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Introduction
Soft tissue lesions of the oral cavity
are common in children
Distinguishing between findings that
are normal and those that are
indicative of gingivitis, periodontal
disease, local or systemic infection,
and potentially lifethreatening
systemic conditions is important
HISTIOCYTOSIS
A rare disorder
Histiocytic infiltration of the bones,
skin, liver, or other organs
Langerhans cell histiocytosis (LCH)
presents with single or multiple-site
involvement
The skin, oral mucosa, bone, and
lymph nodes are typical locations for
single-site involvement
LEUKEMIA
Leukemia, particularly the monocytic
type, can cause gingival enlargement
because of infiltration of the gingival
tissues
Leukemic gingival enlargement is
typically painless, shiny, red, and
edematous
Bleeding is common and can make it
difficult to maintain oral hygiene
NEUTROPENIA
Neutropenia is a hematologic
disorder characterized by reduced
numbers of circulating neutrophils.
It is diagnosed when the absolute
neutrophil count (ANC) is less than
1500/microL
Congenital
Congenital neutropenia occurs in
several conditions where there is a
marked decrease in (or lack of)
circulating neutrophils from the time
of birth
an estimated frequency of two cases
per million population
Autoimmune
Autoimmune neutropenia (AIN) is caused
by granulocyte-specific antibodies.
AIN has been associated with a variety of
underlying diseases, including viral
infection, collagen vascular disease,
primary abnormalities of B or T
lymphocytes or natural killer (NK) cells,
idiopathic thrombocytopenic purpura
(ITP), and autoimmune hemolytic anemia
Cyclic neutropenia
Cyclic neutropenia is characterized
by regular oscillations in the numbers
of circulating neutrophils, monocytes,
eosinophils, lymphocytes, and
reticulocytes
The cycles typically occur at 21-day
intervals, but the intervals can range
from 15 to 35 days
Dental management
Early dental referral and highly
motivated parents are the keys to
successful dental management of
children with neutropenia
Neutropenia predisposes the child to
hemorrhagic gingivitis and periodontal
disease, but the progression of bone
loss is because of the host response to
pathogenic subgingival plaque
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