EARLY-ONSET PERIODONTITIS - PROGRESSION OF ATTACHMENT LOSS DURING 6 YEARS

WE STUDIED THE PATTERN OF PROGRESSION of early-onset periodontitis and the change in the extent and severity of the periodontal condition in adolescents who were followed for 6 years. In a national survey of th e oral health of U.S. children, 14,013 adolescents were examined clini cally in 1986/1987 to assess the periodontal attachment loss of teeth. Individuals with early-onset periodontitis within this population wer e identified and classified into localized juvenile periodontitis (LJP ), generalized juvenile periodontitis (GJP), and incidental attachment loss (IAL) groups. Ninety-one subjects, 13 to 20 years old at baselin e, were examined 6 years later. They included 51 males and 40 females; and 72 Blacks, 6 Hispanics, and 13 Whites. They were clinically re-ex amined and then reclassified according to their periodontal status at follow-up. The severity and extent of these diseases continued to incr ease during the study period. In teeth that were affected at baseline, the lesions had progressed to include deeper portions of the periodon tium, and more of the teeth unaffected at baseline exhibited periodont al attachment loss at follow-up, thus changing the disease characteris tics and the basis for the clinical classification. Of the individuals classified with LJP at baseline, 62% continued to have LJP 6 years la ter and 35% developed GJP. Of those classified with GJP initially, all but two (82%) continued to have GJP at follow-up. Among the IAL group , 28% of subjects developed LJP or GJP, and 30% were reclassified in t he no attachment loss group. Molars and incisors were the teeth most o ften, affected in all three groups. The mean change in attachment loss over 6 years in the LJP, GJP, and IAL groups was 0.45, 1.12, and 0.13 mm, respectively. The present findings demonstrate the limitations of the currently used morphological criteria in the classification of ea rly-onset periodontitis. The findings also suggest that the difference between LJP and GJP is in the number and type of teeth involved, and that the two classifications progress similarly, with some cases of LJ P developing into GJP.