Dental Implants in a Young Patient with Papillon-Lefevre Syndrome: A Case Report

Dental Implants in a Young Patient with Papillon-Lefevre Syndrome: A Case Report
June 2003
Woo, Ian MSc, DDS*; Brunner, Daniel P. DDS, MD**; Yamashita, Dennis-Duke R. DDS***; Le, Bach T. DDS, MDÇƒÜ
Implant Dentistry: Volume 12(2) June 2003 pp 140-144
Lippincott Williams & Wilkins
*Resident, Department of Oral and Maxillofacial Surgery, Los Angeles County/University of Southern California Medical Center, Los Angeles, CA.
**Chief Resident, Department of Oral and Maxillofacial Surgery, Los Angeles County/University of Southern California Medical Center, Los Angeles, CA.
***Chairman, Department of Oral and Maxillofacial Surgery, Los Angeles County/University of Southern California Medical Center, Los Angeles, CA.
ÇƒÜClinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Los Angeles County/University of Southern California Medical Center, Los Angeles, CA.
Reprint requests and correspondence to:
Ian Woo, MSc, DDS
Department of Dentistry
Los Angeles County/USCMS
1175 Cummings Street, OPD 1P51
Los Angeles, CA 90033
Fax: (323) 226-5241
E-mail: ianwoo@doctor.com
Abstract TOP
A case is reported of dental implant placement in a 13-year-old patient diagnosed with Papillon-Lefevre Syndrome. Two titanium dental implants were placed in the mandible for an implant-retained denture after the patient complained of having an unstable prosthesis. Follow-up radiographs showed successful osseointegration and preservation of alveolar bone 1 year after implant placement and the continual wearing of a functional dental prosthesis.
Papillon-Lefevre Syndrome is characterized by generalized rapid destruction of the dental alveolar supporting bone and diffused palmoplantar hyperkeratosis. The disorder manifests itself as an autosomal recessive disease with an occurrence of about one to four cases per million. 1 It affects both the primary and secondary dentition. The periodontal changes usually appear before the age of 4 years. Inflammatory response in the periodontium leads to rapid bone loss and exfoliation of teeth. Because both sets of dentitions are affected, these patients are usually edentulous and wearing complete dentures by their teen years.
The exact immunologic abnormality of Papillon-Lefevre Syndrome is unknown. It has been reported that the disease may be associated with diminished neutrophil activity. 2 Microscopic changes include marked chronic inflammation with predominant plasma-cell infiltration, osteoclastic activity, and lack of osteoblastic activity. 3 The bacterial flora in this disease a similar to those found in adult periodontitis with a prevalence of gram negative cocci, rods, and spirochetes. 4
Because conventional periodontal treatment usually fails to arrest the rapid progression of periodontitis, severe loss of alveolar bone is often the result. 2,5,6 Early extractions of all permanent teeth has been considered as the treatment of choice to preserve the remaining supporting bone. 7
Please visit the Web site to view the report in its entirety.