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Results for “Aggressive Periodontitis”

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At least 19 recordsLinked to original sources

Aggressive periodontal destruction and herpes zoster in a suspected AIDS patient.

An unusual case of spontaneous and rapidly destructive lesions involving the periodontal structures is described in a 54 year old, bi-sexual patients suspected of having AIDS. Concomitant with the periodontal breakdown, the patient developed a severe case of Herpes Zoster involving the area of the face innervated by the 5th cranial nerve. The dermal lesions involved the face, nose, eyes and scalp. Similar lesions were noted on the gingival and palatal mucosa on the same side of the jaw as the skin lesions. The differences between this type of periodontal destruction and more conventional forms of periodontitis are discussed.

Acquired Immunodeficiency Syndrome

The natural history of periodontal disease in man. The rate of periodontal destruction before 40 years of age.

This longitudinal study of randomly selected Norwegian students and academicians has shown that 50% of the 17-year olds have lost no periodontal support, and the other 50% exhibited slight localized loss of attachment primarily on buccal surfaces of first molars and first bicuspids of both jaws. At 21 all students show one or more of these lesions as well as loss of attachment on interproximal surfaces. At 30 years of age the mean cumulative loss is still less than 1 mm. As they approach 40 years of age the mean individual loss of attachment is slightly above 1.5 mm or 10% of the total periodontal support, and the mean annual rate of attachment loss is 0.08 for interproximal surfaces and 0.1 mm for buccal surfaces. No case of juvenile periodontitis (periodontosis) or adult aggressive periodontitis were seen in this population. Seventy percent of the 15-year-old Sri Lankans have no or very little loss of periodontal support. However, approximately 30% exhibit localized lesions measuring between 2 and 9 mm and more than 1% have one or more root surfaces with 10 mm loss of attachment or more. In this age group the lesions occur at the interproximal and buccal aspects of lower central incisors and in first molars of both jaws. At 30 years of age the mean loss of attachment is 3.11 mm and approximately 25% of the tea laborers have lesions extending 10 mm or more below the cemento-enamel junction. As the Sri Lankan approaches 40 years of age the mean loss of attachment is 4.50 mm and the mean rate of progress of the lesion is 0.20 mm per year for buccal surfaces and 0.30 mm for interproximal surfaces. This study suggests that without interference the periodontal lesion progresses at a relatively even pace and that the progress is continuous.

Adolescent

[Importance of periodic follow up of periodontal diseases for the maintenance of periodontal health and the longevity of dental restoration].

The major objective of the author's investigation was to determine if the progression of attachment loss, the recurrence of active phase of periodontitis and development of new carious lesions can be controlled and prevented in individuals with prior history of aggressive periodontitis provided full mouth reconstruction and maintained at a proper level of oral hygiene. The results of a group on regular periodontal recall program were compared with the five years dental and periodontal findings on a matched group of patients having not been on regular maintenance program. The well maintained group of patients' annual recall data did not vary markedly. In five years basically the same amount of attachment apparatus was maintained. The reexamination of the non recall group at the end of the fifth year shoved a total deterioration of dentition due to the progression of periodontal disease and attachment loss. Especially those of rapidly progressing periodontitis cases shoved 70 to 100% attachment loss. This comparative study attempted to outline the insufficiency of our former dental philosophy of patient management and follow up. Authors emphasize the importance of the follow up, and maintenance of a very high level.

Adult

Periodontitis as an early presentation of HIV infection.

OBJECTIVE: To determine whether the presence of rapidly progressive periodontitis (RPP) in people at high risk for acquired immunodeficiency syndrome (AIDS) may be the first symptom of previously unrecognized human immunodeficiency virus (HIV) infection. DESIGN: Case series. SETTING: Dental clinic. PATIENTS: Twenty patients who presented or were referred to the dental clinic over 6 months for the treatment of unexplained RPP and were at high risk for AIDS. OUTCOME MEASURES: Diagnosis of HIV infection: identification of candidal organisms in cytologic smears, determination of complete and differential blood counts and of ratio between T4 (helper) and T8 (suppressor) lymphocytes, and performance of HIV antibody assays. MAIN RESULTS: All of the patients were men, although sex was not an inclusion criterion. Sixteen (80%) of the 20 patients were found to have HIV infection. Four had been aware that they were HIV positive: two admitted it only when their T4:T8 ratio was known and the other two when the T4:T8 test was explained or requested. Fifteen of the patients were homosexual, three came from AIDS-endemic areas, and two had hemophilia. The RPP was responsible for alveolar bone loss in all of the patients. One patient lost bone in one site because of localized osteomyelitis. Only five patients had concurrent candidal overgrowth, and three had Kaposi's sarcoma. The mean T4:T8 ratio was 0.57 (standard deviation 0.52). CONCLUSIONS: These findings suggest that periodontal disease may be one of the first clinical presentations of previously undiagnosed HIV infection. Thus, patients at high risk for AIDS who present with aggressive periodontal disease should be investigated for possible HIV infection. However, further, prospective studies are required to confirm the contention that RPP is one of the first signs of HIV infection or AIDS.

Adult

Unusual periodontal findings in an AIDS patient with Burkitt's lymphoma. A case report.

This report deals with a case of AIDS-related Burkitt's lymphoma in which some of the earliest findings were dental and periodontal in nature. The patient presented initially with painless and extremely loose teeth accompanied by progressive paresthesia of the lower jaw. Unique radiographic findings included extensive periodontal ligament space widening and bulbous, granuloma-like lesions about the apices of the teeth. These findings were associated with progressive tumor infiltration of the mandible and do not appear to be related to other reports of aggressive periodontitis associated with impaired immunologic functions in AIDS patients.

Acquired Immunodeficiency Syndrome

Immunologic mechanisms of pathogenesis in periodontal diseases: an assessment.

Principal lines of evidence that immune reactions are central to the pathogenesis of periodontitis are reviewed. Necessary components of immunologic reactions are present in gingiva in the periodontal diseases. Differences between healthy and periodontitis patients with respect to some measures of immune function further indicate that immune reactions do occur in the gingiva during periodontitis. They are probably responsible for at least some of the destruction of connective tissue and bone that occurs. Classical antibody-mediated hypersensitivity reactions probably do not provide the reasons. Mechanisms are more likely to be found in the pro-inflammatory and tissue-degrading effects of cytokines released in host-protective, antigen-specific and polyclonal responses to oral bacterial constituents or products. Some evidence suggests that limitation of clinical destruction in localized early onset periodontitis (JP) may in part be a function of a protective antibody response which develops after an initial rapidly progressive infection. A relatively deficient immune responsiveness may allow progression to more severe and generalized disease (RPP). Suggestions are made for studies needed to confirm suspected pathogenetic mechanisms, approach resultant targeted therapies, and test hypotheses for contrasting roles of immune reactions in different clinical expressions of periodontitis.

Aggressive Periodontitis

[Do new diagnostic tests improve the differential diagnosis and therapy of periodontitis? A review].

New diagnostic tools give access to information that was previously not available by classical clinical means. This includes methods for the determination of the composition of the microbial flora or for monitoring specific reactions of host tissues to the accumulation of plaque. DNA-probes, monoclonal antibodies and enzyme assays have already been advertised and are sold to dentists. The practical value of new tests depends upon the possibility to improve the efficacy of treatment based on previously inaccessible information. This paper reviews frequently raised clinical questions, the possible answers coming from new diagnostica, and the potential impact of this knowledge on periodontal therapy.

Aggressive Periodontitis

[Microbiology of periodontitis. 2. Microbiological diagnosis of periodontitis].

By common methods like scaling and root planing, flap procedures or surgical furcation treatment, a successful therapy of periodontal disease is possible in about 90% of the cases. The remaining 10%, mainly patients with juvenile or rapidly progressive periodontitis, are causing great problems, due to poor treatment response and frequent, local or general recidives. In the future, microbiological tests for a precise diagnosis of the pocket flora will be used in the dental office. They can provide better indications for additional antibiotic therapy. The present article reviews several microbiological investigation methods and their future use in the office during periodontal treatment.

Aggressive Periodontitis