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Periodontal status in children with primary immunodeficiencies

Research output: Contribution to journalArticlepeer-review

Luigi Nibali, Josephine Bayliss-Chapman, Hiten Halai, Cheryl Somani, Janet Davies, Philip Ancliff, Nikolaos Donos

Original languageEnglish
Pages (from-to)819-827
Number of pages9
JournalJournal of Periodontal Research
Issue number4
Accepted/In press2021
PublishedAug 2021

Bibliographical note

Funding Information: The assistance of Drs. Kruti Desai, Siobhan Burns and Austen Worth in study set-up is gratefully acknowledged. The assistance of Drs. Carol Mason and Urshla Devalia in their roles as investigators and supervisors at GOSH is gratefully acknowledged. Publisher Copyright: © 2021 The Authors. Journal of Periodontal Research published by John Wiley & Sons Ltd. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Objective: This study aimed to assess associations between neutrophil-related primary immunodeficiencies (PIDs) and the presence of periodontal disease and other oral diseases and response to periodontal treatment. Background: Presence of neutrophil-related PIDs is thought to be a major risk factor for development of periodontitis. Methods: This study had both a cross-sectional and cohort design. Twenty-four children (age 4–16) with PIDs and 24 age-matched systemically healthy subjects received a dental clinical examination, including measures of probing pocket depths (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP). Those found to be affected by periodontal disease were offered periodontal treatment and reassessed 6 months later. Results: Diagnosis of PIDs was associated with increased odds of presence of periodontal disease (p =.008 adjusted for age, gender, plaque, OR = 10.0, 95% CI = 1.83–54.38) and with continuous measures of periodontal disease such as number of PPDs >4 mm, mean PPD and mean CAL (all p <.001) and BOP (p =.001). However, only 7 out of 24 children were diagnosed with periodontitis. PIDs were also associated with a history of oral ulcers (p =.001, OR 12.47, 95% CI 2.71–57.29). An improvement in periodontal parameters (PPD and CAL) was detected following oral hygiene instructions and non-surgical periodontal therapy. Conclusion: Although children affected by neutrophil-associated PIDs exhibited a higher prevalence of periodontal disease compared with systemically healthy children, severe periodontitis was rarely seen. This suggests that good systemic control of the PIDs may reduce their impact on the periodontium.

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