Generalized aggressive periodontitis in a prepubertal patient: A case report

A 10-year-old boy presented with generalized gingival inflammation, extensi ve alveolar bone loss, and tooth mobility. Clinical and radiographic examin ation supplemented by microbiologic investigation led to a diagnosis of cla ssically termed prepubertal periodontitis (now known as generalized aggress ive periodontitis). Other than severe periodontitis, the child was systemic ally healthy. Neither unusual infections nor abnormalities in neutrophil fu nctions were detected. Microbiologic examinations by culture revealed the p resence of the periodontal pathogen Actinobacillus actinomycetemcomitans. T reatment consisted of extraction of mobile teeth, supragingival and subging ival debridement, subgingival curettage, and root planing combined with a 1 -week prescription of a combination of metronidazole and amoxicillin. Scann ing electron microscopy of extracted teeth revealed hypoplastic and aplasti c cementum at the periodontally exposed and intact surfaces. Clinical and m icrobiologic follow-up was continued over a 1-year period. No periodontal l esions have been detected, and A actinomycetemcomitans could not be isolate d from the subgingival areas of the remaining teeth at the end of the first year. Since A actinomycetemcomitans was the main pathogen present in the s ubgingival microflora of the patient, it might play a key role in the etiol ogy of prepubertal periodontitis.