Smith Q T, Hamilton M J
J Periodontol. 1981 Nov;52(11):673-9. doi: 10.1902/jop.1981.52.11.673.
Unstimulated and stimulated whole and unstimulated and stimulated parotid saliva were collected from subjected in three groups: I, control; II, seizure subjects ingesting phenytoin and without gingival overgrowth; III, seizure subjects receiving phenytoin and with grades 1 and 2 gingival overgrowth. Unstimulated whole saliva was obtained from mentally retarded donors with grade 3 phenytoin associated gingival overgrowth. The samples were analyzed for protein, lysozyme, lactoperoxidase, lactoferrin and aggregation capacity towards Streptococcus sanguis. Differences occurred in the salivary composition of patients ingesting phenytoin. No deficiencies of flow rate, protein or the specific proteins were found in subjects ingesting phenytoin. Instead, the only changes in these parameters were greater concentrations or secretion rates. Several differences occurred only in subjects with gingival overgrowth. These latter differences were prominent in unstimulated whole saliva. The data demonstrate changes in the oral cavity environment of patients ingesting phenytoin. These differences, however, do not have an obvious relationship to development of phenytoin associated gingival overgrowth. Some of the salivary changes occurred in patients undergoing therapy for seizures both with phenytoin and with other drugs. Increased amounts of unstimulated whole saliva components likely are due to excess tissue rather than a phenytoin effect on salivary gland secretions. In addition, most of the changes in salivary composition would not be expected to produce an environment the encourages plaque accumulation.
第一组为对照组；第二组为服用苯妥英钠且无牙龈增生的癫痫患者；第三组为服用苯妥英钠且牙龈增生程度为1级和2级的癫痫患者。从未刺激的全唾液取自患有3级苯妥英钠相关性牙龈增生的智力迟钝供体。对样本进行蛋白质、溶菌酶、乳过氧化物酶、乳铁蛋白以及对血链球菌的聚集能力分析。服用苯妥英钠的患者唾液成分存在差异。服用苯妥英钠的受试者未发现流速、蛋白质或特定蛋白质缺乏。相反，这些参数的唯一变化是浓度或分泌率更高。仅在牙龈增生的受试者中出现了一些差异。这些差异在未刺激的全唾液中尤为突出。数据表明服用苯妥英钠的患者口腔环境发生了变化。然而，这些差异与苯妥英钠相关性牙龈增生的发展没有明显关系。一些唾液变化发生在同时使用苯妥英钠和其他药物进行癫痫治疗的患者中。未刺激的全唾液成分增加可能是由于组织过多，而非苯妥英钠对唾液腺分泌的影响。此外，预计唾液成分的大多数变化不会产生促进牙菌斑积聚的环境。
