A Case Report of Papillon-Lefèvre Syndrome Patient Treated for Ten Years

Abstract

A Papillon-Lefèvre syndrome patient, who showed rapid and severe breakdown of periodontal tissues in deciduous dentition, was treated for more than ten years and has maintained stable clinical periodontal condition until now. The patient, a six years old female, first visited the periodontal clinic with the chief complaint of continuous inflammation of gingiva. The patient had mixed dentition and deep periodontal pockets, advanced resorption of alveolar bone, tooth mobility, redness and swelling of gingiva were observed at most remaining deciduous teeth. Actinobacillus actinomycetemcomitans and Tannerella forsythensis were detected in the oral cavity on microbiological examination. All deciduous teeth with periodontal pockets were extracted to eliminate the reservoir of periodontal pathogens. After removal of the reservoir, frequent oral prophylaxis was performed to prevent recolonization of periodontal pathogens. Nevertheless, periodontal destruction recurred at 31, 32, 41, 42 with inflammation of whole gingiva and rapid breakdown of periodontal tissues and periodontal pathogens were detected at the progressing sites. As periodontal surgery and administration of minocycline were not effective against the rapid destruction of periodontium, levofloxacin was administered at the age of 10 years. Also, a family member who was affected with periodontitis was treated to prevent the infection of periodontal pathogens among the family. After the treatment, periodontal pathogens were removed from the oral cavity of PLS patient and the clinical condition rapidly improved. The patient is now 16 years old with a clinically stable periodontal condition. This PLS patient was treated successfully by the detection of periodontal pathogens, effective removal and monitoring bacteria and prevention of infection from family members.