Topically Applied Phenytoin Gel as Adjunctive Treatment in Periodontitis Patients

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.