METHODS: A 55-year-old Asian woman visited our department with concerns of worsening tooth mobility, discomfort, and spontaneous gingival bleeding. Initial periodontal examination revealed generalized severe periodontitis (Stage IV Grade C) resulting from leukopenia/neutropenia and poor oral hygiene. A thorough treatment strategy involving comprehensive dental procedures, such as multiple extractions and extensive prosthetic treatment, was implemented. Following the diagnosis of Felty syndrome, the patient was started on treatment with oral prednisolone 40 mg/day, which effectively controlled the disease. Furthermore, there was no recurrence of severe periodontitis after the periodontal treatment.
CONCLUSIONS: Dentists and physicians should be aware that immunocompromised individuals with pancytopenia and poor oral hygiene are at risk of developing extensive periodontitis. If their susceptibility to infection and pancytopenia-related bleeding can be managed, such patients can still receive comprehensive dental treatment, including teeth extractions and periodontal therapy. Cooperation among the dentist, hematologist, and patient is necessary to improve treatment outcomes and the patient\'s quality of life.
方法:一位55岁的亚裔妇女因担心牙齿活动度恶化而访问我们的部门,不适,和自发性牙龈出血.最初的牙周检查显示,由于白细胞减少/中性粒细胞减少和口腔卫生不良,导致广泛性重度牙周炎(IV级C级)。涉及全面牙科手术的彻底治疗策略,如多次拔除和广泛的假体治疗,已实施。在Felty综合征诊断之后,患者开始口服泼尼松龙40毫克/天,有效控制了疾病。此外,牙周治疗后无重度牙周炎复发。
结论:牙医和医生应该意识到,患有全血细胞减少症和口腔卫生差的免疫受损个体有发展为广泛性牙周炎的风险。如果他们对感染和全血细胞减少相关出血的易感性可以得到控制,这些患者仍然可以接受全面的牙科治疗,包括拔牙和牙周治疗。牙医之间的合作,血液学家,和病人是必要的,以改善治疗结果和病人的生活质量。