Implications of Down Syndrome for the Periodontium
1. It is widely known that people with down syndrome often develop severe,
aggressive periodontitis. The prevalence of periodontal disease ranges from 58% to 96% of young people aged up to 35 years old with down syndrome [33].
2. The prevalence of periodontal disease simply cannot be associated with poor oral hygiene. In the etiology of periodontal disease in persons with down syndrome is complex. In recent years, much attention was paid in the altered immune response in the basic genetic disorder [33].
a. Impaired chemotaxis and phagocytosis of neutrophils probably explain the high prevalence and high severity of periodontal disease associated with down syndrome [34,35].
B. Impaired cell motility gingival fibroblasts obstacle wound healing and regeneration of periodontal tissues may be involved in the etiology of the syndrome of periodontal disease [36].
3. Significant plaque biofilm formation, deep periodontal pockets, and extensive inflammation of the gums characterize periodontal down syndrome (Fig.
10-8) [37].
4. Studies show that various periodontal pathogens to colonize the gingival tissue in very early childhood years with children with down syndrome [38].
3. Tests for genetic predisposition to periodontitis. Genetic tests for chronic
periodontitis is difficult to develop, since it appears that there is a single gene responsible for the predisposition to this condition.
A. genetic tests for gene mutations
1. Genetic tests for gene mutations that lead to some of the syndrome forms of periodontitis, such as Chediak-Higashi syndrome and Papillon-Lefevre syndrome already been used.
2. It is important to understand that gene mutations in these rare cases, it appears that no matter when trying to assess the risk for the most common forms of periodontitis, such as chronic periodontitis and aggressive periodontitis.
B. genetic tests for gene variations
1. Gene variations (or SNPs) were examined for possible Association with chronic periodontitis; the most promising of these include several of interleukin (IL) genes.
2. Currently, genetic tests are now sold in the United States for testing for gene polymorphism IL.
a. When two variants : or polymorphisms two Il-1 gene meet together, it appears that there is an increased risk of developing severe periodontitis. This relationship, however, has only been demonstrated in non-smokers.
B. Testing some changes of IL-1 gene is the basis of the genetic test.
c. Although this test focuses on the relationship between periodontal disease and genetics, further research is needed to clarify the clinical usefulness of this type of testing.
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