Influences of systemic diseases on periodontitis in children and adolescents

Abstract

Systemic diseases affecting the host response as primary immunodeficiencies or secondary defects caused by lack of nutrients or changes in the local tissues are very often accompanied by early-onset prepubertal periodontitis. Local treatment in combination with systemic antibiotics may in milder forms improve the situation, but in many cases the success is questionable and premature loss of teeth occurs. Since the genetic basis of many of the diseases has been identified, future developments permit the correction of at least some of these defects by gene therapy.

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“…Periodontal treatment includes the efficient control of dental plaque and calculus with regular professional cleaning [5].…”

“…Under physiological conditions, the neutrophils that are present in the junctional epithelium help with the phagocytosis of the bacteria. This type of defense is not possible during the neutropenic phase of the disease, or other cells such as monocytes take over [5]. Individuals with this condition often present with otitis media, upper respiratory infections, lymphadenopathy, pneumonia and sepsis due to the decreased response to infections [16].…”

“…According to the literature, severe gingivitis, oral ulcerations and early onset periodontitis, are the most common oral manifestations [5,16].…”

“…Some of the periodontal pathogens present in the periodontal pockets were found to be Actinobacillus actinomycetemcomitans, Prevotella intermedia, Eikenella corrodens and Capnocytophaga sputigena [4]. Aggressive form of periodontal disease in children and adolescents, resulting in premature tooth loss, is uncommon and is often associated with chronic diseases and disabilities that have a major impact on the immune system [5,6]. The age of onset is early, during or after the eruption of primary dentition [7].…”

Pathogenic Factors of P. gingivalis and the Host Defense Mechanisms

“…The protective function of PMNL in human periodontal diseases is demonstrated by the fact that patients with PMNL disorders, e.g. Chédiak-Higashi syndrome, lazy leukocyte syndrome, cyclic neutropeni, chronic granulomatous disease and diabetes mellitus, have usually rapid and severe periodontitis (Genco, 1996;da Fonseca & Fontes, 2000;Delcourt-Debruyne et al, 2000;Meyle & Gonzáles, 2001;Lalla et al, 2007). Furthermore, quantitative analyses using flow cytometer revealed that about 50% of the patients with localized and generalized aggressive periodontitis exhibited depression of phagocytic function of peripheral blood PMNL (Kimura et al, 1992(Kimura et al, & 1993, suggesting that the functional abnormalities of PMNL are implicated in the pathogenesis of both forms of aggressive periodontitis.…”