Periodontitis as a Manifestation of Systemic diseases

Periodontitis as a Manifestation of Systemic diseases

1. Leukaemia

   • Gingival overgrowth
   • Malignancy of WBCs
   • Gingival bleeding & oral petechiae
   • Oral ulcers

2. Downs Syndrome

   • Trisomy 21
   • Increased prevalence & severity of perio in both dentitions
     • Incisor-molar pattern
     • Rapid disease progression
     • MoA
       • Poor OH
       • Alterations in immune response
     • Avoided with optimal OH

3. Papillon-LeFevre syndrome

   • Cathepsin C gene defect
   • Palmar-plantar keratosis
   • Severe generalised perio
     • Onset before puberty (2yrs)
     • Child usually loses primary dentition before permanent dentition is fully developed

4. Ehlers Danlos

   • Defective collagen synthesis
   • Skin hyper-extensibility (stretchy), joint hypermobility
   • 10 types
     • Type 8 = Periodontitis type
       • Severe generalised perio
         • Early onset
         • Often tooth loss before 30
     • Type 4 assoc. with perio
   • Bruising of skin & oral tissues

5. Hypophosphotasia

   • Defective alkaline phosphate enzyme
     • Essential for bone/teeth mineralisation
   • Skeletal defects
     • Short limbs, bowed legs
   • Early loss of primary & permanent dentition
   • Abnormal tooth formation
     • Enlarged pulps
     • Abnormal morphology
     • Hypoplasia

6. Chediak-Higashi syndrome

   • Rare but fatal
   • Partial albinism, photophobia, nystagmus
   • Recurrent pyogenic infections
   • Lymphoma
   • Severe, rapidly progressing periodontitis
     • Premature tooth loss

7. Neutropenia

   • Acquired neutropenia
     • Prolonged low neutrophil levels
   • Cyclic neutropenia
     • 3wk cycles of low neutrophil levels
     • Genetic
   • Familial neutropenia
     • Prolonged low neutrophil levels
   • Localised or Generalised aggressive perio
     • Gingiva
       • Ulceration
       • Desquamation
       • Inflammation
     • Treatment
       • Removal of plaque & calculus
       • Chx MW
   • Multiple pyogenic infections of skin & mucous membranes

8. Leukocyte-adhesion deficiency syndrome

   • Severe, recurrent bacterial infections
   • Impaired wound healing
   • Aggressive gingivitis
   • Majority die by 30yrs