Treatment of aggressive periodontitis in a patient with systemic lupus erythematosus: A case report with 8 years follow-up.

Systemic lupus erythematosus (SLE) with oral desquamative lesions is one of the rare clinical entities. Periodontal disease and SLE display various mechanisms and possess a wide range of pathological characteristics. The tissue destruction mechanism of periodontitis and autoimmune diseases share similar pathways, and mounting reports studied the association between these two entities. The present case is of a 24-year-old female patient who complained of generalized widening of spaces in between the teeth. Along with it, She suffered from loss of hair, weakness, edema in the legs as well as arthralgia. The patient was identified to be suffering from SLE according to the American Rheumatism Association and European Academy of Dermatology and Venereology criteria 1 year before she reported to the dentist. She suffered from hair loss, weakness, arthralgia as well as edema in the legs. Based on the oral, clinical, and radiographic findings, she was diagnosed with aggressive periodontitis case. After nonsurgical periodontal treatment, the flap was reflected, debridement was done, after root conditioning with tetracycline, bovine osseous xenograft was placed in all the sites where ever there is angular bone loss, later sutured with interrupted direct loop suturing technique with 4-0 silk suture. Clinical and radiographic evaluation was done every 6 weeks to check the progress of the treatment. 6 months and 8-year follow-up revealed satisfactory clinical and radiographic outcomes. Based on the present case report and the previous literature, we recommend the use of xenograft in treating aggressive periodontitis patients.

Résumé Le lupus érythémateux systémique (LES) avec lésions buccales desquamatives est l'une des rares entités cliniques. La maladie parodontale et le LED présentent divers mécanismes et possèdent un large éventail de caractéristiques pathologiques. Le mécanisme de destruction des tissus de la parodontite et des maladies auto-immunes partage des voies similaires. partagent des voies similaires, et de nombreux rapports ont étudié l'association entre ces deux entités. Le cas présent est celui d'une patiente de 24 ans 24 ans qui se plaignait d'un élargissement généralisé des espaces entre les dents. En plus de cela, elle a souffert d'une perte de cheveux, de faiblesse, d'œdème dans les jambes et d'arthralgie. La patiente a été identifiée comme souffrant d'un LED selon les critères de l'American Rheumatism Association et de l'Académie européenne de dermatologie et de vénéréologie un an avant de se présenter chez le dentiste. Elle souffrait de de perte de cheveux, de faiblesse, d'arthralgie et d'œdèmes dans les jambes. Sur la base des résultats buccaux, cliniques et radiographiques, elle a été diagnostiquée comme souffrant de parodontite agressive. Après un traitement parodontal non chirurgical, le lambeau a été réfléchi, un débridement a été effectué, après un conditionnement radiculaire après conditionnement radiculaire à la tétracycline, une xénogreffe osseuse bovine a été placée dans tous les sites où il y avait une perte osseuse angulaire. technique de suture en boucle directe interrompue avec une suture en soie 4-0. Une évaluation clinique et radiographique a été faite toutes les 6 semaines pour vérifier la progression du traitement. traitement. Le suivi à 6 mois et à 8 ans a révélé des résultats cliniques et radiographiques satisfaisants. Sur la base du présent rapport de cas et de la littérature précédente, nous recommandons l'utilisation de la xénogreffe dans le traitement des patients atteints de parodontite agressive. Mots-clés: Parodontite, lupus érythémateux systémique, xénogreffe.

Anterior loop of the mental nerve in Saudi sample in Riyadh, KSA. A cone beam computerized tomography study.

BACKGROUND: The portion of inferior alveolar nerve (IAN) existent anterior to the mental foramen, before parting the canal, is referred to as the anterior loop (AL) of the IAN. The presence of AL is important when placing the implant interforaminal area of the mandible. These anatomical discrepancies can be assessed by cone-beam CT (CBCT), for evaluating its position and exact location. The AL is classified into Types I, II and III. In Type I, Y-shaped anatomy; in Type II, anatomy is T-shaped; and in Type III, Y-shaped anatomy is seen, and the incisive branch is thicker as compared to the main branch. AIM: In this study, we aim to analyse the prevalence of different types of AL of the IAN in Saudi sample population. MATERIALS AND METHODS: The present study is a retrospective analysis of 149 (86 female & 63 male) CBCT images of patients records from 2018 June to 2018 September in the department of implant dentistry, KSMC, Riyadh. The age range of the patients who participated in the study was 30-60 years. The mean age of female participants is 42.5 ± 5.8, for the male participants is 48.6 ± 11.4 years respectively. RESULTS: The most frequent type of AL of mental nerve noticed on the right side was of type I (59.1%), followed by type II (27.5%) and type III (13.4%). The most frequent type of AL of mental nerve noticed on the left side was type I (61.7%), followed by type II (26.8%) and type III (11.4%). CONCLUSION: The results of the study encourage the usage of CBCT for planning implant treatment. We also suggest that it is obligatory for professionals to categorise the presence of AL and to measure them appropriately when planning for the procedures in the interforaminal region.