Clinical, Bacteriological, and Immunological Examinations and the Treatment Process of Two Papillon‐Lefèvre Syndrome Patients

Abstract

papillon‐lefèvre syndrome (pls) is a rare disease associated with the early onset of periodontal breakdown in deciduous and permanent dentition. The etiology of the destruction has not been completely clarified. Two female patients (ages 4 and 7 years) with severe destruction of the periodontal structures were examined. Except for palmar and plantar hyperkeratosis, dermatologie examination revealed no other medical disorders. On immunological analysis, measurement of serum antibody titers to 7 periodontopathic bacteria‐ including Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans was performed by enzyme‐linked immunosorbent assay (ELISA). Further immunblot analysis of A. actinomycetemcomitans and microbial culture of samples collected from deep periodontal pockets and mouthrinse solution were performed. The serum of the two patients showed high IgG titer against A. actinomycetemcomitans. Immunoblot results of the two patients against sonicated extract of A. actinomycetemcomitans Y4 strain exhibited a similar pattern. The band pattern differed from that observed in other forms of early onset periodontitis patients or periodontally healthy subjects. Moreover, A. actinomycetemcomitans colonies were cultured in high percentages from the pocket samples. Antibiotic therapy was instituted in addition to conventional periodontal therapy. In the younger patient, all deciduous teeth were extracted as part of the treatment and A. actinomycetemcomitans was no longer detected. All four permanent first molars and 8 permanent incisors subsequently erupted with healthy periodontium. However, the older patient did not improve after periodontal and antibiotic (minocycline and erythromycin) treatments and A. actinomycetemcomitans was consistently detected. Ofloxacin medication finally eliminated A. actinomycetemcomitans from the periodontal pockets. This antibiotic was also associated with reduced gingival inflammation and probing depth. Further destruction of the periodontium has not been detected for 3 years. The serum IgG titers against A. actinomycetemcomitans decreased in both patients. It is suggested that A. actinomycetemcomitans is a major pathogen closely related to periodontal tissue destruction in PLS patients. J Periodontol 1994; 65:364–371.

Pyogenic Liver Abscess and Papillon-Lefèvre Syndrome: Not a Rare Association

“…11,12 A possible role of Actinobacillus actinomycetemcomitans has been reported. [13][14][15] Recurrent infections are relatively common in PLS. 14 An estimated 17% of patients present with marked predisposition to a variety of usually mild infections like skin pyodermas.…”

“…Reported effective treatment for the periodontitis includes extraction of the primary teeth combined with oral antibiotics and professional teeth cleaning. 15,27,28 Moreover, etretinate and acitretin have been claimed to modulate the course of periodontitis and preserve the teeth. 9,26,29,30 However, frequently these treatments do not succeed in preserving the permanent teeth.…”

Papillon-Lefevre Sendromu İle İli̇şki̇li̇ Peri̇odonti̇ti̇s Olgusu: 1 Yillik Taki̇p

“…Bu araşt›rmalarda, periodontal ceplerden elde edilen subgingival plak örneklerinde Actinobacillus actinomycetamcomitans'a ek olarak (11,14,(29)(30)(31)(32)(33), Porphyromonas gingivalis, Fusobacterium nucleatum, Bacteroides forsythus, Treponema denticola ve Prevotella intermedia gibi diğer putatif periodontopatojenlerin de PLS ile ilişkili periodontitis patogenezinde rol oynad›ğ› ortaya konmuştur (11,34,35). Ancak spesifik bakteriyel profile ilişkin bulgular, Lundgren ve ark.…”

Syndromes That Include Both Palmoplantar Keratoderma And Severe Periodontitis: A Review

“…Aggregatibacter actinomycetemcomitans was also reported to have a significant role in the pathogenesis and progression of periodontal involvements in PLS patients. Several patients, however, were positive for other periodontal pathogens [19][20][21]. PLS-periodontitis was also reported to be associated with human herpesviruses [22].…”