Preventive periodontal regimen in Papillon-Lefèvre syndrome

The purpose of this study was to evaluate the effect of a comprehensive preventive program, based on mechanical plaque control and local and systemic antibacterial measures, on periodontal health and preservation of permanent teeth in patients with Papillon-Lefèvre syndrome (PLS).

Thirty-five consecutive PLS patients (median age=7 years; range=3-19 years) were treated and followed every third month over 3 to 7 years. Visible plaque, bleeding on probing, periodontal pockets > or = 5 mm, and number of lost permanent teeth were registered at the first visit and during the follow-up period. Due to severe periodontal inflammation, all primary teeth were extracted prior to the eruption of the first permanent tooth. Tooth-brushing was supported by comprehensive periodontal care and local and systemic chemotherapeutics (chlorhexidine and amoxicillin/metronidazole) on individual indications.

Subjects treated strictly according to the program from their early years showed significantly fewer signs of periodontal disease and lost fewer permanent teeth than patients who started the program at an older age (P<.05). This was especially true if signs of periodontal disease had emerged when the treatment started. Compliance with the treatment protocol had a significant impact on the presence of plaque, bleeding surfaces, periodontal pockets, and number of lost permanent teeth.

Early treatment and compliance with the preventive program were the major determinants for preserving permanent teeth in young PLS patients.