Periodontal therapy in siblings with Papillon-Lefèvre syndrome and tinea capitis: a report of two cases.
OBJECTIVE
Report of clinical and microbiological periodontal findings before and 6 months after treatment of two siblings with Papillon-Lefèvre syndrome (PLS) and tinea capitis.


METHODS
Two brothers, RG 3 years and NG 5 years of age, were referred for treatment due to premature mobility of their deciduous teeth. Probing depths (PPD), attachment levels (PAL-V), and furcation involvements were examined clinically. Panoramic radiographs were taken. Subgingival plaque samples within the deepest pocket of each tooth were taken and analysed by real-time polymerase chain reaction (PCR) for Actinobacillus actinomycetemcomitans (AA), Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Fusobacterium nucleatum, and Prevotella intermedia. One-stage full-mouth scaling and extraction of hopeless teeth were performed under general anaesthesia, followed by systemic amoxicillin and metronidazole for 7 days. Clinical and microbiological analyses were performed 6 months after treatment.


RESULTS
Before treatment, both siblings had exhibited PPD of up to 13 mm, Class III furcation defects at four teeth, and marginal suppuration. AA was detected in both patients and at all teeth at levels ranging from 3.0 x 10(2) to 5.1 x 10(6). Both patients exhibited palmar and plantar hyperkeratosis. Seven teeth were extracted from RG, and nine from NG. Six months after treatment, PPD had been reduced to <or=5 mm. AA was not detected in any of the remaining teeth.


CONCLUSIONS
Even periodontally affected deciduous teeth of PLS patients can be treated successfully. Suppression of AA to below detection level seems to be of high significance.
Schacher
B
B
Department of Periodontology, Center for Dental, Oral and Maxilllofacial Medicine, Hospital of the J.W. Goethe-University at Frankfurt, Germany. schacher@em.uni-frankfurt.de
Baron
F
F
Ludwig
B
B
Valesky
E
E
Noack
B
B
Eickholz
P
P
D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003773:Dental Plaque / Q000382:microbiology; D012534:Dental Scaling; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000235:genetics / Q000628:therapy; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D010214:Papillon-Lefevre Disease / Q000235:genetics*; D017622:Periodontal Attachment Loss / Q000235:genetics / Q000628:therapy; D010510:Periodontal Diseases / Q000235:genetics* / Q000628:therapy; D010514:Periodontal Pocket / Q000235:genetics / Q000628:therapy; D014006:Tinea Capitis / Q000235:genetics*; D014081:Tooth Extraction; D014086:Tooth Mobility / Q000235:genetics / Q000628:therapy; D014094:Tooth, Deciduous / Q000473:pathology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D000658:Amoxicillin