Periodontal changes associated with chronic idiopathic neutropenia.

Abstract

This case report focuses on the periodontal status of a young patient with chronic idiopathic neutropenia. A fouryear clinical course is presented. Chronic idiopatin’c neutropenia is a relatively rare blood dyscrasia characterized by a severe decrease in the number of circulating neutrophils. Young individuals exin’biting tins problem experience rapid destruction of periodontal structures. A review of related literature reveals that the few discussions of dental symptoms available relate common findings: exaggerated gingivitis, premature exfoliation of the primary dentition and recurrent occurrence of aphthoustype lesions. While some mechanisms explaining the lack of circulating neutrophils have been postulated, the exact etiology of chronic idiopathic neutropenia is unknown. Dental therapy for individuals exin’biting tins condition shouM be aimed at the reduction of local inflammation by careful and frequent removal of local irdtational factors. Great care shouM be employed during dental therapy to reduce the possibility of bacteremias. and respiratory tract. Several cases7-11,~,~.4~-57.4.s~ have discussed the response of the gingiva and periodontal supporting apparatus during the neutrophil disorder. Severe gingivitis, oral ulcers and destruction of the alveolar crest have been consistently noted. Suggested therapy for children exhibiting this hematologic phenomena has included cysteine, ~ blood transfusions/ pyridoxine hydrochloride (vitamin B6), ~.~ plasma transfusions, s transfusion with packed white cells, ~ non-specific fever therapy/ splenectomy, u,~3 cortisone, 41,~.u testosterone, 5 and somatotropic hormone? Only antibiotic therapy has had predictable success in control of the systemic sequela.’s,~a.4~ Newer methods of granulocyte transfusion appear to exhibit significant promise in future therapy regimes? ~ The purpose of this paper is to present a case report of a child exhibiting chronic neutropenia, discuss classification of such neutropenias and review dental management for children with such problems.