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Review
. 2024 Jan;38(1-2):e25002.
doi: 10.1002/jcla.25002. Epub 2024 Jan 22.

Periodontal disease in down syndrome: Predisposing factors and potential non-surgical therapeutic approaches

Mahdie Ghaffarpour  1 , Morteza Karami-Zarandi  2 , Hossein Ali Rahdar  3 , Seifu Gizaw Feyisa  4 , Elahe Taki  5
Affiliations
Review

Periodontal disease in down syndrome: Predisposing factors and potential non-surgical therapeutic approaches

Mahdie Ghaffarpour et al. J Clin Lab Anal. 2024 Jan.

Abstract

Background: Periodontal diseases (PDs) have been documented to be significantly more prevalent and severe in patients with Down syndrome (DS). Different immunological and microbiological factors contributed to predisposing these patients to progressive and recurrent PDs.

Aim: The aim of this review was to investigate the altered immunological responses and oral microbiota disorders as well as focus on adjunctive non-surgical methods for the treatment of PDs and its applicability in patients with DS.

Material and methods: A literature review was conducted addressing the following topics: (1) the altered immunological responses, (2) orofacial disorders related to DS patients, (3) oral microbiota changing, and (4) adjunctive non-surgical treatment and its efficacy in patients with DS.

Results: Due to the early onset of PDs in children with DS, the need for prompt and effective treatment in these patients is essential.

Discussion and conclusion: So, investigating underlying factors may open a new window to better understand the pathology of PDs in DS people and thus, find better strategies for treatment in such group. Although non-surgical treatments such as photodynamic therapy and probiotic consumption represented acceptable outcomes in different examined patients without DS, data about the application of these convenience and no need for local anesthesia methods in patients with DS is limited.

Keywords: dentistry; down syndrome; immunological defects; oral microbiota; periodontal disease; periodontology; photodynamic therapy; probiotics.

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Conflict of interest statement

The authors declare that there is no conflict of interest in this study.

Figures

FIGURE 1
FIGURE 1
Immune function in Down syndrome. Abnormalities of the cytokines, innate, and adaptive immune system in Down syndrome that result in predisposing periodontitis. Ag, antigen; MMP, matrix metallo proteinase; NK cell, natural killer cell; PGE2, prostaglandin E2; PMN, polymorphonuclear; Treg, T regulatory.
FIGURE 2
FIGURE 2
Photodynamic therapy inhibits periodontal pathogens and promotes tissue regeneration in periodontal pockets. bFGF, basic fibroblast growth factor; LPS, lipopolysaccharide; ROS, reactive oxygen species; TNF, tumor necrosis factor.
See this image and copyright information in PMC

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