Periodontal status in children with primary immunodeficiencies.

Abstract

This study aimed to assess associations between neutrophil-related primary immunodeficiencies (PIDs) and the presence of periodontal disease and other oral diseases and response to periodontal treatment. Presence of neutrophil-related PIDs is thought to be a major risk factor for development of periodontitis. This study had both a cross-sectional and cohort design. Twenty-four children (age 4-16) with PIDs and 24 age-matched systemically healthy subjects received a dental clinical examination, including measures of probing pocket depths (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP). Those found to be affected by periodontal disease were offered periodontal treatment and reassessed 6months later. Diagnosis of PIDs was associated with increased odds of presence of periodontal disease (p=.008 adjusted for age, gender, plaque, OR=10.0, 95% CI=1.83-54.38) and with continuous measures of periodontal disease such as number of PPDs >4mm, mean PPD and mean CAL (all p<.001) and BOP (p=.001). However, only 7 out of 24 children were diagnosed with periodontitis. PIDs were also associated with a history of oral ulcers (p=.001, OR 12.47, 95% CI 2.71-57.29). An improvement in periodontal parameters (PPD and CAL) was detected following oral hygiene instructions and non-surgical periodontal therapy. Although children affected by neutrophil-associated PIDs exhibited a higher prevalence of periodontal disease compared with systemically healthy children, severe periodontitis was rarely seen. This suggests that good systemic control of the PIDs may reduce their impact on the periodontium.