[Periodontal disease in patients with HIV infection. Radiographic study].

A painful and rapidly progressive form of periodontitis--involving both soft tissue and bone, with gingival bleeding and loss of teeth--was observed in HIV-patients in the mid-80's. Today, there are few reports regarding the real incidence of periodontitis in HIV populations: however, it seems not as high as first supposed on discovering the disease, and bacterial plaque is moderate, compared with "conventional" periodontitis. Since there are few radiologic studies, the Authors report on the clinical-radiographic patterns of periodontitis in 20 HIV patients, compared to 20 normal controls. All the subjects were submitted to clinical-instrumental investigations (clinical tests, periodontal sampling, DMF index), and panoramic radiography. To assess periodontal disease severity, bone pocket depth is investigated radiographically, defined as the distance between the highest point of alveolar bone and root apex, at the mesial and distal aspects of all the teeth. We measured four alveolar quadrants, from the first premolar to the second molar. Statistical analysis was carried out with one way ANOVA test and non-parametric Kruskal-Willis's test; statistical significance is accepted at the probability level p < 0.05. Clinical-radiographic results demonstrated minimal bone loss and little teeth mobility, in the early stage of disease; involvement of total gingival attachment with partial bone sequestration at muco-gingival line, in the moderate stage; severe bone loss with soft tissue necrosis and risk of teeth exfoliation, in the advanced stage. Gingival tartar was also found. A significant statistical difference was demonstrated between the two examined populations. HIV-related periodontitis may represent one of the various features of the clinical picture of HIV infection, which must not be underestimated and mistaken for "conventional" adult periodontitis. If the diagnosis of periodontic disease is essentially clinic, radiography remains nevertheless important, because it yields data on bone status, integrity of lamina dura and morphology of roots, which data help make diagnosis and prognosis more reliable.