苯妥英钠对癫痫儿童牙齿生长发育影响的研究

目的观察长期苯妥英钠（ＤＰＨ）治疗对癫痫儿童牙齿生长发育的影响。方法把１８８例长期单服ＤＰＨ的患者按开始服的年龄分为乳牙组（Ａ组）,换牙组（Ｂ组）及恒牙组（Ｃ组）。比较三组牙齿的色泽、排列、形状、乳牙滞留、恒牙萌出异常以及与齿龈增生的关系。结果三组牙异常发生率分别为３７２１％、３３３３％及８３３％,Ａ、Ｂ组明显高于Ｃ组;Ａ组较Ｂ组严重,但两组间无统计学意义的差异。１１例停药后随访３年以上,未见明显改善。结论换牙前接受ＤＰＨ治疗,牙的生长发育将会受到影响,并对牙齿带来难以逆转的影响,因此对儿童选用ＤＰＨ时应十分慎重。

A study on influence of diphenylhydantoin to teeth growth in epileptic children.

Objective To observe the effects on teeth growth in epileptic children treated with diphenylhydantoin (DPH). Methods According to the age started to receive DPH therapy, one hundrend and eighty eight of epileptic children were divided into three groups:group of milk teeth (group A), group of milk teeth exchanging to permanent teeth (group B), group of permanent teeth (group C).The colour, the arrangment and form of teeth, the status of milk teeth detained, dysplasia of permanent teeth sprouted and their relation to hyperplasia of gum in each groups were analysed. Results The percentages of dysplasia of teeth in group A, B and C were 37 21%, 33 33% and 8.33% respectively. There was no significant difference in the percentages between group A and B, but there was higher significant difference both in group A and B than group C ( P <0.01). After cessation of DPH therapy,eleven cases were followed up more than 3-5 years and there was no improvement in their teeth dysplasia. Conclusions If DPH therapy were started in the time before replacement of permanent teeth, the teeth growth will be subjected to a irreversible influence especially in younger children. DPH should be carefully chosen for epileptic children.