By Francis J. Hughes, Kevin G. Seymour, Wendy Turner, Shakeel Shahdad, Francis Nohl
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Extra info for Clinical Problem Solving in Periodontology and Implantology
Example text
Patients who receive prolonged chemotherapy in this way may often show signs of increased periodontal breakdown as a result of this treatment. 9), aplastic anaemia, and a number of specific single gene disorders in which periodontal breakdown in the deciduous dentition is a prominent feature, which are discussed in the next section. There are a number of inherited diseases that can have profound effects on the periodontal tissues and that are the result of single point genetic mutations that are transmitted by classic Mendelian genetic inheritance patterns.
HIV infection Many patients with diagnosed HIV infection will suffer from periodontitis, as will many patients without HIV infection. In most cases of HIV-infected patients who are being successfully managed by antiretroviral therapies, the effects on periodontitis may be negligible, and patients can be managed using conventional methods. In a small group of patients with HIV infection, particularly those whose infection is not yet under control by appropriate therapy, the HIV infection may predispose to recurring acute necrotizing ulcerative periodontitis.
It appears that the effects of smoking are largely due to a systemic effect resulting in an impaired inflammatory response, with, for example, reduced neutrophil numbers and function at the inflammatory site. Studies of the direct local effects of smoking on the plaque microflora are equivocal, although some studies have suggested an increased number of patho genic bacteria present in plaque of smokers. It is interesting to note that although the effects of smoking on periodontitis have been described for many years, until approximately two decades ago it was thought that the main effect of smoking on periodontitis risk was that smokers tended to have poorer oral hygiene.