The effects of antiepileptic drugs on oral health.

OBJECTIVE: Long-term use of phenytoin (PHT) causes gingival hyperplasia; however, little is known about the oral side effects of other antiepileptic drugs (AEDs). Through a systematic review of the literature, we explored the effects of AEDs on the oral health of patients with epilepsy. METHODS: We searched PubMed, EMBASE and the Cochrane library between January 1963 and August 2010. The search strategy retrieved 170 abstracts. We included studies that involved original research and had ≥ 10 patients in our review. We also checked the reference lists of reviews, letters and other manuscripts to find studies that met our selection criteria. RESULTS: Only 15 articles were included in the final analysis. Gingival hyperplasia was very common in patients taking PHT (16%-94% of patients). Alveolar bone loss occurred in patients taking carbamazepine or PHT. Patients taking valproate, carbamazepine or phenobarbital also had gingival hyperplasia. We found no published studies of newer-generation AEDs. CONCLUSION: Although several studies examined the effects of PHT on oral health, none have studied those of the newer generation of AEDs. Studies exploring oral side effects of AEDs are needed.

Implant overdentures: dental students' performance in fabrication, denture quality, and patient satisfaction.

The purpose of this study was to evaluate dental students' performance when fabricating a mandibular two-implant overdenture (OD) as compared to conventional dentures (CD) and to determine if these prostheses were successful. Twenty students and twenty patients were divided into two groups: complete denture group (CDG) and maxillary denture and two-implant OD group (ODG). Students' progress was evaluated at each appointment as they were given a clinical assessment score (CAS), which varied from 1 (unacceptable, needs to repeat procedure) to 4 (acceptable, no errors). The success of the prosthesis was evaluated by the patients using a visual analog scale (VAS) and an expert (a prosthodontist) using a denture quality assessment (DQA) form. Performance for both groups was not statistically different across all eight appointments (CDG 3.16 versus ODG 3.25; p=0.46). Patients with ODs reported greater stability with their dentures (p=0.048) and greater ability to chew than patients with CDs (p=0.03). There were no differences between the groups in terms of expert appraisal (ODG 71.1 versus CDG 67.5; p=0.59). The performance of dental students when fabricating a two-implant OD is thus not different from that of a CD. Students can successfully fabricate a two-implant OD as perceived by both patients and prosthodontists.