Manifestations and treatment of periodontal disease in a patient suffering from cyclic neutropenia.
A case of severe periodontitis in a young man suffering from cyclic neutropenia is reported. The periodontal status as evaluated from oral radiographs at the age of 13 reveals advanced periodontal breakdown around the molars and the incisors in both jaws. At the age of 21, when clinical examination was performed, all teeth were found to be periodontally involved. The treatment was divided into three phases: (1) a causative treatment phase (oral hygiene phase) aimed at achieving the highest possible level of oral cleanliness, (2) a corrective phase including periodontal surgery and prosthetic rehabilitation and (3) a maintenance phase aimed at prevention of recurrence of periodontal disease. The oral hygiene phase was markedly extended both in time (2 years) and intensity. Several reexaminations were carried out during the course of this phase to evaluate the patient's ability to exercise proper plaque control and the response of the tissues to treatment. The progression of the periodontal disease could be arrested and the prosthetic treatment indicated was successfully performed. Following the corrective treatment phase a maintenance care program was designed including frequent recall appointments in order to prevent disease recurrence. Four years after active treatment no further periodontal breakdown could be observed as evaluated from pocket depth, attachment level and bone height measurements. The result of the treatment of this patient shows that treatment, designed to eliminate plaque infection, is effective also in an individual with defective host defense against bacterial infections, but the demand on the patient's cooperation must be extraordinary high as well as the demand on the effectiveness of the maintenance care program.
D000328:Adult; D000380:Agranulocytosis / Q000150:complications*; D003729:Dental Care; D003830:Denture, Partial, Fixed; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000150:complications*; D009910:Oral Hygiene; D010518:Periodontitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011859:Radiography; D013524:Surgical Flaps