The periodontal management of a patient with a profound immunodeficiency disorder

Abstract

A case of severe, uncontrolled periodontal disease in a patient with a profound immunodeficiency disorder is reported. The periodontal disease was noted before the age of 10 years and is generalized, with marked associated alveolar bone loss, even threatening a mandibular fracture. Severely involved teeth were allowed to exfoliate, and extractions were avoided. At the age of 17 years, the patient now has only nine remaining teeth. The management adopted and alternative approaches are critically reviewed. The implications of the dental findings for current concepts of the pathogenesis of periodontal disease and dental caries are discussed.

Periodontal changes by HIV serostatus in a cohort of homosexual and bisexual men

“…The relationship of periodontal health to HIV-1 infection is an unresolved topic. Reports of periodontal disease prevalence among seropositive subjects vary widely (Masouredis et al 1991, Melnick et al 1989, Silverman et al 1986, and studies on inflammatory gingival and periodontal disease in immunosuppressed humans are conflicting (Been & Engel 1982, Oshrain et al 1983, Roberts & Walker 1976, Robertson et al 1980, Swango et al 1991, Tollefson et al 1977. Because of diversity in study methods, periodontal disease definitions and study groups, comparisons of prevalence between studies are not reliable.…”

“…Melnick et al (1989) reported that periodontitis was more common in HIV antibody-positive subjects than in antibody-negative subjects, 5% compared to 0.2%, among a non-clinic sample of 747 homosexual males. Roberts & Walker (1976) reported a case of severe uncontrolled periodontal disease in a patient with profound immunodeficiency disorder. And, Oshrain et al (1983) reported a significantly higher increase over time in the gingival index, and not in the plaque index, of six renal transplant patients on immunosuppressant therapy compared to 6 healthy age matched controls.…”

Abnormalities of leukocyte chemotaxis in patients with various forms of periodontitis

“…To our knowledge, there have been subgingival plaque components in prepuonly three prior publications describing leu-bertal patients. Antibodies to Capnocytokocyte dysfunction in children with this dis-phaga sputigena were most common in these order, and each has presented data on one patients, while antibodies to B. gingivalis, A. or two subjects (Roberts & Walker 1976, actinomycetemcomitans, and H. aphrophilus Shurin et al 1979, Bowen et al 1982). In were absent or found rarely.…”