Treatment of Patient With Papillon-Lefevre Syndrome With Short Dental Implants: A Case Report

Papillon-Lefèvre syndrome in dental pediatric patient: A comprehensive review

Introduction

Papillon-Lefèvre syndrome (PLS) is an autosomal recessive genetic disorder characterized by the presence of palmoplantar hyperkeratosis on the hands and feet, as well as severe periodontal disease affecting both the primary and permanent teeth, which can lead to premature tooth loss.

Aims

This review aimed to characterize the etiology, clinical manifestations, diagnosis, and recent dental management strategies of pediatric patients with PLS.

Material and Methods

A comprehensive search of the electronic literature was conducted using specific keywords such as "Papillon-Lefèvre syndrome in dentistry," "Etiology of Papillon-Lefèvre syndrome," "Oral manifestations of Papillon-Lefèvre syndrome," "Management of Papillon-Lefèvre syndrome," and "Papillon-Lefèvre syndrome." A total of 47 publications that provided relevant information and discussed the various aspects of PLS were identified.

Conclusion

The management of PLS necessitates a multidisciplinary approach, including the active involvement of a dental surgeon, dermatologist, and pediatrician to ensure comprehensive care. Extraction of primary teeth and administration of antibiotics is a successful treatment strategy, while placement of removable partial denture is the best option for pediatric patients.

Fixed prosthetic rehabilitation of a patient with Papillon-Lefevre syndrome supported by a Quad Zygoma Approach: A clinical report

Papillon-Lefevere syndrome (PLS) is a rare disorder with severe oral manifestations resulting in premature tooth loss at an early stage of life. As a result, extensive bone resorption pattern in the maxilla negates conventional implant treatment in the majority of cases. This clinical report describes a prosthetic rehabilitation revision of a 26-year-old female diagnosed with PLS using an implant supported fixed complete denture with a quad zygoma approach. A 1 year follow-up is also presented.

Long-Term Results after Placing Dental Implants in Patients with Papillon-Lefèvre Syndrome: Results 2.5-20 Years after Implant Insertion

Aim: A retrospective evaluation of patients with Papillon-Lefèvre syndrome (PLS) treated with dental implants to identify factors that may influence treatment outcomes. Methods: All PLS patients with dental implants currently registered at the Department of Periodontology, Goethe-University Frankfurt (20–38 years; mean: 29.6 years), were recruited. Five patients from three families (two pairs of siblings) with a total of 48 dental implants (inserted in different dental institutions) were included with a follow-up time of 2.5–20 years (mean: 10.4 years). Results: Implant failure occurred in three patients (at least 15 implants). Nearly all patients demonstrated peri-implantitis in more or less advanced stages; 60% of patients demonstrated bone loss ≥50% around the implants. Two patients did not follow any supportive therapy. Conclusions: Implants in PLS patients who did not follow any maintenance programme had a high risk of peri-implantitis and implant loss.

"Oral Manifestations of Patients with Inherited Defect in Phagocyte Number or Function" a systematic review

INTRODUCTION

Inherited phagocyte defects are one of the subgroups of primary immunodeficiency diseases (PIDs) with various clinical manifestations. As oral manifestations are common at the early ages, oral practitioners can have a special role in the early diagnosis.

MATERIALS AND METHODS

A comprehensive search was conducted in this systematic review study and data of included studies were categorized into four subgroups of phagocyte defects, including congenital neutropenia, defects of motility, defects of respiratory burst, and other non-lymphoid defects.

RESULTS

Among all phagocyte defects, 12 disorders had reported data for oral manifestations in published articles. A total of 987 cases were included in this study. Periodontitis is one of the most common oral manifestations.

CONCLUSION

There is a need to organize better collaboration between medical doctors and dentists to diagnose and treat patients with phagocyte defects. Regular dental visits and professional oral health care are recommended from the time of the first primary teeth eruption in newborns.

Oral rehabilitation of Papillon-Lefèvre syndrome patients by dental implants: a systematic review

Objectives

Papillon–Lefèvre syndrome (PLS) is a rare autosomal recessive disorder. These patients lose their teeth at a young age and are in need of prosthetic rehabilitation. The aim of this systematic review was to assess the success of dental implant placement in these patients.

Materials and Methods

An electronic search was performed in PubMed Central, Scopus, and Web of Science using the keyword “Papillon–Lefèvre syndrome” AND “dental implant” OR “prosthodontics”. Articles reporting implant placement in patients with PLS until July 2019 were included.

Results

Assessment of the included 11 articles reporting 15 cases showed 136 implant placements in these patients. Implant failure occurred in 3 patients (20 implants). The peri-implantitis and failure rate was higher in the maxilla. Meta-analysis showed the probability of failure to be 7% (95% confidence interval [CI] 0%-31%) for maxillary implants and 2% (95% CI 0%-9%) for mandibular implants. The follow-up time ranged between 1 and 20 years. Healing after bone graft and implant placement in these patients was uneventful.

Conclusion

Dental implants may be a viable treatment option for PLS patients. Implantation can help preserve alveolar bone if the patients’ immunological and growing conditions are well-considered and proper oral hygiene and compliance with the maintenance program are continued.

Primary Immunodeficiencies With Defects in Innate Immunity: Focus on Orofacial Manifestations

The field of primary immunodeficiencies (PIDs) is rapidly evolving. Indeed, the number of described diseases is constantly increasing thanks to the rapid identification of novel genetic defects by next-generation sequencing. PIDs are now rather referred to as “inborn errors of immunity” due to the association between a wide range of immune dysregulation-related clinical features and the “prototypic” increased infection susceptibility. The phenotypic spectrum of PIDs is therefore very large and includes several orofacial features. However, the latter are often overshadowed by severe systemic manifestations and remain underdiagnosed. Patients with impaired innate immunity are predisposed to a variety of oral manifestations including oral infections (e.g., candidiasis, herpes gingivostomatitis), aphthous ulcers, and severe periodontal diseases. Although less frequently, they can also show orofacial developmental abnormalities. Oral lesions can even represent the main clinical manifestation of some PIDs or be inaugural, being therefore one of the first features indicating the existence of an underlying immune defect. The aim of this review is to describe the orofacial features associated with the different PIDs of innate immunity based on the new 2019 classification from the International Union of Immunological Societies (IUIS) expert committee. This review highlights the important role played by the dentist, in close collaboration with the multidisciplinary medical team, in the management and the diagnostic of these conditions.

Papillon-lefevre syndrome: Case series and review of literature

Papillon-lefevre syndrome (PLS) belongs to a heterogeneous group of skin diseases that are characterized by hyperkeratosis of palms and soles. It is a type IV palmoplantar keratosis (PPK) while the palmoplantar keratodermas share some features of PPK, they are etiologically heterogeneous. PLS differs from other types of PPK by the presence of severe and early onset periodontitis. Genetic studies have shown that mutation in the major gene locus of chromosome 11q14 with the loss of function of cathepsin-C (CTSC) gene is responsible for PLS. CTSC gene mutations are causative for PLS. The resultant loss of CTSC function is responsible for the severe periodontal destruction seen clinically. This report represents two siblings with classical signs and symptoms of PLS.

The prosthodontic management of a young edentulous patient with the papillon lefevre syndrome-a rare case report

The Papillon Lefevre syndrome is an autosomal recessive disorder which is characterized by various dermatological manifestations and periodontitis as a manifestation of a systemic disease. Its aetiopathogenesis is thought to be secondary to the mutation of the Cathepsin C gene. Various studies have shown that the immune related cells like the polymorphonuclear leucocytes and the macrophages and their precursors were affected.This report elicits about an edentulous male with this syndrome, who was treated with a modified complete denture prosthesis (hollow, maxillary, complete denture), considering his young age and low socioeconomic status.

Short implants in partially edentuolous maxillae and mandibles: a 10 to 20 years retrospective evaluation

Purpose. Evaluation of the short implant (8 mm in height) long-term prognosis and of the implant site influence on the prognosis. Methods. A longitudinal study was carried out on 121 patients (57 males and 64 females) consecutively treated with 257 implants. 108 implants were short. Results. Four (3.6%) short implants supporting fixed partial prostheses failed. Similarly, three standard implants supporting fixed partial prostheses and one supporting single-crown prosthesis failed. Mean marginal bone loss (MBL) and probing depth (PD) of short and standard implants were statistically comparable (P > .05). The 20-year cumulative survival rates of short and standard implants were 92.3 and 95.9%, respectively. The cumulative success rates were 78.3 and 81.4%. The survival rates of short implants in posterior and anterior regions were comparable: 95 and 96.4%, respectively. The difference between survival rates was not significant (P > .05). Conclusions. The high reliability of short implants in supporting fixed prostheses was confirmed. Short and standard implants long-term prognoses were not significantly different. The prognosis of short implants in posterior regions was comparable to that of in anterior regions. Nevertheless, a larger sample is required to confirm this trend.