Aggressive Periodontitis

Question 1

What is the bacteriology of molar incisior aggressive periodontitis?

Answer 1

A. Actinomycetemocomitans - JP2 clone is related to this form of periodontitis. Produce leukotoxin which survive in biofilm for longer and release factors leading to periodontal destruction.
Gram negative cocci
Releases lethal leukotoxin directed against monocytes and neutrophils. LPS induces bone resorption.
Chemotactic inhibition factors, collagenases produced, resists phagocytosis

Question 2

Management of generalised, advanced, aggressive periodontitis?

Answer 2

OHI
Smoking Cessation
Extract hopeless teeth
NSPT augmented with systemic antibiotics in specific cases - 250mg Amoxicillin tid 5-7 days. Metronidazole 200mg tid 5-7 days
Periodontal surgery
Maintenance - hardest patients to stabilise

Question 3

Management of molar incisor aggressive periodontitis

Answer 3

OHI
Smoking cessation
RSD to remove plaque biofilm
Local delivery antimicrobials - Dentomycin or Atridox
Perio surgery 
Maintenance