title: Combined systemic and local antimicrobial therapy of periodontal disease in Papillon-Lefèvre syndrome. A report of 4 cases.
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.
authors.affiliation: Department of Periodontology, School of Dental Medicine, University of Würzburg, Germany. stefan.rudiger@odontologi.gu.se
authors.forename: S
authors.initials: S
authors.lastname: Rüdiger
authors.forename: G
authors.initials: G
authors.lastname: Petersilka
authors.forename: T F
authors.initials: TF
authors.lastname: Flemmig
mesh_terms: D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001439:Bacteroides / Q000187:drug effects; D002648:Child; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009067:Mouthwashes / Q000627:therapeutic use*; D010214:Papillon-Lefevre Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000382:microbiology; D010375:Pedigree; D010510:Periodontal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000382:microbiology; D016966:Porphyromonas gingivalis / Q000187:drug effects; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; C010882:chlorhexidine gluconate; D002710:Chlorhexidine