Since 2018, the Chicago Classification of Periodontal Diseases and Conditions, has listed Down syndrome (DS)/trisomy 21 (T21) as a systemic disease with periodontal implications. Numerous studies report an increased prevalence and severity of periodontitis in DS/T21 individuals under the age of 35. Approximately 35% of adolescents with DS show early signs of alveolar bone loss. However, very few s…
Since 2018, the Chicago Classification of Periodontal Diseases and Conditions, has listed Down syndrome (DS)/trisomy 21 (T21) as a systemic disease with periodontal implications. Numerous studies report an increased prevalence and severity of periodontitis in DS/T21 individuals under the age of 35. Approximately 35% of adolescents with DS show early signs of alveolar bone loss. However, very few studies have examined the role of immune deficiency in DS/T21 patients in the pathogenesis of periodontitis. Indeed, periodontitis induced by bacterial plaque is virtually non-existent in the paediatric population, leaving the field to systemically-induced periodontitis.
The investigators hypothesize that specific neutrophil phenotypes in DS/T21 patients are key to explaining the rapid progression to periodontitis.
Investigator's primary objective is to characterize the different oral and blood neutrophil subtypes in DS/T21 children with gingival inflammation.
Investigator's secondary objective is to assess the involvement of different neutrophil subtypes in early periodontitis in children with DS/T21.
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Eligibility Criteria
Inclusion Criteria:
Common to all groups:
* Age: 3 to 12
* Patient affiliated to a social security program, beneficiary not covered by the AME.
* Legal representatives who speak and understand French well enough to be able to read and understand the study information.
* Legal representatives givin…
Inclusion Criteria:
Common to all groups:
* Age: 3 to 12
* Patient affiliated to a social security program, beneficiary not covered by the AME.
* Legal representatives who speak and understand French well enough to be able to read and understand the study information.
* Legal representatives giving written consent for their child's participation in the study.
Specific:
Case Group:
* Trisomy 21 patient with gingival inflammation (subgroup 1)
* Trisomy 21 patient with healthy gingiva on intact periodontium with no history of periodontitis (subgroup 2)
Control Group: child meeting one of these criteria:
* Patient with psychomotor retardation with no known repercussions on the orofacial sphere or immunity, presenting gingival inflammation (subgroup 1)
* Patients with psychomotor retardation and no known repercussions on orofacial health or immunity, presenting gingival health on intact periodontium with no history of gingival inflammation (subgroup 2).
* Patients with no known general pathology and gingival inflammation (subgroup 3)
* Patients with no known general pathology and healthy gingiva on intact periodontium with no history of gingival inflammation (subgroup 4)
Exclusion Criteria:
Common to all groups:
* Patient having received antibiotic prophylaxis, antibiotic therapy or anti-inflammatory treatment in the 3 months prior to inclusion
* Patient included in another interventional research protocol or in a period of exclusion.
* Patient on AME
* Patients with a contraindication to the use of MEOPA:
* Patients requiring pure oxygen ventilation
* Intracranial hypertension
* Unevaluated head trauma
* New-onset, unexplained neurological abnormalities
* Pneumothorax
* Emphysema bubbles
* Gas embolism
* Diving accident
* Abdominal gas distension, occlusion
* Patient recently treated with ophthalmic gas (SF6, C3F8, C2F6)
* Known, unsubstituted vitamin B12 deficiency
Specific to Trisomy 21 group:
\- Patient with no genetic diagnosis
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