Clinical periodontal findings and microflora profiles in children with chronic neutropenia under supervised oral hygiene.
BACKGROUND
This is the first known case report that used a polymerase chain reaction (PCR)-based method to help identify the oral microflora in patients with chronic neutropenia. In this study, we report clinical periodontal findings and microflora profiles of 2 children, 1 with severe congenital neutropenia (SCN, Kostmann type) and 1 with cyclic neutropenia (CN).


METHODS
The SCN patient had severe gingivitis, whereas the patient with CN had mild gingivitis in the gingival margins. Monthly oral cleaning instruction and review were performed without subsequent periodontal therapy. Oral hygiene conditions remained satisfactory and visible plaque was scarce, despite the persistence of mild gingivitis. Under supervised oral hygiene, we examined the presence of periodontal pathogens from patient plaque samples.


RESULTS
By a PCR-based method, Prevotella nigrescens, Bacteroides forsythus, Campylobacter rectus, and Capnocytophaga gingivalis were detected in the SCN patient and P. intermedia, C. rectus, C. gingivalis, and C. sputigena in the CN patient, suggesting the existence of periodontal pathogens. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and C. ochracea were not found in either patient.


CONCLUSIONS
Use of 1% povidone iodine solution and local antibiotic application under supervised oral hygiene were helpful to improve gingival conditions in patients with chronic neutropenia.
Okada
M
M
Department of Pediatric Dentistry, Hiroshima University Faculty of Dentistry, Japan. mitsugi@hiroshima-u.ac.jp
Kobayashi
M
M
Hino
T
T
Kurihara
H
H
Miura
K
K
D016976:Aggregatibacter actinomycetemcomitans / Q000145:classification; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001439:Bacteroides / Q000145:classification; D002167:Campylobacter / Q000145:classification; D002206:Capnocytophaga / Q000145:classification; D002675:Child, Preschool; D002908:Chronic Disease; D003774:Dental Plaque Index; D005882:Gingival Diseases / Q000382:microbiology* / Q000503:physiopathology / Q000517:prevention & control; D005884:Gingival Hemorrhage / Q000382:microbiology / Q000503:physiopathology / Q000517:prevention & control; D005888:Gingival Pocket / Q000382:microbiology / Q000503:physiopathology / Q000517:prevention & control; D005891:Gingivitis / Q000382:microbiology / Q000503:physiopathology / Q000517:prevention & control; D006090:Gram-Negative Bacteria / Q000145:classification*; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000150:complications* / Q000151:congenital; D009910:Oral Hygiene; D010507:Periodicity; D016133:Polymerase Chain Reaction; D016966:Porphyromonas gingivalis / Q000145:classification; D011206:Povidone-Iodine / Q000627:therapeutic use; D018720:Prevotella / Q000145:classification; D018713:Prevotella intermedia / Q000145:classification; D014208:Treponema / Q000145:classification
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine