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    LOCALISED AGGRESSIVE PERIODONTITIS is a distinct types of periodontitis that affect people who, in most cases, otherwise appear healthy. It tends to have a familial aggregation and there is a rapid rate of disease progression. Genetic predisposition for LAP suggest that a major gene plays a role in this disease, which is transmitted through an autosomal dominant mode of inheritance.

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    LOCALISED AGGRESSIVE PERIODONTITIS is a distinct types of periodontitis that affect people who, in most cases, otherwise appear healthy. It tends to have a familial aggregation and there is a rapid rate of disease progression. Genetic predisposition for LAP suggest that a major gene plays a role in this disease, which is transmitted through an autosomal dominant mode of inheritance.

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    12 views19 pages

    Localised Aggressive Period On Tit Is

    Uploaded by

    Fadhilrf Rf
    LOCALISED AGGRESSIVE PERIODONTITIS is a distinct types of periodontitis that affect people who, in most cases, otherwise appear healthy. It tends to have a familial aggregation and there is a rapid rate of disease progression. Genetic predisposition for LAP suggest that a major gene plays a role in this disease, which is transmitted through an autosomal dominant mode of inheritance.

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    of 19

    LOCALISED AGGRESSIVE PERIODONTITIS

    caution

    Group 1

    Aggressive periodontitis
    A distinct types of periodontitis that affect people who, in most cases, otherwise appear healthy. It tends to have a familial aggregation and there is a rapid rate of disease progression.

    Risk factor of LAP


    Microbiologic factors
    High frequency of Actinobacillus actinomycetemcomitans is implicated as the primary pathogen associated with this disease.

    Immunologic factors Some immune defect are implicated in the progression of LAP. Functional defects of PMNs can impair either the chemotactic attraction to PMN to the site of infection their ability to phagocytose and kill microorganism. Genetic factors A familial pattern of alveolar bone loss have implicated genetic factors n aggressive periodontitis. Genetic predisposition for LAP suggest that a major gene plays a role in this disease, which is transmitted through an autosomal dominant mode of inheritance.

    Environmental factors
    The amount and duration of smoking can influence the extent of destruction seen in young adults.

    AAP consensus report 2000Primary features


    Other than the presence of periodontitis, patients are otherwise clinically healthy. Rapid attachment loss and bone destruction. Familial aggregation.

    AAP consensus report 2000-Secondary features


    Amounts of microbial deposits VS severity of periodontal tissue destruction inconsistent Elevated Actinobacillus actinomycetemcomitans (Far East populations, Porphyromonas gingivalis may be elevated as well) Phagocyte abnormalities; Hyper-responsive macrophage phenotype, including elevated levels of PGE2 and IL-1b in response to bacterial endotoxins; Progression of attachment loss and bone loss may be self-arresting.

    Localized Aggressive Periodontitis


    Circumpubertal onset; Robust serum antibody response to infecting agents; Localized first molar/incisor presentation with interproximal attachment loss on at least two permanent teeth, one of which is a first molar, and involving no more than two teeth other than first molars and incisors.

    Progression of Periodontal Disease


    Aggressive Chronic

    Attachment or Bone Loss

    Normal

    Age

    Clinical appearance:
    extreme bone loss around 1st molars and incisors; loose, drifting teeth; no plaque or inflammation; good OH severe inflammation, rapid bone loss, and early tooth loss

    Aggressive Periodontitis
    Radiographic features: advanced bone loss

    Localized
    Aggressive Periodontitis:
    Etiology: Aa, large percentage of neutrophils with slow chemotactic response

    Clinical Management of Aggressive Periodontitis


    -Patient education. -Oral hygiene instructions and reinforcement. -Scaling and root planing and control of local factors. -A general medical evaluation may determine if systemic disease is present in children and young adults.

    Adjunctive antimicrobial therapy combined with scaling and root plaining with or without surgical therapy. Examples of antibiotics: Tetracyclins(avoid in children), metronidazole+ amoxycillin,azithromycin. -Evaluation and counseling of family members.

    *antibiotics may help but it usually slows rather than stops disease

    Aggressive Periodontitis
    Prognosis: Poor individuals with prepubertal gingivitis frequently become edentulous at an early age

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