Dental treatment of a rare case of pyoderma gangrenosum with aggressive periodontal disease

Background and Overview: Pyoderma gangrenosum (PG) is a rare neutrophil-mediated autoinflammatory dermatosis that can involve the oral mucosa. Dental surgery is a potential triggering factor for the onset of PG lesions. The authors describe and discuss the dental management of a rare case of aggress...

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Main Authors: Barbieri, C. (Author), Canciani, E. (Author), Carmagnola, D. (Author), Dellavia, C. (Author), Lodi, G. (Author), Pispero, A. (Author), Varoni, E.M (Author)
Format: Article
Language:English
Published: American Dental Association 2018
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Online Access:View Fulltext in Publisher
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Summary:Background and Overview: Pyoderma gangrenosum (PG) is a rare neutrophil-mediated autoinflammatory dermatosis that can involve the oral mucosa. Dental surgery is a potential triggering factor for the onset of PG lesions. The authors describe and discuss the dental management of a rare case of aggressive periodontitis in a patient with PG, from multiple tooth extractions to prosthetic rehabilitation, including administration of systemic steroid prophylaxis before surgery to prevent the potential onset of PG-related lesions. Case Description: A 22-year-old man who had a diagnosis of PG and who had aggressive periodontal disease underwent dental extractions, gingivoplastic surgery, and prosthetic rehabilitation. The patient received 8 milligrams of betamethasone intramuscularly 20 minutes before the oral surgery. The tissues healed perfectly, and no adverse effects were reported. Conclusions and Practical Implications: For minor oral surgery, prophylactic corticosteroids might help reduce the risk of developing PG-related lesions. The clinician should plan the prosthetic devices to be as atraumatic as possible. © 2018 American Dental Association
ISBN:00028177 (ISSN)
DOI:10.1016/j.adaj.2018.04.025