Periodontology

Papillon-Lefevre Syndrome

Classic Triad

1. Plantar Hyperkeratosis: Thickening of palms and soles
2. Early-Onset Periodontitis: Severe periodontal destruction in primary and permanent dentition
3. Dural Calcification: Intracranial calcifications

Genetics and Pathogenesis

• Inheritance: Autosomal recessive
• Gene: CTSC gene mutation affecting cathepsin C

Drug-Induced Gingival Hyperplasia

Most Common Causative Drug

• Primary Agent: Phenytoin (anti-seizure medication)
• Other Drugs: Cyclosporine, nifedipine, amlodipine

Grading System

• Grade III: Three-quarters of tooth crown covered by hyperplastic tissue
• Management: Drug substitution when possible, surgical reduction