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Background: Buccal mucosal ulcers are common oral lesions that may arise from chemical damage to oral mucosa. Appropriate treatment and wound care speed up the healing process, avoid chronicity and wound infection. Phenytoin is considered one of the promising wound healing agents that may have the ability to decrease the duration of the healing process of wounds.
Objectives: The aim of the present study was to evaluate the effect of topical application of phenytoin on chemically induced buccal mucosal ulcer in albino rats.
Material and methods: After chemical induction of ulceration on left side buccal mucosa, sixty three adult male albino rats were divided equally into 3 main groups (21 rats each) as follows: Control group: The right side buccal mucosa was left intact to act as negative control group (group I), while the ulcerated left buccal mucosa of rats was left untreated to heal normally and serve as a positive control (group II), rats in control group were sacrificed in parallel with its corresponding experimental groups. group III (plain gel) ulcerated buccal mucosa in albino rats received topical application of plain gel twice daily on the ulcer from the day following ulcer induction (day 1) till the day of sacrification at 4, 7 and 12 days. group IV (phenytoin gel) rats received topical application of 1% phenytoin gel twice daily on the ulcer from the day following ulcer induction (day 1) till the day of sacrification at 4, 7 and 12 days. Each group was equally subdivided into 3 subgroups according to sacrification periods. Buccal mucosa was dissected free and examined histologically and immunohistochemically.
Results: Histologically, group II showed complete epithelial degeneration at day 4, re-epithelization at day 7 and complete regeneration at day 12. group III showed complete epithelial degeneration day 4, re-epithelization started at day 7 and partial regeneration at day 12. group IV showed beginning of re-epithelization at day 4, continuous epithelial lining at day 7 and complete regeneration at day 12. Immunohistochemically and statistically, group IV showed the highest anti-PCNA expression regarding immunopositive epithelial cells followed by group III then group II. group I showed the lowest mean.
Conclusions: Topical application of phenytoin 1% can help accelerate healing of chemically induced ulcers through increased vascularization, relatively decreased inflammatory cell count and hastened re-epithelization.