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Borges MLRDR, Souza JLC, Rodrigues LH, Cornélio MTMN, Anjos ACD, Santos N, Salles TDJM. Clinical and cytogenetic profile of Fanconi anemia diagnosed after implementation of mitomycin C cytogenetic test in the state of Pernambuco, Brazil. Hematol Transfus Cell Ther 2024; 46:113-118. [PMID: 36759292 DOI: 10.1016/j.htct.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/22/2022] [Accepted: 11/16/2022] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Fanconi anemia (FA) is a rare autosomal recessive disease characterized by chromosomal instability and increased predisposition to malignancy. The diagnosis of FA requires clinical evaluation, confirmation of chromosomal fragility and/or analysis of genetic mutations. Therefore, this study aims to identify the clinical profile of patients with FA in the state of Pernambuco, Brazil. METHOD We analyzed 100 individuals referred from the major hematology and bone marrow (BM) transplant centers in the state of Pernambuco, Brazil, between the years 2018 and 2022. The diagnosis of FA was performed using the mitomycin C chromosomal fragility test, clinical data and classical and molecular cytogenetic analyses. RESULTS We enrolled a total of 16 patients with FA to comprise this study. Most of these individuals (87.5%) came from the Agreste and Sertão regions of Pernambuco. We observed a slight female prevalence of FA (1.3:1). The primary clinical and laboratory findings were café au lait spots (62.5%) and bone abnormalities (53%, mainly thumb deformities [40%]). We performed BM cytogenetic analysis for eight patients - seven showed no chromosomal abnormalities and one presented the karyotype 47,XY,+21 [15]. CONCLUSIONS Our results are important to promote public health measures for the early diagnosis of FA, as well as to foster the engagement of a multidisciplinary group in the treatment of this disease.
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Affiliation(s)
| | | | | | | | | | - Neide Santos
- Universidade Federal de Pernambuco (UFP), Recife, PE, Brazil
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Guha Biswas P, Mohan A, Kandaswamy E. Treatment of Periodontitis Affecting Human Primary Teeth-A Systematic Review. Dent J (Basel) 2023; 11:171. [PMID: 37504237 PMCID: PMC10378644 DOI: 10.3390/dj11070171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
The aim of this systematic review is to report the treatment options (Intervention) and outcomes (O) for primary teeth affected by periodontitis (Population) and if the treatment of primary teeth can prevent the spread of periodontitis to permanent teeth (Outcomes). The following databases were searched for papers published before December 2022: PubMed, Embase, Web of Science, and Ebscohost. Studies on children affected by periodontitis involving the primary teeth were included and those on children who presented with periodontitis as a manifestation of systemic disease were excluded. Narrative synthesis and methodological quality assessments were performed for the included studies. Three interventional studies (without a control group) that evaluated treatments involving scaling and root planing (SRP with antibiotics) and extraction were included (total n = 60 patients). Additionally, twelve case reports/case series articles (n = 19 patients) were identified. The diagnoses ranged from aggressive periodontitis to juvenile periodontitis and pre-pubertal periodontitis. Based on a limited number of published studies, it was found that the early treatment of periodontitis affecting the primary teeth using SRP and systemic antibiotics resulted in favorable improvements in PD and CAL. Limited evidence suggests that SRP and the extraction of the primary teeth involved have the potential to prevent periodontitis affecting permanent teeth. Future trials are required to standardize the treatment protocols and to confirm these findings.
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Affiliation(s)
- Protyusha Guha Biswas
- Department of Oral Pathology and Microbiology, Meenakshi Ammal Dental College and Hospital, Chennai 600095, India
| | | | - Eswar Kandaswamy
- Department of Periodontics, Louisiana State University Health Sciences Center, School of Dentistry, New Orleans, LA 70119, USA
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Perdoncini NN, Furquim CP, Bonfim CMS, Soares GMS, Torres-Pereira CC. Self-perception of periodontal health status among individuals with Fanconi anemia. Hematol Transfus Cell Ther 2021; 43:453-458. [PMID: 33023865 PMCID: PMC8573027 DOI: 10.1016/j.htct.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. AIM To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. METHODS AND RESULTS Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (p = 0.014). The DMFT was higher in those who had already undergone dental treatments (p = 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (p = 0.03). The question "Do your gums bleed easily?" had good accuracy in the evaluation of periodontal disease (p = 0.68). CONCLUSION Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
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Touil D, Bouhouch R, Chebil RB, Oualha L, Douki N. Gingival Bleeding in a Child with Fanconi Anemia: A Case Report and Literature Review. Case Rep Dent 2020; 2020:3161053. [PMID: 32231808 PMCID: PMC7085353 DOI: 10.1155/2020/3161053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/13/2020] [Accepted: 02/17/2020] [Indexed: 11/18/2022] Open
Abstract
Fanconi anemia (FA) is a rare autosomal recessive disorder characterized by multiple congenital abnormalities, bone marrow failure, and higher susceptibility to malignancies, especially to head and neck carcinomas. Only few reports about the oral manifestations of FA are available. The main reported oral conditions associated with FA are microdontia and advanced periodontitis. The aim of this paper was to report a case of a 10-year-old patient with FA presenting severe spontaneous gingival bleeding, as well as to discuss the role of the dentist in the management and treatment of this condition.
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Affiliation(s)
- Dorsaf Touil
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Rahma Bouhouch
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Raoua Belkacem Chebil
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Lamia Oualha
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
| | - Nabiha Douki
- University of Monastir, Dental Faculty of Monastir, Research Laboratory LR12ES11, Tunisia
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Pavlič A, Matoh U, Rajić V, Petelin M. Effect of Repeated Antimicrobial Photodynamic Therapy in Treatment of Periodontitis Associated with Fanconi Anemia. Photomed Laser Surg 2016; 35:64-68. [PMID: 27626108 DOI: 10.1089/pho.2016.4122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Periodontal disease is one of common oral manifestations in patients with Fanconi anemia (FA). The aim of the study was to evaluate the effect of photodynamic therapy (PDT) on periodontal clinical and microbial parameters in a patient with FA. MATERIALS AND METHODS For a 16-year-old girl, diagnosed with having FA and periodontal disease, the protocol treatment with duration of 10 months was designed. Every 2 months, thorough oral cavity disinfection was followed by PDT, using photosensitizer phenothiazine chloride activated by a diode laser light. During each visit, periodontal parameters were evaluated: plaque index (PI), gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment level. Simultaneously, the presence of Candida albicans and of five periodontal pathogens was evaluated. RESULTS Clinical results showed improvement in GI, BOP, and PPD during this 10-month period. BOP subsequently reduced from 100% to 79%, 72%, and 60% at 6, 8, and 10 months, respectively. The proportion of sites with PPD of ≥4 mm decreased from 38.7% at the baseline to zero after 10 months. Further, all five bacterial species and C. albicans were reduced significantly. CONCLUSIONS PDT effectively influences periodontal healing and reduces periodontopathogenic bacteria without damaging the patient's tissues.
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Affiliation(s)
- Alenka Pavlič
- 1 Department of Paediatric and Preventive Dentistry, Faculty of Medicine, University of Ljubljana , Ljubljana, Slovenia
| | - Urban Matoh
- 2 Unit of Oral Medicine and Periodontology, Division of Stomatology, University Medical Centre Ljubljana , Ljubljana, Slovenia
| | - Vladan Rajić
- 3 Department of Haematology and Oncology, University Children's Hospital , Ljubljana, Slovenia
| | - Milan Petelin
- 4 Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana , Ljubljana, Slovenia
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Goswami M, Bhushan U, Goswami M. Dental Perspective of Rare Disease of Fanconi Anemia: Case Report with Review. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2016; 9:25-30. [PMID: 27013901 PMCID: PMC4798261 DOI: 10.4137/ccrep.s37931] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/10/2016] [Accepted: 01/12/2016] [Indexed: 11/09/2022]
Abstract
Fanconi anemia is an extremely rare genetic disease characterized by chromosomal instability that induces congenital alterations in individuals. It causes defective hemopoiesis ultimately leading to bone marrow failure. Patients are susceptible to recurrent infections and increased risk of hemorrhage, as well as delayed and poor wound healing. Herein, we report a case of Fanconi anemia in which various classical signs of the disease were present. The patient has been on regular follow-up since three and a half years for management of dental problems. The different aspects of this rare disorder are discussed with emphasis on oral manifestations and their influence on the general health of affected patients. Due to an increased susceptibility to developing cancers in this specific population, it is imperative for pediatric dentists to know about the common oral manifestations and potentially cancerous lesions, in order to make an early diagnosis and provide comprehensive care and maintenance of oral health in affected individuals.
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Affiliation(s)
- Mridula Goswami
- HOD and Professor, Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences (MAIDS), New Delhi, India
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Lyko K, Lemes AL, Bonfim C, Torres-Pereira CC, Amenábar JM. Oral health status in children and adolescents with Fanconi anemia. SPECIAL CARE IN DENTISTRY 2015; 36:71-4. [PMID: 26603241 DOI: 10.1111/scd.12151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the caries experience, dental care level, and oral hygiene in children and adolescents with Fanconi anemia. METHODS Decay-missing-filled teeth index, restorative index and simplified oral hygiene index were examined in two groups of children and adolescents: FA, diagnosed with Fanconi anemia (n = 35) and a healthy control group, non-FA (n = 35). Oral hygiene habits were assessed through questionnaires completed by parents. RESULTS FA group presents higher decay-missing-filled teeth index values, dental care index, oral hygiene index. Nevertheless, no statistical difference was observed between the groups. Frequency of visits to the dentist was higher in the non-FA group. Frequency of tooth brushing was higher in FA group and it was performed by the subjects without the help of their parents. CONCLUSIONS No difference was observed in caries experience, dental care level, and oral hygiene in children and adolescents with FA when compare with non-FA.
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Affiliation(s)
- Karine Lyko
- Post-Graduate Program in Dentistry Student, Oral Medicine Department, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Aline Louise Lemes
- Post-Graduate Program in Dentistry Student, Oral Medicine Department, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Carmem Bonfim
- Bone Marrow Transpantation Unit physician, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | - José Miguel Amenábar
- Oral Medicine Department Professor, Universidade Federal do Paraná, Curitiba, PR, Brazil
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D'AGULHAM ACD, CHAIBEN CL, LIMA AASD, TORRES-PEREIRA CC, MACHADO MÂN. Fanconi Anemia: main oral manifestations. ACTA ACUST UNITED AC 2014. [DOI: 10.1590/1981-8637201400030000082275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Fanconi Anemia is a recessive and rare genetic disorder, characterized by chromosomal instability that induces congenital alterations in individuals. Aplastic anemia due to the progressive failure of the bone marrow, malignant neoplasias such as acute myeloid leukemia, liver tumors and squamous cell carcinoma are some of the possible evolutions of Fanconi Anemia. Some of these diseases develop mainly after bone marrow transplantation. The aim of this critical review of the literature was to discourse about the main oral manifestations and their involvement in the health of individuals who are ill with Fanconi Anemia. The clinical oral findings described in the literature include periodontal changes, such as gingivitis and aggressive periodontitis, recurrent aphthous ulcers and traumatic lesions. Papillary atrophy, macroglossia, melanic pigmentation and squamous cell carcinoma are the most common oral manifestations on the tongue. An increased risk for the development of malignant neoplasias in individuals with Fanconi Anemia has been reported, and this is progressive after bone marrow transplantation. In radiographs, dental anomalies such as the presence of supernumerary teeth, tooth agenesis, tooth rotation and transposition of teeth are observed. Salivary flow and some salivary components are also altered. Due to the increased susceptibility to the development of cancer in this specific population, it is important for the dentist to know the common oral manifestations and potentially cancerous lesions, in order to make an early diagnosis in individuals with Fanconi Anemia.
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Vieira AR, Albandar JM. Role of genetic factors in the pathogenesis of aggressive periodontitis. Periodontol 2000 2014; 65:92-106. [DOI: 10.1111/prd.12021] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2012] [Indexed: 12/14/2022]
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Lyko K, Bonfim C, Benelli EM, Torres-Pereira CC, Amenábar JM. Salivary detection of periodontopathic bacteria in Fanconi's anemia patients. Anaerobe 2013; 24:32-5. [DOI: 10.1016/j.anaerobe.2013.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 09/09/2013] [Indexed: 11/26/2022]
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Ambili R, Preeja C, Archana V, Nisha KJ, Seba A, Reejamol MK. Viruses: are they really culprits for periodontal disease? A critical review. ACTA ACUST UNITED AC 2013; 5:179-87. [DOI: 10.1111/jicd.12029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Accepted: 12/03/2012] [Indexed: 12/26/2022]
Affiliation(s)
- Ranjith Ambili
- Department of Periodontics; PMS College of Dental Science and Research; Kerala India
| | - Chandran Preeja
- Department of Periodontics; PMS College of Dental Science and Research; Kerala India
| | - Vilasan Archana
- Department of Periodontics; PMS College of Dental Science and Research; Kerala India
| | | | - Abraham Seba
- Department of Periodontics; PMS College of Dental Science and Research; Kerala India
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Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain C. [Clinical manifestations of hematological non-neoplastic diseases in Dentistry]. Med Clin (Barc) 2012; 139:18-24. [PMID: 22197599 DOI: 10.1016/j.medcli.2011.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 10/05/2011] [Accepted: 10/06/2011] [Indexed: 10/14/2022]
Abstract
Systemic disease can cause clinical manifestations in the oral and maxillofacial area, which is important to recognize because it could be the first symptom of an undiagnosed illness. There are different oral signs that could suggest the clinician a blood disorder, such as pallor, petechiae, ecchymosis, ulcerations, gingival hypertrophy or spontaneous gingival bleeding. In addition, blood disorders will determine the dental management of these patients and the protocol for limiting possible complications that may arise due to the treatment itself. This paper reviews the oral manifestations and dental management of non-neoplastic alterations of red cells, white cells and hemostasis, with emphasis on two-way relationship that must exist between the dentist and the patient's hematologist for making a treatment plan.
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Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, España.
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Kim JH, Park BL, Pasaje CFA, Bae JS, Park JS, Park SW, Uh ST, Choi JS, Kim YH, Kim MK, Choi IS, Cho SH, Choi BW, Park CS, Shin HD. Association of FANCC polymorphisms with FEV1 decline in aspirin exacerbated respiratory disease. Mol Biol Rep 2011; 39:2385-94. [PMID: 21670957 DOI: 10.1007/s11033-011-0989-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 05/28/2011] [Indexed: 11/24/2022]
Abstract
Aspirin exacerbated respiratory disease (AERD) is a clinical condition characterized by severe decline in forced expiratory volume in one second (FEV1) following the ingestion of non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin. The exacerbated inflammatory response in Fancc-deficient mice has been reported to be associated with hemopoietic responses that are also related to AERD pathogenesis. To investigate associations of FANCC polymorphisms with AERD and related phenotypes, this study genotyped 25 common single nucleotide polymorphisms (SNPs) in a total of 592 Korean asthmatics including 163 AERD and 429 aspirin-tolerant asthma (ATA) subjects. Logistic analysis revealed that genetic polymorphisms of the FANCC gene might not be directly related to AERD development and nasal polyposis (P > 0.05). However, the FEV1 decline by aspirin provocation showed significant associations with FANCC polymorphisms (P = 0.006-0.04) and a haplotype (unique to rs4647416G > A, P = 0.01 under co-dominant, P = 0.006 under recessive model). In silico analysis showed that the "A" allele of rs4647376C > A, which was more prevalent in AERD than in ATA, could act as a potential branch point (BP) site for alternative splicing (BP score = 4.16). Although replications in independent cohorts and further functional evaluations are still needed, our preliminary findings suggest that FANCC polymorphisms might be associated with the obstructive symptoms in allergic diseases.
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Affiliation(s)
- Jeong-Hyun Kim
- Department of Life Science, Sogang University, Seoul 121-742, Republic of Korea
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de Araujo MR, de Oliveira Ribas M, Koubik ACGA, Mattioli T, de Lima AAS, França BHS. Fanconi's anemia: clinical and radiographic oral manifestations. Oral Dis 2007; 13:291-5. [PMID: 17448211 DOI: 10.1111/j.1601-0825.2006.01282.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fanconi's anemia (FA) is a rare autosomal recessive disorder characterized by progressive bone marrow failure, congenital abnormalities, and predisposition to malignancies. There are 11 genetic subtypes characterized by complementation groups - FA- A, B, C, D1, D2, E, F, G, I, J, and L. OBJECTIVE To evaluate and describe clinical, oral and radiographic manifestations of patients with FA. METHODS A quantitative analysis of clinical manifestations, oral lesions and panoramic radiographs was performed in 33 patients. RESULTS Clinical manifestations included melanin skin pigmentation, skin vascular and ocular anomalies. Melanin pigmentation on oral mucosa, traumatic lesions, gingival bleeding, dental biofilm and gingival alterations were the main oral manifestations that were found. Oral and clinical manifestations were not dependent on patient's sex. No significant statistical difference between females and males was detected. Dental anomalies were not remarkable either at clinical or at radiographic examinations. Although several dental anomalies were observed in patients with FA, the correlation between this disease was not established from this study. Panoramic radiographs showed agenesis, taurodontism, radicular anomalies such as dilaceration, tapering, and foreshortening. CONCLUSION This study suggests that gingival alterations are associated with defective oral hygiene but not with hematologic conditions. It also helps elucidate oral manifestations of FA. These patients are living longer and need special dental care.
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Affiliation(s)
- M R de Araujo
- Department of Stomatology and Surgery of Pontifícia, Universidade Católica do Paraná, Paraná, Brazil.
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Abstract
BACKGROUND Guillain-Barré syndrome (GBS), an autoimmune disorder of the peripheral nervous system, is characterized by rapidly ascending neural paralysis, hyporeflexia, and areflexia. The polyneuropathy of the GBS affects one to four humans per 100,000 of the population annually throughout the world (adults and children). The pathogenesis of GBS remains unclear. However, there are increasing indications that the disease is triggered by a preceding well-established febrile infection by cytomegalovirus (CMV). The present report describes active CMV within the periodontium of a 37-year-old patient affected by GBS. METHODS Real-time reverse transcriptase-polymerase chain reaction (real-time RT-PCR) was performed to detect CMV, Epstein-Barr virus-1 (EBV-1), herpes simplex 1 (HSV-1) and 2 (HSV-2) virus, and enteroviruses (polio-, coxsackie-, echo-, and enteroviruses 68 and 71) from periodontal sites demonstrating advanced attachment loss. Healthy sites and sites with inflamed gingival tissue were not included in the study. Anaerobic bacterial culture determined the occurrence of potential major periodontal pathogens. RESULTS Real-time RT-PCR and microbiologic analysis revealed the presence of a dual infection of CMV and specific bacterial plaque. CMV, Porphyromonas gingivalis, Tannerella forsythensis, and Campylobacter species were associated with periodontitis active sites, loss of attachment, and gingival bleeding. Furthermore, periodontal sites infected by active CMV had no visible radiographic crestal lamina dura. CONCLUSIONS The periodontium may serve as a reservoir for CMV and a source of viral replication. However, further research is needed to test whether viral replication in the periodontium precedes the GBS symptoms.
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Affiliation(s)
- Giorgio Tabanella
- Department of Periodontology, Advanced Periodontology, School of Dentistry, University of Southern California, Los Angeles, CA 90089-0641, USA.
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Açikgöz A, Ozden FO, Fisgin T, Açikgöz G, Duru F, Yarali N, Albayrak D. Oral and dental findings in Fanconi's anemia. Pediatr Hematol Oncol 2005; 22:531-9. [PMID: 16169820 DOI: 10.1080/08880010591002413] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Fanconi's anemia is an autosomal recessive disorder characterized by progressive pancytopenia and congenital malformation of the skeleton. This study investigated the oral health status of 15 children with Fanconi's anemia, including oral lesions, gingival and periodontal status, and dental abnormalities. All children in the group were found to have a tendency to develop tooth decay and were in need of dental treatment. Two had aggressive periodontitis. In one patient supernumerary teeth were found, while in another teeth were congenitally missing. The increased tendency toward periodontal disease in patients with Fanconi's anemia may be due not only to the anemia, leukopenia, and defective detoxification of oxygen radicals that are characteristic of the disease itself, but also to medications applied during intense immunosuppressive treatment, such as prednisolone.
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Affiliation(s)
- Aydan Açikgöz
- Baskent University Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Ankara, Turkey
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Abstract
The purpose of this review was to evaluate the evidence supporting the hypothesis that viral infection plays a role in the development of periodontitis. An involvement in periodontal diseases has been suspected specifically for human immunodeficiency virus (HIV) and herpes viruses. An association has been demonstrated between HIV infection and some distinct forms of periodontal infection, i.e. necrotizing lesions. Furthermore, reports of increased prevalence and severity of chronic periodontitis in HIV-positive subjects suggests that HIV infection predispose to chronic periodontitis. Several studies, most of them from the same research group, have demonstrated an association of herpesviruses with periodontal disease. Viral DNA have been detected in gingival tissue, gingival cervicular fluid (GCF) and subgingival plaque from periodontaly diseased sites. In addition markers of herpesviral activation have been demonstrated in the GCF from periodontal lesions. Active human cytomegalovirus (HCMV) replication in periodontal sites may suggest that HCMV re-activation triggers periodontal disease activity. Concerns regarding sampling, methods and interpretation cast doubts on the role of viruses as causes of periodontal disease.
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Affiliation(s)
- I Cappuyns
- School of Dental Medicine, University of Geneva, Geneva, Switzerland.
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Affiliation(s)
- Jørgen Slots
- School of Dentistry, University of Southern California, Los Angeles, CA, USA
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Açikgöz G, Açikgöz A, Keskiner I, Türk T, Otan F. Aggressive periodontitis with supernumerary teeth: a retrospective study. J Periodontol 2005; 75:1458-60. [PMID: 15633320 DOI: 10.1902/jop.2004.75.11.1458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There are four key studies in the periodontology literature reporting the correlation between supernumerary teeth and aggressive periodontitis. The aim of this study is to detect such a relationship. METHODS Patients with supernumerary teeth were identified retrospectively from their orthopantomographs and were invited to the periodontology department for intraoral examination. They were then evaluated for aggressive periodontitis. The number of existing teeth, age, family histories, attachment loss, probing depths, and bleeding on probing scores were recorded. RESULTS Of the 5,850 subjects randomly observed among 48,000 patients, only 174 exhibited supernumerary teeth. Of these 174 subjects, only three patients were diagnosed with aggressive periodontitis. One of the patients was also suffering from Fanconi's anemia. CONCLUSIONS Despite the similarities (aggressive periodontitis accompanied by supernumerary teeth) in the previous reports, we do not agree with the earlier results. We rather suggest that this association might be a random occurrence, rather than a biological one, although this observation should be further investigated using genetic testing.
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Affiliation(s)
- Gökhan Açikgöz
- Department of Periodontology, Faculty of Dentistry, University of Ondokuz Mayis, Samsun, Turkey.
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Abstract
AIM Human cytomegalovirus (HCMV), a herpesvirus, is discussed in this review as it relates to destructive periodontal disease in humans. RESULTS HCMV genomic sequences, detected by polymerase chain reaction identification, occur with elevated frequency in severe adult periodontitis, localized and generalized aggressive (juvenile) periodontitis, Papillon-Lefèvre syndrome periodontitis, acute necrotizing ulcerative gingivitis, and periodontal abscesses. DISCUSSION Herpesviruses establish lifelong persistent infections. HCMV infection involves an asymptomatic latent phase interrupted by periods of recrudescence where viral replication and possibly clinical disease become manifest. HCMV reactivation is triggered by a number of immunosuppressive factors, some of which have been shown also to be risk factors/indicators of periodontitis. HCMV periodontal infection may cause release of tissue-destructive cytokines, overgrowth of pathogenic periodontal bacteria, and initiation of cytotoxic or immunopathologic events. CONCLUSIONS A growing body of data supports the concept that HCMV contributes to severe types of periodontal disease. HCMV infection of the periodontium may alter the immune control of resident microorganisms and be important in a multistage pathogenesis of periodontitis involving viral activation, periodontopathic bacteria, and host immune responses. Understanding the significance of HCMV and other herpesviruses in the development of periodontal disease may have important therapeutic implications. Vaccines against HCMV, which are in various stages of development, need to be evaluated for their ability to decrease the incidence of destructive periodontal disease.
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Affiliation(s)
- J Slots
- University of Southern California, School of Dentistry, Los Angeles, CA 90089-0641, USA.
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23
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Nowzari H, Jorgensen MG, Aswad S, Khan N, Osorio E, Safarian A, Shidban H, Munroe S. Human cytomegalovirus-associated periodontitis in renal transplant patients. Transplant Proc 2004; 35:2949-52. [PMID: 14697947 DOI: 10.1016/j.transproceed.2003.10.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Human cytomegalovirus (HCMV) infection is associated with renal transplant failure. Periodontal pockets may be reservoirs for HCMV replication. OBJECTIVES This study was done to determine active HCMV replication in saliva and gingival crevicular fluid of renal transplant patients affected by periodontitis. METHODS HCMV pp67-mRNA amplification was analyzed in oral fluids of 38 transplant recipients at 6 months' posttransplantation. Patients received antiviral therapy until 3 months' posttransplantation. The HCMV-positive cell line VR-977 was the positive control, and oral fluids from healthy volunteers served as the negative control. Periodontitis was diagnosed by clinical examination. Serum HCMV IgG and IgM were analyzed to differentiate recent and latent infection. RESULTS Prevalence of gingival overgrowth was 68.4%. HCMV gene transcripts were detected in the saliva of 21% and the gingival crevicular fluid of 18% of patients. All patients (100%) with HCMV pp67-mRNA detected in saliva demonstrated clinical manifestations of viral infection, as did 86% of patients with HCMV pp67-mRNA detected in the gingival crevicular fluid. Serum IgM was positive in 7.9% of patients and IgG in 65.8%; however, associations with active mRNA replication were not statistically significant. CONCLUSIONS Renal transplant patients affected by periodontitis are at risk of viral replication within the periodontal tissues despite antiviral therapy. This study suggests that use of HCMV pp67-mRNA detection in saliva and gingival crevicular fluid provides markers of active viral infection, and evidence for a link between HCMV-associated periodontitis and renal transplant complications.
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Affiliation(s)
- H Nowzari
- School of Dentistry, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089-0641, USA
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24
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Abstract
Fanconi's anaemia (FA) is an autosomal recessive disorder that is clinically characterized by aplastic anaemia, congenital malformations of the renal, cardiac, skeletal and skin structures, and an increased predisposition to malignancies. Patients with FA often present with bleeding and infection, which are symptoms related to thrombocytopenia and neutropenia. There are few reports of the oral manifestations of FA. We describe oral aphthous ulcerations in two siblings with FA. There was a rapid improvement and healing of ulcers after blood transfusions and increased haemoglobin levels. This may support the role of severe anaemia in oral ulcerations.
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Affiliation(s)
- Feyza Otan
- Ondokuz Mayis University, Faculty of Dentistry, Department of Periodontology, Kurupelit-Samsun, Turkey
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25
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Stanford TW, Rees TD. Acquired immune suppression and other risk factors/indicators for periodontal disease progression. Periodontol 2000 2003; 32:118-35. [PMID: 12756038 DOI: 10.1046/j.0906-6713.2003.03210.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Thomas W Stanford
- Department of Peiodontics Baylor College of Dentistry Texas A&M University System Health Science Center, Dallas, Texas, USA
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