Inflammation of the supporting tissues of the teeth resulting in rapid permanent tissue destruction; it characteristically manifests itself before the age of 35. It is also known as juvenile, pre-pubertal or early-onset periodontitis. It may affect an isolated group of teeth or the whole dentition, and only affects a small group of the population. There is rapid periodontal attachment loss with destruction of the periodontal ligament and supporting alveolar bone in an otherwise healthy mouth. Delayed diagnosis can result in rapid and extensive tooth loss. There is often a familial tendency; bacteria associated with this condition are Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Clinical features include a low level of gingival inflammation, usually in combination with low plaque levels and good oral hygiene, which can cause the diagnosis to be overlooked; radiographically, however, bone loss is evident. Treatment is by the removal of surface deposits, oral hygiene instruction, and addressing any predisposing risk factors. A 7 day course of adjunctive antibiotics such as metronidazole and amoxicillin can improve the short-term clinical outcomes. See also periodontitis, aggressive; classification of periodontal disease.
Aggressive periodontitis on x-ray