Zastosowanie terapii fotodynamicznej w leczeniu zapalenia przyzębia u pacjenta z neutropenią wrodzoną (zespołem Kostmanna) – opis przypadku

Treatment

General treatment of neutropenia depends on the patient’s clinical state. Typically, the patients are subjected to prolonged antibiotic and antifungal therapy. For several years now, neutropenia has successfully been treated with the recombinant human granulocyte colony-stimulating factor (rhG-CSF) (1, 2, 4). Treatment of oral lesions in neutropenic patients is often ineffective, or produces short-term effects (3). Therefore, continuous monitoring of the patient’s oral health (professional dental hygiene aided by local and general antibiotic therapy), proper oral care routine at home, and control of blood neutrophil levels are of great importance (2, 4). Since neutropenic patients are frequently subjected to antibiotic therapies, the search for alternative periodontal disease treatments, such as photodynamic therapy, or ozone therapy, has become particularly important these days (2). Any dental intervention that may disrupt the continuity of tissue (e.g. extractions, scaling) should be performed using antibiotic prophylaxis (6).

The treatment of periodontitis is primarily aimed at reducing the number of perio-pathogens, and producing a qualitative change in the microflora of periodontal pockets. The majority of patients with gingivitis and periodontitis respond correctly to the classic, mechanical scaling and root planning procedure. However, in some cases, the conventional periodontal therapy requires the introduction of an additional systemic antibiotic treatment. Because the drug resistance of micro-organisms is constantly increasing, alternative options of bacteria eradication from periodontal pockets should be sought (9-12). New forms of treatment are particularly recommended for neutropenic patients who often undergo prolonged antibiotic therapies (2).