DOSIS DAN LAMA PEMBERIAN FENITOIN SEBAGAI FAKTOR RISIKO TIMBULNYA HIPERPLASIA GINGGIVA PADA PASIEN EPILEPSI Dossage and duration of phenytoin administration as a risk factor for gingival hyperplasia in patients with epilepsy

Abstract

Background : Phenytoin is commonly used as first line drug therapy for epilepsy because of its potency and low cost. Dossage and duration of phenytoin administration have been considered as important factors in the development of ginggival enlargement. There has no report about association between both risk factors causing ginggival hyperplasia. Objective : To investigate whether dossage and duration of the phenytoin administration were risk factors of ginggival hyperplasia in epileptic patients. Method : Case control, case group consist of 20 epileptic patiens with phenytoin monotherapy who developed ginggival hyperplasia, and 20 epileptic patients with phenytoin monotherapy without ginggival hyperplasia as control group. The history of illness, physical examination, fasting and post prandial blood glucose level, funduscopy, oral hygiene, index of hyperplasia scoring from Saymor, and 3-5 cc blood sample were taken to examine the level of phenytoin. Oral dose, serum dose and duration of administration were evaluated. Patients characterictics were analized by chi-square or Mann Whitney for ratio scale. Odds ratio (OR) was calculated from dossage and duration of phenytoin administration to development of ginggival hyperplasia. Correlation test was done to those variables, followed by multiple regression test. Result : High dose of phenytoin was significant risk factor of ginggival hyperplasia, (p <0,05), while duration of administration > 6 months was not showed as a risk factor (p = 0,522). Taken together, oral dose of phenytoin was significant risk factor for ginggival hyperplasia(p<0,05,odds ratio 29,145, 95%CI) , while duration of administration was not. Conclusion : High dose of phenytoin was significant risk factor for ginggival hyperplasia. Key words : dossage and duration of phenytoin administration, ginggival hyperplasia