Patients with Kindler syndrome have earlier onset periodontitis, and it progresses more rapidly than in patients without the disorder, say researchers in the January issue of the Journal of Periodontology.
Researchers believe Kindler syndrome is caused by an unidentified genetic disorder that gives the appearance of two congenital skin diseases: epidermolysis bullosa dystrophica and poikiloderma. In the former, the skin and mucous membranes are fragile, and any trauma to the skin or mucous membranes can cause blisters and the skin to come off. Poikiloderma is a condition characterized by pigmentary and atrophic changes in the skin, giving skin a spotted appearance.
Canadian researchers studied 31 patients (18 with Kindler syndrome and 13 without) from rural Panama to determine the extent to which periodontal disease is associated with Kindler syndrome.
In this study, the authors defined periodontitis as clinical attachment loss, or CAL, of at least 4 millimeters. They found that 72 percent and 46 percent of the Kindler and control patients, respectively, had periodontitis. The median age for Kindler patients with periodontitis was 17 years, and the median age for control patients was 35 years. Kindler patients had an average CAL of 6 mm by age 20 years, while it was estimated to take 60 years to accumulate the same level of CAL in patients in the control groups.
"The major finding of this study was that individuals with Kindler syndrome develop periodontitis at an earlier age and the disease progresses rapidly," said study author Dr. Colin Wiebe. "Therefore, we believe it is important to include Kindler syndrome in the category of medical disorders predisposing to destructive periodontal disease."
"Of considerable interest is the additional information that can be learned about the relationship of periodontal disease and the genetic defect of these patients," said Dr. Gordon Douglass, president of the American Academy of Periodontology. "Once the defect has been identified, we can take the information and apply it to other patients who are genetically predisposed to periodontal disease, which may help us determine positive treatment outcomes for periodontal disease."
