Periodontitis associated with plasminogen deficiency: a case report.

Area of Science:

• Periodontology
• Genetics
• Microbiology

Background:

• Plasminogen deficiency is a rare autosomal recessive disorder linked to aggressive periodontitis and gingival enlargement.
• Previous treatments for this condition have yielded limited success.
• This report presents the first successful therapeutic approach for plasminogen deficiency-associated periodontitis.

Observation:

• A 17-year-old female with severe plasminogen deficiency presented with generalized severe periodontitis (pocket depths 6-9 mm, bleeding on probing >30%, mobility).
• Microbiological analysis detected Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and others.
• Treatment involved full mouth disinfection, systemic amoxicillin and metronidazole, and quarterly supportive periodontal therapy.

Findings:

• The therapy resulted in significant periodontal health improvement and arrested disease progression over 4 years.
• Post-treatment examination showed reduced pocket depths (1-6 mm), decreased bleeding on probing (<30%), and improved tooth mobility.
• Microbiological analysis revealed the absence of key periodontal pathogens like Porphyromonas gingivalis post-therapy.

Implications:

• Adjunctive antibiotic therapy may modulate the oral microbiome, reducing inflammation and the risk of pseudomembrane formation in plasminogen deficiency-associated periodontitis.
• Patients with plasminogen deficiency may benefit from a comprehensive treatment strategy including non-surgical debridement, antibiotics, and rigorous supportive care.