小児の歯周疾患  [in Japanese] Periodontal Diseases in Children  [in Japanese]

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Author(s)

    • 山口 登 YAMAGUCHI Noboru
    • 九州大学大学院歯学研究院口腔保健推進学講座小児口腔医学分野 Section of Pediatric Dentistry, Division of Oral Health, Growth and Development, Kyushu University Faculty of Dental Science

Abstract

本稿では,小児歯周炎で特徴的な限局型侵襲性歯周炎(LAP : localized aggressive periodontitis)および遺伝性疾患を伴う歯周炎の中で最も遭遇する頻度の高いダウン症患児の歯周炎について述べる。まず,LAP の主な特徴は,臨床的に歯肉の炎症が比較的軽度であるにもかかわらず,一方では永久前歯および第一大臼歯部の急速な歯槽骨吸収のため,早期に歯の動揺を引き起こす。口腔内からは,血清型b のロイコトキシン(Ltx : leukotoxin)高産生株である<i>Aggregatibacter actinomycetemcomitans</i>(Aa)が高頻度に検出される。 そのためLAP が疑われた場合は細菌検査を行う。したがって,通常の歯周治療に加えAa 菌に感受性の高いテトラサイクリンなどの抗生物質の全身投与を併用して除菌を行う必要がある。 また,ダウン症患児では,早期に難治性の重篤な歯周組織の破壊を呈することが多い。そのため,徹底的なプラークの除去を行い,一方,細菌検査で歯周病細菌が検出された場合には,感受性の高い抗生物質を投与した併用療法を行うことが望まれる。ダウン症患児の口腔内環境については,まだ不明な点が多い。したがって同患児の口腔内環境をさらに詳しく分析しながら,ダウン症患児のみならず小児の歯周疾患の予防と治療に貢献していきたい。

Here I review the localized aggressive periodontitis (LAP) and the periodontitis associated with Down syndrome. At first, the feature of LAP is that while the gingivitis is clinically weak, severe movement of teeth at the early stage takes place due to the drastic bone resorption of incisors and the first molar. Highly toxic <i>Aggregatibacter actinomycetemcomitan</i>s (Aa) serotype b strains are frequently detected in periodontal pockets. Therefore, the microbacterial tests are recommended in LAP suspected cases. In addition to regular treatments, administration of systemic antibiotics, particularly tetracycline during treatment of LAP is needed.On the other hand, in the patients with Down syndrome, the severe destruction in the periodontal tissues at the early stage and the refractory tendency were shown. Therefore, plaque control is thoroughly necessary. In case that periodontopathic bacteria were detected by the microbial test, they should take an antibiotic therapy using sensitive reagents for each bacteria.However, this environment in the patients with Down syndrome is not still clear. It is necessary to analyze further the oral environment in the patients with Down syndrome in detail, and contribute the prevention and development of a new therapy for dental diseases of these patients in the future.

Journal

  • The Japanese Journal of Pediatric Dentistry

    The Japanese Journal of Pediatric Dentistry 47(5), 693-699, 2009-12-25

    Japanese Society of Pediatric Dentistry

References:  20

Codes

  • NII Article ID (NAID)
    10027488853
  • NII NACSIS-CAT ID (NCID)
    AN00116228
  • Text Lang
    JPN
  • Article Type
    REV
  • ISSN
    05831199
  • Data Source
    CJP  J-STAGE 
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