Researchers Identify First Case of Periodontitis in Marfan's Syndrome Patient

July 18, 2002
Findings support theory that connective tissue disorders increase susceptability to periodontal disease.

Researchers from the Eastman Dental Institute at the University College in London identified the first case of severe periodontitis in a person with Marfan's Syndrome, a rare heredity disorder that causes connective tissues to be weaker than normal. The case report is published in the July issue of the Journal of Periodontology.

"Reports of oral findings in Marfan's syndrome patients have focused mainly on skeletal abnormalities. This case is notable since the detected periodontal breakdown was severe and could be only partly explained by known risk factors, such as cigarette smoking and inadequate oral hygiene," said Maurizio Tonetti, D.M.D., PhD, professor and chair of the department of periodontology at the University College London. "It also supports our hypothesis that a variety of connective tissue disorders may increase susceptibility to periodontal tissue breakdown."

Severe periodontitis is an advanced form of a chronic bacterial infection (periodontal disease) that inflames the supporting tissues of the teeth and destroys attachment fibers (periodontal ligaments) and supporting bone that hold teeth in the mouth. The main cause of periodontal diseases are bacterial plaque, sticky, colorless film that constantly forms on the teeth. Other factors that contribute to the disease include the following: smoking/tobacco use; genetics; hormonal changes; stress; certain medications; clenching or grinding your teeth; poor nutrition; systemic diseases; and notably, diabetes.

An oral examination determined the 41-year-old patient had swollen and receding gums, severe periodontal ligament attachment loss on all teeth and bleeding gums at 76 percent of the areas examined. The patient had no family history of periodontitis.

"It is important to note that this case report does not show a causal relationship between Marfan's syndrome and periodontal diseases," said Kenneth Bueltmann, D.D.S., president of the American Academy of Periodontology. "More research needs to be conducted to determine if there is an association between the diseases."

However, Dr. Tonetti recommends that Marfan patients follow a preventive oral program based on professional tooth cleaning and daily brushing and flossing. And that they receive regular periodontal screenings by a periodontist.

Marfan syndrome is a heritable disorder of the connective tissue that affects many organ systems, including the skeleton, lungs, eyes, heart and blood vessels. The condition affects both men and women of any race or ethnic group. Scientists estimate that as many as 1 million people in the United States may have a heritable disorder of connective tissue, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. When the attachment fibers are destroyed, gums separate from the teeth, forming pockets that fill with plaque and even more infection. As the disease progresses, these pockets deepen even further, more gum tissue and bone are destroyed and the teeth eventually become loose. Approximately 15 percent of adults between 21 and 50 years old and 30 percent of adults over 50 have the disease.

A referral to a periodontist and free oral health brochures are available by calling 800-FLOSS-EM or visiting the AAP's Web site at

*Editors Note: A copy of the JOP case report "Severe Periodontitis in Marfan's Syndrome" can be obtained by calling Shelia Naab at 312/573-3243.