Oral manifestations and histochemical studies of the gingiva in Down syndrome

Down syndrome is the most frequent of the aneuploids observed in newborn infants whose major manifestations are mental and growth retardation. The purpose of this work was to study the oral manifestations, histological and histochemical changes in gingiva of Egyptian Down syndrome children and to correlate the noted histochemical changes with the intelligence quotient and the karyotype. The study comprised 29 cases (19 males and 10 females) with a mean age of (4.673 + 2.406) and 30 control children (19 males and 11 females) with a mean age of (4.632 + 2.568). 27 cases had pure trisomy 21 and 2 cases was mosaics. General clinical and orodental examination confirmed the developmental variability of Down syndrome patients. The orodental examination showed: 1--A high susceptibility to periodontal disease. 2--Bad oral hygiene. 3--High arched palate, macroglossia, hypocalcification, fissured tongue, underdeveloped maxilla delayed eruption of the primary teeth. The histological and histochemical changes were: 1--Increased inflammatory signs in the epithelium and connective tissue of the gingiva. 2--Amorphous amyloid deposits in lamina propria of Down syndrome children, while it was absent in that of control children. It was more in low I.Q. children with fair gingival index than those with better I.Q. 3--Neutral glycoprotein was stronger in Down syndrome than that in controls. 4--Reduction in the highly acidic MPS. 5--Total protein content was increased in Down syndrome children that of their controls. 6--Acid phosphatase activity was stronger in Down syndrome than of their controls. 7--Alkaline phosphatase activity was less in Down syndrome than of their controls. These changes point to a correlation which needs further investigation in a larger number of cases.