatric disorders, migraine prophylaxis, and neuropathic pain. According to epidemiologic studies, it is more prevalent in male children and adolescents. This study investigated the influence of phenytoin on proliferation of gingival fibroblasts in adults and pediatrics.

Methods: The adult fibroblast samples were derived from 4 healthy adults who were submitted to crown lengthening surgery. The age range was 35-42 years. In addition, pediatric samples were obtained from 4 healthy children, aging from 4 to 11 years, during a procedure of impacted tooth extraction. After fibroblast extraction and growing up, they were seeded into 24-well plates at a density of 6010³ cells/well. After 48 hours, phenytoin was added to the experimental wells. Samples were then incubated at 37 °C in 95% humidified atmosphere containing CO₂. The MTT assay was performed ant alpha error was set at 0.05.

Results: Rate of fibroblast proliferation in both adults and pediatrics groups increased in the presence of phenytoin. However, these changes did not reach a significant level. The difference between phenytoin-induced proliferation in adults group and in pediatrics group was not significant

Conclusions: Further studies are suggested to investigate the exact ECM metabolism of phenytoin, and to reach a better understanding of the relations between gingival epithelial cells and connective tissue, in order to find a solution for the gingival overgrowth other than pure pharmacologic effects of Phenytoin.