{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:29Z","timestamp":1787071229304,"version":"build-2736575974"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Epilepsy is a prevalent neurological disorder often requiring long-term pharmacological management. Antiepileptic drugs (AEDs), such as valproic acid and phenytoin, are known to influence bone metabolism and calcium homeostasis. However, the impact of these systemic medications on craniofacial skeletal development and the efficiency of orthodontic tooth movement remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was conducted involving 50 adolescent patients (mean age 14.2 \u00b1 1.5 years) treated with fixed orthodontic appliances. The sample was divided into the Study Group (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 25), comprising patients with a history of AED use for &gt; 3 years, and the Control Group (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 25), consisting of matched healthy individuals. Pre-treatment lateral cephalograms were analyzed for skeletal dimensions. Treatment duration and periodontal health (Gingival Index) were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The Study Group exhibited a significantly steeper mandibular plane angle (SN-GoGn) of 36.4\u00b0 \u00b14.2\u00b0 compared to 31.2\u00b0 \u00b13.5\u00b0 in controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) and reduced effective mandibular length (Co-Gn: 108.5 \u00b1 5.1 mm vs. 114.2 \u00b1 4.8 mm;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Orthodontic treatment duration was significantly prolonged in the AED group (26.4 \u00b1 3.8 months) compared to controls (21.1 \u00b1 2.4 months;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Long-term administration of antiepileptic medication is associated with a hyperdivergent growth pattern and reduced mandibular dimensions. Furthermore, these patients require significantly longer orthodontic treatment time, potentially due to altered bone remodeling dynamics and periodontal complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jpbs.jpbs_1763_25","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T10:00:20Z","timestamp":1773309620000},"page":"28-30","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Long-term Antiepileptic Medication on Craniofacial Growth Patterns and Orthodontic Treatment Outcomes"],"prefix":"10.4103","volume":"18","author":[{"given":"Mohammad K.","family":"Alam","sequence":"first","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia"},{"name":"Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India"},{"name":"Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Y.","family":"Hajeer","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mawiah I.","family":"Aljadou","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam B.","family":"Albadi","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almas B.","family":"Aljoufi","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munirah S.","family":"Alabid","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haya","family":"Alrayes","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara F.","family":"Alshammari","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"R1-20260416","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.seizure.2007.11.020","article-title":"Bone health in people with epilepsy: Is it impaired and what are the risk factors?","volume":"17","author":"Pack","year":"2008","journal-title":"Seizure"},{"key":"R2-20260416","first-page":"501","article-title":"Antiepileptic drugs and bone health","volume":"58","author":"Lazzari","year":"2014","journal-title":"Arq Bras Endocrinol Metabol"},{"key":"R3-20260416","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1600-0404.2005.00474.x","article-title":"Epilepsy, osteoporosis and fracture risk \u2013 A meta-analysis","volume":"112","author":"Vestergaard","year":"2005","journal-title":"Acta Neurol Scand"},{"key":"R4-20260416","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/j.1600-051X.2005.00657.x","article-title":"Risk factors for gingival overgrowth in patients medicated with ciclosporin in the absence of calcium channel blockers","volume":"32","author":"Thomason","year":"2005","journal-title":"J Clin Periodontol"},{"key":"R5-20260416","first-page":"19","article-title":"Effects of long-term antiepileptic drug treatment on bone mineral density in children and adolescents with epilepsy","volume":"144","author":"Dahlin","year":"2018","journal-title":"Epilepsy Res"},{"key":"R6-20260416","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1053\/j.sodo.2006.01.004","article-title":"The importance of masticatory muscle function in dentofacial growth","volume":"12","author":"Kiliaridis","year":"2006","journal-title":"Semin Orthod"},{"key":"R7-20260416","first-page":"537","article-title":"The effect of long-term phenytoin administration on mandibular growth of rats","volume":"123","author":"Ozer","year":"2003","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"R8-20260416","first-page":"635235","article-title":"Gingival overgrowth in orthodontic patients \u2013 A review","volume":"2","author":"Pels","year":"2021","journal-title":"Front Dent Med"}],"container-title":["Journal of Pharmacy and Bioallied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_1763_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:24Z","timestamp":1787067804000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_1763_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jpbs.jpbs_1763_25","relation":{},"ISSN":["0976-4879","0975-7406"],"issn-type":[{"value":"0976-4879","type":"print"},{"value":"0975-7406","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-12-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}