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Article: Volume 43 Number 2 Page 130 - March 2016

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  Dent Update 2016; 43: 130-136

Periodontics:  Gingival Inflammation and Aggressive Periodontitis in a Child with a Specific Antibody Deficiency

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Abstract: Exuberant gingival inflammation accompanied by periodontitis is a rare finding in a very young child and may indicate a defect in the host response. Affected children should be referred to appropriate specialists to establish a definitive diagnosis. A 5-year-old girl presented with persistent gingival inflammation and periodontal destruction. Immunological investigations identified specific polysaccharide antibody deficiency which, when treated, resulted in a significant improvement in the gingival condition. This case illustrates the need for integrated management by a wide range of dental and medical specialists. Antibody deficiency is rare but, if not identified and treated effectively, can be associated with chronic ill health and decreased life expectancy.

Clinical relevance: This article describes a rare case of gingival inflammation accompanied by periodontitis in a very young child secondary to an underlying host antibody deficiency and details the investigation, management and clinical outcomes.

Author notes: Singithi Liyange, BDS, Senior House Officer, Periodontal Department, School of Dentistry, Belfast Health Social Care Trust, David Edgar, FRCP, Consultant and Senior Lecturer, Regional Immunology Service of Northern Ireland, Royal Victoria Hospital, Belfast Health Social Care Trust, Michael D Shields, MD, Clinical Professor, Centre for Inflammation and Immunity, Queen’s University Belfast and Gerard J Linden, PhD, Professor of Periodontology, Periodontal Department, School of Dentistry, Belfast Health Social Care Trust and Centre for Public Health, Queen’s University Belfast, Northern Ireland, UK.

Objective: To highlight the need for the integrated management of a complex immune defect affecting both periodontal and systemic health.