Combined systemic and local antimicrobial therapy of periodontal disease in Papillon-Lefèvre syndrome. A report of 4 cases

J Clin Periodontol. 1999 Dec;26(12):847-54.

Abstract

4 patients, 2 pairs of siblings, suffering from Papillon-Lefèvre syndrome were treated for periodontal disease. Following extraction of hopeless teeth, the children received scaling and adjunctive systemic antibiotics (metronidazole and amoxicillin for 7 to 10 days). In addition, they performed supragingival pulsated jet irrigation with 0.06% chlorhexidine digluconate 1 x daily. In 2 siblings, A. actinomycetemcomitans was suppressed subgingivally below detectable levels, pocket probing depths were reduced to 4 mm or less, and plaque and bleeding indices were low. No further disease progression was seen over a 3-year-period. Another female patient also showed clinical improvement and suppression of subgingival A. actinomycetemcomitans and B. forsythus up to the 9-month-follow-up, while her sister showed further attachment loss over the course of 4 years. The present case reports indicated that in some patients suffering from Papillon-Lefèvre syndrome periodontal disease may be arrested by means of (i) oral hygiene instruction, (ii) extraction of severely diseased teeth, (iii) scaling, (iv) systemic antibiotics and (v) long-term antimicrobial irrigation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aggregatibacter actinomycetemcomitans / drug effects
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Infective Agents, Local / therapeutic use*
  • Bacteroides / drug effects
  • Child
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Mouthwashes / therapeutic use*
  • Papillon-Lefevre Disease / diagnosis
  • Papillon-Lefevre Disease / drug therapy*
  • Papillon-Lefevre Disease / genetics
  • Papillon-Lefevre Disease / microbiology
  • Pedigree
  • Periodontal Diseases / diagnosis
  • Periodontal Diseases / drug therapy*
  • Periodontal Diseases / genetics
  • Periodontal Diseases / microbiology
  • Porphyromonas gingivalis / drug effects
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Mouthwashes
  • chlorhexidine gluconate
  • Chlorhexidine