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Phenytoin effects on inflammatory mediator's production by gingival fibroblasts: a comparative study in children and adults.

BACKGROUND: About 30 to 50% of patients taking Phenytoin develop significant gingival alternations especially in buccal anterior part of oral cavity. This study was done to compare the synthesis of its inflammatory mediators and related gingival overgrowth in different ages.

METHODS: Samples were collected from biopsy of a healthy gingival of four adults in 35-42 years old through crown lengthening surgery and four children in 4-11 years old through impact tooth surgery, after local anesthesia and from the keratinized soft tissues around the teeth. Gingival biopsies were transferred to a medium which containing DMEM and cultured on specific plates 25 cm2 and put on incubator containing CO2 with temperature of 37 °C. MTT was used to compare the Proliferation rate of fi broblasts. Supernatant of culture medium of test and control sinks were collected by sampler and concentration of IL1β, PGE2, IL6, TGFβ, TNFα and IL8 were analyzed by ELISA.

RESULTS: Different proliferation rate of Phenytoin induced gingival fibroblasts in adults (0.073 ± 0.177) as compared to children (0.056 ± 0.028) was not significant. Production of PGE2, TGFβ and IL6 by Phenytoin induced gingival fibroblasts in children was increased as compared to adults (p < 0.05). Production of IL8 by Phenytoin induced gingival fibroblasts in children was decreased compared to adults (P = 0.02).

CONCLUSION: Phenytoin induced gingival fibroblasts of children produce more amounts of IL1β, PGE2, IL6, TGFβ and IL8 as compared to adults' fibroblasts. More Comprehensive studies with well-documented designs using other methods are recommended to verify these results.

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