Background: Leukocyte Adhesion Deficiency Type I (LAD-I) is a rare autosomal recessive immunodeficiency characterized by defective neutrophil function due to mutations in the CD18 gene. It results in recurrent systemic infections and aggressive early-onset periodontitis.

Case Presentation: This report describes two novel cases of LAD-I in male siblings aged 10 and 15, both born to consanguineous parents. Both patients presented with severe periodontal inflammation, tooth mobility, cutaneous lesions, and a history of recurrent respiratory and gastrointestinal infections. Radiographic evaluation revealed generalized alveolar bone loss with a "floating teeth" appearance. Periodontal therapy included oral hygiene education, scaling and root planing, multiple extractions under general anesthesia, and antibiotic prophylaxis.

Conclusion: Early diagnosis and interdisciplinary management are critical in improving both periodontal and systemic health in patients with LAD-I. These cases underline the importance of dental practitioners being aware of oral manifestations of systemic immunodeficiencies.