Treatment of periodontal disease in a patient with Ehlers-Danlos syndrome. A case report and literature review.
BACKGROUND
Ehlers-Danlos syndrome (EDS) designates a heterogeneous group of connective tissue disorders characterized by skin elasticity, tissue fragility, and chronic joint pain. Dental findings have been reported with some types of EDS. This case report describes the periodontal findings in a patient with a previously undiagnosed EDS type VIII.


METHODS
Diagnostic aids utilized included microbial testing, histological examination, gingival crevicular fluid (GCF) analysis for the levels of C-telopeptide pyridinoline cross-links (ICTP), and genetic counseling. Periodontal treatment consisted of mechanical debridement and adjunctive antibiotic therapy.


RESULTS
Genetic counseling and clinical presentation confirmed the diagnosis of EDS type VIII. Periodontal treatment led to marked clinical improvements and GCF levels of the bone resorptive marker ICTP were significantly reduced. The patient and her siblings are currently pursuing appropriate medical care and genetic counseling.


CONCLUSIONS
Periodontal involvement may lead to the diagnosis of an underlying systemic condition. Identification of suspected etiological factors of periodontal disease may prove critical for the general well-being of some patients.
Perez
Luis A
LA
Department of Periodontics/Prevention/Geriatrics, University of Michigan School of Dentistry, Ann Arbor, USA.
Al-Shammari
Khalaf F
KF
Giannobile
William V
WV
Wang
Hom-Lay
HL
D016301:Alveolar Bone Loss / Q000209:etiology; D003094:Collagen / Q000032:analysis; D024042:Collagen Type I; D004535:Ehlers-Danlos Syndrome / Q000150:complications* / Q000175:diagnosis; D005260:Female; D016967:Fusobacterium nucleatum / Q000254:growth & development; D005817:Genetic Counseling; D005883:Gingival Crevicular Fluid / Q000737:chemistry; D005885:Gingival Hyperplasia / Q000209:etiology; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D010455:Peptides / Q000032:analysis; D017622:Periodontal Attachment Loss / Q000209:etiology; D010510:Periodontal Diseases / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D010514:Periodontal Pocket / Q000209:etiology
D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D003094:Collagen