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

J Am Dent Assoc. 2018 Sep;149(9):794-800. doi: 10.1016/j.adaj.2018.04.025. Epub 2018 Jun 23.

Abstract

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.

Keywords: Oral surgery; prosthetics; tooth extraction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dental Care
  • Humans
  • Male
  • Mouth Mucosa
  • Periodontal Diseases*
  • Pyoderma Gangrenosum*
  • Tooth Extraction
  • Young Adult