Aim: The aim of this work was to evaluate efficacy of topically applied 
1% phenytoin as an adjunctive treatment in stage II grade A periodontitis. 
Subjects and methods: The current study was designed as a randomized controlled 
clinical trial performed on 60 patients of both sexes, aged from (30-52) years with 
stage II grade A periodontitis. Patients sites were classified into the following groups: 
Group I: included 30 patients treated by scaling and root planning. Group II: included 
30 patients treated by scaling and root planning combined with 1% phenytoin gel 
application. Clinical parameters were measured at baseline, 3 and 6 months. The effect 
of phenytoin on vascular endothelial growth factor (VEGF) and platelet-derived growth 
factor (PDGF-BB) expression in gingival crevicular fluid (GCF) was investigated at 
baseline, 1, 2, 3 and 4 weeks. Results: The clinical parameters PPD and CAL showed a 
significant reduction in phenytoin treated sites compared with control and this reduction 
was considered significant at 3 months. Although phenytoin (PHT) significantly 
upregulated levels of PDGF-BB and VEGF in GCF than control sites within the first 
and second week, growth factors level decreased to nearly the base line value at 3 weeks 
and this reduction still to 4 weeks. Conclusion: It can be concluded that adjunctive use 
of 1% phenytoin gel showed a positive impact on clinical periodontal parameters in the 
form of probing depth reduction and attachment level gain.