Professional Documents
Culture Documents
TAK RANUCH
NGET RATTANA
Please turn on cell phones
To Vibrate mode
Content
Introduction
Classification
Genetic
Diagnosis
Treatment
Reference
Introduction
Periodontitis is the inflammation of the
periodontium which comprise of tissues
supporting the teeth in the oral cavity.
Early onset periodontitis was the previous
classification of aggressive periodontitis.
Anatomy of the
Periodontium
Classification of Aggressive
Periodontitis
Localized aggressive periodontitis (LAP)
Generalized aggressive periodontitis (GAP)
Changes in junctional epithelium
Due to bacterial
Replaced by pocket
enzymes and
epithelium
physical forces
exerted by them
Localized Aggressive
Periodontitis
First molar and/ or incisors
Low clinical inflammation
Poor inflammatory response
Mobility and migration of first molar and
incisors most common on the maxillary
(Diastema).
Neutrophils
Chemotatic
Factor
Matrix-
MetaloProteina
Macrophage
se
-Lysosomal
enzymes
-
collagenase
- PE2
Localized Aggressive
Periodontitis
Symptom of LAP
Root surface sensitivity
Deep dull radiating pain
Periodontal abscess formation
Regional lymph node enlargement.
Patient serum is be found Ig G2.
The high risks of LAP is seen mostly between
puberty and 20 year of age. (Female)
Localized Aggressive
Periodontitis
Aetiology of LAP
Plaque (primary): A. actinomycetemcomitans
(Aggregatibacter BDJ), P. gingivalis, P.
intermidia.
Diabetes
Trauma occlusion
Ig G2 type which is specific to antigens of
A. actinomycetemcomitans.
Generalized Aggressive
Periodontitis
Previously classified as Generalized Juvenile
periodontitis and Rapid Progressive periodontitits.
Characterized by generalized interproximal
attachment loss affecting at least 3 permanent teeth.
Highly inflammatory response
Highly bone and attachment loss
Generalized Aggressive
Periodontitis
Aetiology of GAP
Plaque: A. actinomycetemcomitans, P.
gingivalis, Baceroids forsuthus.
Invading bacteria: Capnocytophaga sputigena,
Mycoplasama sub-species and Spirochetes.
Generalized Aggressive
Periodontitis
Symptom:
Acute inflammation tissues
Spontaneous bleeding
Deep pocket
GAP affects persons between puberty and 35
year old.
Genetic Factors
Many researchers have suggested that, a major
gene play a role in Aggressive periodontal
disease, which is transmitted by the autosomal
dominant mode of inheritance.
Approximately 75% of LAP has dyfunctional
neutrophils. (Chemotatic )
Complement component C5a
Leukotriene B4
40% deficiency in glycoprotein (GP110) on
neutrophil surface.
Diagnosis
Clinical diagnosis
X – ray
Test of mobility
Serological test (A. actinomycetecomitans)
Treatment
Remove plaque and calculus
Extraction
Oral hygiene
Scaling (mild)
Root planning (moderate)
Surgery (severe)
Medication
Tetracycline hydrochloride 250mg qid at least
a week
Doxycyline
Chlorhexidine rinse should be prescribed
Such case: Amoxicillin + Metronidazole
Reference
www.Scribd.com
www.Pubmed.com
Essential Clinical Periondontology and
Periodontologic (Shantipriya Reddy
2006)
Periodontology 10th edition (2008)