Periodontal

Shapiro, Experimental Medicine and Surgery (1958),³³⁹ conducted a double-blind study of the effects of PHT on healing in patients with various degrees of periodontal disease. Thirty-three patients received oral PHT and nineteen received placebo.Sections of gingiva were surgically removed and the wounds were covered with protective packs. When the packs were changed at the end of one week, the PHT-treated group exhibited less erythema, less pain and advanced wound healing. On histological section, there was marked acceleration of fibroblastic activity, clot organization, and epithelial proliferation as compared to the control group.The author stated that PHT may be useful to increase the rate of wound healing in other areas of the body, as in burns.

339. Shapiro, M., Acceleration of gingival wound healing in non-epileptic patients receiving diphenylhydantoin sodium, Exp. Med. Surg., 16: 41-53, 1958.

Savini, Poitevin and Poitevin, Revue Francaise d'Odontostomatologie (1972),¹⁵⁰⁴ presented a study of the use of PHT locally in the treatment of periodontal disease in 118 cases.The authors examined the effect of PHT in a gingival paste-type ointment which was applied by the patient with massage to the gingival mucosa inside and outside after normal tooth brushing, morning and evening, and left for about five minutes before rinsing.The findings were based both on the patient's observations and on physical examination, x-rays and, in forty-six cases, by biopsy. With PHT, total resolution of pain occurred in most cases. Rapid regression of gingival bleeding and inflammation, increased healing, and decreased dental mobility were also seen. Although lesions were stabilized, there was no periodontal restoration.The authors conclude that PHT is an effective aid in the treatment of periodontal disease.

1504. Savini, E. C., Poitevin, R. and Poitevin, J., New treatment of periodontolysis, Rev. Franc. Odontostomat., 19: 55-61, 1972.

Payen, Revue d'Odontostomatologie du Midi de la France (1972),¹⁴⁰³ studied the effect of a topical preparation of PHT for gingival massage in seventy-five patients with periodontal disease. Twenty-nine of the patients were hospitalized and forty-six were outpatients. With PHT, decreased inflammation and increased production of collagen in the healing process were observed in twenty of the hospitalized patients and in forty-five of the outpatients.

1403. Payen, J., A study of changes in the gum during treatment with diphenylhydantoin sodium, Rev. Odonto-Stomatol., 19: 47-53, 1972.

Chikhani, Actualites Odontostomatologiques (1972), ⁸⁹⁴ in a study of fifty-eight patients, reported clinical and histological effects of daily PHT gingival massage in periodontopathies. The author states that the study demonstrates the beneficial effect of PHT, particularly on bleed-ing gums and on pain; and histological findings confirmed the fibroblastic action of PHT and the healing with sclerosis which accompanied the decrease in inflammatory infiltration. The author states that beneficial effects were clear after forty to sixty days of treatment.

894. Chikhani, P., The use of  “diphenylhydantoin sodium” in the treatment of periodontal disease, Actualities Odontostomat, 98: 1-8, 1972.

Goebel, Journal of Oral Surgery (1972),¹⁰⁸⁰ reported a controlled study of the effects of PHT, before and after surgery, on wound healing of extraction sockets. As controls, eighteen patients were given chlorpromazine, and fifteen were untreated. Compared with controls, significant improvement was observed in wound healing in the nine patients who received PHT.

1080. Goebel, R. W., Sodium diphenylhydantoin association with oral healing, J. Oral Surg., 30: 191-195, 1972.

Otto, Ludewig and Kotzschke, Stomatologie der DDR (1977),²⁰⁰⁹ in a double-blind study, treated eighty patients with complex periodontal disease with a local application of PHT gel. Compared with the control group, there was marked subjective and objective improvement in the group treated with PHT.

2009. Otto, G., Ludewig, R. and Kotzschke, H. J., Specific action of local phenytoin application on periodontal disease, Stomatol. DDR, 27: 262-8, 1977.

Ludewig and Otto, Russian Pharmacology and Toxicology (1982),²⁷³⁰ studied the effects of topical PHT in the treatment of atrophic gingivitis. Sixty patients were divided into three groups. Two groups were treated with topical PHT in a 1% gel applied twice a day for six and twelve weeks, respectively. A third group was treated with the gel alone and served as control. The PHT-treated patients ceased to complain of gum pain and heat sensitivity. Edema and gum bleeding disappeared. On biopsy, improvement was evidenced by decrease in inflammatory infiltration and regeneration of connective tissue. No benefits were seen in the control group.

2730. Ludewig, R., Otto, G., Therapeutic effect of topical phenytoin application, Russian Pharmacol. Toxicol., 45(3): 101-3,1982.

Domachowska, Personal Communication (2001), ³²⁷⁷ conducted a study at the Warsaw Center of Stomatology in Poland, to test the efficacy of PHT in various oral mucosal lesions and ulcerations in HIV-positive patients and patients with gingivitis and/or periodontitis. The study group consisted of twenty patients: fifteen women and five men (mean age approximately 55). Topical PHT treatment was administered for three months and follow-up visits were conducted. Significant symptomatic relief was noted in all cases, and six of the twenty patients had complete healing of their lesions. In another three patients, decreased size of the lesions was observed. All the patients with gingivitis had symptomatic relief and diminished inflammation and edema. In the five patients with aphthous ulcers, pain decreased on the second day of treatment and the inflammatory process resolved in four to seven days.

3277. Domachowska, W., Clinical use of phenytoin 5% oral mucosa disorders and periodontitis, Personal Communication, 2001.

Domachowska, Personal Communication (2001), ³²⁷⁸ conducted a study at the Warsaw Center of Stomatology in Poland to test the efficacy of phenytoin treatment in various oral mucosal lesions and ulcerations in HIV-positive patients. The study group consisted of nine HIV-positive patients: six males (between the ages of 24 and 28 years) and one female (28 years old), and 2 other patients who had received previous dental surgical treatment. Phenytoin was applied topically once daily in two-day intervals during a period of nine days. All the patients experienced pain relief and diminished inflammation during the study period, and these results were most pronounced during the first few days of treatment.

3278. Domachowska, W., Clinical applications of phenytoin sodium (PHT), Personal Communication, 2001.

See also Ref.

3279. Savini, E.C., Poitevin, R., Payen, J., Topical application of hydantoins in gingival disorders, in: Phenytoin-Induced Teratology and Gingival Pathology, Hassell, T.M., et al, eds., Raven Press, New York, 215-222, 1980.