Management of Gingival Enlargement in Papillon–Lefèvre Syndrome Using Diode Laser-Assisted Gingivectomy: A Case Report
Main Article Content
Abstract
Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder characterized by progressive periodontitis and palmoplantar hyperkeratosis, associated with CTSC gene mutations causing cathepsin C deficiency. This case report presents the diagnosis and management of gingival enlargement in an 18-year-old female with PLS. Clinical examination revealed gingival inflammation, mobile teeth, and periodontal pockets. The patient faced challenges in understanding and maintaining proper oral hygiene. The treatment plan included scaling and root planing, extraction of a hopeless lower central incisor and a laser-assisted gingivectomy to achieve aesthetic and functional outcomes. This case highlights the importance of early diagnosis and a comprehensive treatment approach for managing the oral manifestations of Papillon-Lefèvre syndrome, aiming to improve both oral health and the patient’s quality of life.
Article Details
Section

This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Biraggari SK, Reddy KK, Sudhakar J, Bugude SS, Nichenametla R, Hakeem MA, Tiyyagura SR. Papillon-Lefèvre syndrome: periodontists’ perspective. Case Rep Dent. 2015; 2015:137381. https://doi.org/10.1155/2015/137381
2. Hart TC, Shapira L. Papillon-Lefèvre syndrome. Periodontol 2000. 1994; 6:88–100. https://doi.org/10.1111/j.1600-0757.1994.tb00029.x
3. Hattab FN, Rawashdeh MA, Yassin OM, al-Momani AS, al-Ubosi M. Papillon-Lefèvre syndrome: a review of the literature and report of 4 cases. J Periodontol. 1995; 66:413 - 420. https://doi.org/10.1902/jop.1995.66.5.413
4. Cury VF, Costa JE, Gomez RS, Boson WL, Loures CG, De ML. A novel mutation of the cathepsin C gene in Papillon-Lefèvre syndrome. J Periodontol. 2002; 73:307–312. https://doi.org/10.1902/jop.2002.73.3.307
5. Rajeswari KR, Almansour R, Alrajhi F, Binmeqren AF, Albaqami MS, abdullah Albarrak R. Papillon-Lefèvre syndrome in dental pediatric patient: A comprehensive review. Saudi Dent J. 2024;36(5):682-7. https://doi.org/10.1016/j.sdentj.2024.02.003
6. Pham CTN, Ivanovich JL, Raptis SZ, Zehnbauer B, Ley TJ. Papillon-Lefèvre syndrome: correlating the molecular, cellular, and clinical consequences of cathepsin C deficiency. J Immunol. 2004; 173:7277–7281. https://doi.org/10.4049/jimmunol.173.12.7277
7. Miyasaki KT. The neutrophil: mechanisms of controlling periodontal bacteria. J Periodontol. 1991; 62:761–774. https://doi.org/10.1902/jop.1991.62.12.761
8. Toomes C, James J, Wood AJ, Wu CL, McCormick D, Lench N, et al. Loss-of-function mutations in the cathepsin C gene result in periodontal disease and palmoplantar keratosis. Nat Genet. 1999; 23:421– 424. https://doi.org/10.1038/70525
9. de Haar SF, Jansen DC, Schoenmaker T, de Vree H, Everts V, Beertsen W. Loss-of-function mutations in cathepsin C in two families with Papillon-Lefèvre syndrome are associated with deficiency of serine proteinases in PMNs. Hum Mutat. 2004;23(5):524. https://doi.org/10.1002/humu.9243
10. Khan FY, Jan SM, Mushtaq M. Papillon-Lefèvre syndrome: Case report and review of the literature. J Indian Soc Periodontol. 2012;16(2):261–265. https://doi.org/10.4103/0972-124X.99273
11. Liu R, Cao C, Meng H, Tang Z. Leukocyte function in 2 cases of Papillon-Lefèvre syndrome. J Clin Periodontol. 2000; 27:69–73. https://doi.org/10.1034/j.1600-051x.2000.027001069.x
12. Maboudi A, Fekrazad R, Shiva A, Salehabadi N, Moosazadeh M, Ehsani H, Yazdani O. Gingivectomy with diode laser versus the conventional scalpel surgery and nonsurgical periodontal therapy in treatment of orthodontic treatment-induced gingival enlargement: a systematic review. Photobiomodulation, Photomed, Laser Surg. 2023;41(9):449-59. https://doi.org/10.1089/photob.2023.0060
13. Ullbro C, Brown A, Twetman S. Preventive periodontal regimen in Papillon-Lefèvre syndrome. Pediatr Dent. 2005;27(3):226-32.
14. Almuneef M, Al Khenaizan S, Al Ajaji S, Al Anazi A. Pyogenic liver abscess and Papillon-Lefèvre syndrome: not a rare association. Pediatrics. 2003;111: e85–e88. https://doi.org/10.1542/peds.111.1.e85
15. Lundgren T, Crossner CG, Twetman S. Systemic retinoid therapy in Papillon-Lefèvre syndrome. J Clin Periodontol.1996;23:176–179. https://doi.org/10.1111/j.1600-051X.1996.tb02073.x
16. Kressin S, Herforth A, Preis S, Wahn V, Lenard HG. Papillon-Lefèvre syndrome-Successful treatment with a combination of retinoid and concurrent systematic periodontal therapy. Quintessence Int. 1995;26(11):795.