| 3808 Outcomes substituting alternatives regimens for Dilantin® in patients with MR/DD | ||
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J. NICHOLS1, A.G. FARMAN1, M. GRUENTHAL1, H. HOOD2, M.H. MURRAY3, and A. CRONE4, 1University of Louisville, KY, USA, 2Nova University SE, Davie, FL, USA, 3Hazelwood Center, Underwood and Lee Clinic, Louisville, KY, USA, 4Hazelwood Center, Louisville, KY, USA Purpose: Dentulous patients (n=42)with mental retardation and developmental disabilities (MR/DD) invariably had gingival hyperplasia when receiving Dilantin®. We report findings for 19 MR/DD patients 18 months following weaning from Dilantin®. Methods: Following baseline examination (seizure monitoring, periodontal charting, soft tissue characterization, radiographs and photographs), weaning from Dilantin® was initiated. Patients were titrated with Topamax® and weaned from Dilantin®. Seizure frequency and adverse reactions were documented. If a patient could not tolerate Topamax®, Depakote®, was administered. Patients were given periodic oral evaluations through to 18 months after the wean date. Results: Of 19 patients initially weaned from Dilantin® where 18 month follow-up data is available, 10 were successfully weaned, 8 were returned to Dilantin®, and one was lost to follow-up. All 10 patients off Dilantin® for 18 months show improvement in soft tissue quality from moderate to severe gingivitis with friable and hemorrhagic gingivae and multiple pocket depths of >5mm, to diminished pocket depths combined with firm fibrous gingivae. Regarding seizure frequency, 3 of these 10 experienced a decrease, 4 showed no change, and 3 experienced an increase. Five of the 10 successfully-weaned had to be removed from Topomax® due to appetite suppression that lead to loss of 10% or more in body weight. Baseline body weight was restored subsequent to substituting Depakote® medication. Conclusions: A substantial oral health benefit from substituting alternative anti-epileptic drugs in place of Dilantin® was possible when such substitution could be sustained. Weight loss and increased seizure frequencies were common reasons given by treating physicians for returning patients to Dilantin®. | ||
| Seq #382 - Gingival Overgrowth 10:15 AM-11:30 AM, Saturday, 13 March 2004 Hawaii Convention Center Exhibit Hall 1-2 | ||
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