Fogorvosi szemle, 2010 (103. évfolyam, 1-4. szám)
2010-06-01 / 2. szám
67 FOGORVOSI SZEMLE ■ 103. évf. 2. sz. 2010. Classification Workshop Consensus report: Aggressive periodontitis. Ann Periodontol 1999; 4:53. 8. Lang NP, Tonetti MS: Periodontal risk assessment for patients in supportive periodontal therapy (SPT). Oral Health and Prev. Dent 2003; 1:7-16. 9. Löe, H. & Brown, LJ: Early onset periodontitis in the United States of America. Journal of Periodontology 1991 ; 62: 608-616. 10. Meyle J, Gonzalez JR, Bodeker RH, Hoffmann T, et al: A randomized clinical trial comparing enamel matrix derivative and membrane treatment of buccal class II furcation involvement in mandibular molars. Part II: secondary outcomes. J Periodontol 2004; 75: 1188-1195. 11. Palioto DB, Coletta RD, Graner E, Joly JC, De Lima AF: The influence of enamel matrix derivative associated with insulin-like growth factor-l on periodontal ligament fibroblasts. J Periodontol 2004; 75: 498-504. 12. Renvert S, Wikström M, Dahlen G, Slots J, Egelberg J: On the inability of root debridement and periodontal surgery to eliminate Actinobacillus actinomycetemcomitans from periodontal pockets. J Clin Periodontol:990; 17: 351-355. 13. Sculean A, Windisch P, Keglevich T, Chiantella GC, Gera I, Donos N: Clinical and histologic evaluation of human intrabony defects treated with an enamel matrix protein derivative combined with a bovine-derived xenograft. Int J Periodontics Restorative Dent 2003; 23:47-55 14. Sculean A, Donos N, Miliauskaite A, Arweiler N, Brecx M: Treatment of intrabony defects with enamel matrix proteins or bioresorbable membranes. A four year follow up splith-mouth study. J Periodontol 2001; 72:1695-1701. 15. Socransky S & Haffajee A: The bacterial aetiology of destructive periodontal disease: current concepts. J Periodontol 1992; 63: 332-331. 16. Suvan JE: Effectiveness of mechanical nonsurgical pocket therapy. Periodontol 2000 2005; 37: 48-71. 17. Tonetti M & Mombelli A: Early onset periodontitis. Ann Periodontol 1999; 4: 39-53. 18. Van Dyke TE, Schweinebraten M, Cianciola LJ, Offenbacher S & Genco RJ: Neutrophil Chemotaxis in families with localized juvenile periodontitis. J Periodont Res 1985; 20: 503-514. 19. Wennström JL, Lindhe J: Some effects of enamel matrix proteins on wound healing in the dento-gingival region. J Clin Periodontol 2002; 29: 9-14. Dr. Lukacs L, Dr. Gera I: Combined conservative-surgical management of generalized aggressive periodontitis Case presentation The aggressive periodontitis is a well-defined clinical entity markedly differing from the chronic form of periodontitis. A localized and a generalized form can be distinguished. The main bacterial étiologie factor for the localized form is A. actinomycetemcomitans. It mainly starts in the first quarter of ones life. The magnitude of clinical attachment loss is not proportional to the amount of local biofilm and plaque retentive factors. The rapid, mostly vertical type of bone destruction is very characteristic. In many cases the attachment loss is localized to only a few teeth, but it may spread and progress to the generalized form, affecting practically the whole dentition. In that case a mixed Gram-negative anaerobic biofilm is present subgingivally, but the AA can also dominate the pocket flora. Its treatment is very complex and time-consuming, and needs perfect patient compliance. Predictable clinical results can only be achieved by a combined conservative-surgical therapy. The corrective phase of the comprehensive treatment and patient’s rehabilitation is crucial and mainly involves certain kind of regenerative therapy. One of the most critical phases is the supportive therapy. This can give a good chance to stop the progression of attachment loss and prevent the recurrence of the active disease. The presented case is to demonstrate how time-consuming a 32-year-old female patient’s comprehensive periodontal therapy was, who had suffered with active aggressive periodontitis at admittance. The extensive disease control period followed by a relatively long follow-up and finished with a series of regenerative surgery could ensure a predictable outcome that might be maintained over a long period of time with regular supportive therapy. Key words: Aggressive periodontitis, conservative theraphy, regenerative theraphy, enamel matrix derivative
