Periodontitis as a Manifestation of Systemic diseases

Leukaemia
1. Gingival overgrowth
2. Malignancy of WBCs
3. Gingival bleeding & oral petechiae
4. Oral ulcers
Downs Syndrome
1. Trisomy 21
2. Increased prevalence & severity of perio in both dentitions
  1. Incisor-molar pattern
  2. Rapid disease progression
  3. MoA
    1. Poor OH
    2. Alterations in immune response
  4. Avoided with optimal OH
Papillon-LeFevre syndrome
1. Cathepsin C gene defect
2. Palmar-plantar keratosis
3. Severe generalised perio
  1. Onset before puberty (2yrs)
  2. Child usually loses primary dentition before permanent dentition is fully developed
Ehlers Danlos
1. Defective collagen synthesis
2. Skin hyper-extensibility (stretchy), joint hypermobility
3. 10 types
  1. Type 8 = Periodontitis type
    1. Severe generalised perio
      1. Early onset
      2. Often tooth loss before 30
  2. Type 4 assoc. with perio
4. Bruising of skin & oral tissues
Hypophosphotasia
1. Defective alkaline phosphate enzyme
  1. Essential for bone/teeth mineralisation
2. Skeletal defects
  1. Short limbs, bowed legs
3. Early loss of primary & permanent dentition
4. Abnormal tooth formation
  1. Enlarged pulps
  2. Abnormal morphology
  3. Hypoplasia
Chediak-Higashi syndrome
1. Rare but fatal
2. Partial albinism, photophobia, nystagmus
3. Recurrent pyogenic infections
4. Lymphoma
5. Severe, rapidly progressing periodontitis
  1. Premature tooth loss
Neutropenia
1. Acquired neutropenia
  1. Prolonged low neutrophil levels
2. Cyclic neutropenia
  1. 3wk cycles of low neutrophil levels
  2. Genetic
3. Familial neutropenia
  1. Prolonged low neutrophil levels
4. Localised or Generalised aggressive perio
  1. Gingiva
    1. Ulceration
    2. Desquamation
    3. Inflammation
  2. Treatment
    1. Removal of plaque & calculus
    2. Chx MW
5. Multiple pyogenic infections of skin & mucous membranes
Leukocyte-adhesion deficiency syndrome
1. Severe, recurrent bacterial infections
2. Impaired wound healing
3. Aggressive gingivitis
4. Majority die by 30yrs

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Periodontitis as a Manifestation of Systemic diseases

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