NECROTIZING PERIODONTITIS IN PATIENTS WITH HIV INFECTION

Abstract

In the new International Classification of periodontal and peri-implant diseases and conditions (AAP&EFP, Chicago, 2017) necrotizing periodontal diseases, namely necrotizing gingivitis, necrotizing periodontitis and necrotizing stomatitis are included in a separate subsection in group II “Periodontitis”. Currently, the term "ulcerative- necrotizing periodontitis" is excluded. The isolation of necrotizing periodontal diseases into a separate group is due to the fact that they differ significantly from other periodontal diseases in etiology, pathogenesis and clinical manifestations. The main cause of the development of necrotizing periodontal diseases is immunodeficiency conditions caused by the presence of chronic bacterial, fungal and viral infections in patients, including HIV infection. Necrotizing periodontal diseases are assigned to the first group of oral manifestations of human immunodeficiency virus, which occur in the III-IV clinical stages of HIV infection. The most severe of these is necrotizing periodontitis, which occurs in HIV+/AIDS patients with CD4 counts less than 200 cells/ μl. Purpose of the study. To determine the effectiveness of treatment of necrotizing periodontitis in an HIV-positive patient taking antiretroviral therapy. Results. The study demonstrated the clinical case of primary recognition of HIV infection at a dental appointment in patient K., 21 years old, according to the clinical symptoms of necrotizing periodontitis. Results of primary dental care (2010), as well as further treatment (2014) during antiretroviral therapy are presented. Conclusions. If clinical symptoms of necrotizing periodontitis are detected, mandatory examination of the patient for HIV infection is necessary. Routine dental treatment, invasive procedures and dental prosthetics can be carried out after improving the general condition of the patient when taking antiretroviral therapy.