Progress On Etiological And Clinical Research Of Aggressive Periodontitis

Aggressive periodontitis (AgP) refers to a kind of series oral diseases which occur on human's periodontal tissues and can rapidly destroy the supporting tissues of teeth. It usually presents at the age ranging from 15 to 35, and seriously damages the health of involved juveniles, and it always causes quick periodontal attachment loss and results in mobility of the teeth. It has been extensively emphasized by the dental society, especially by periodontologist because of its severe harm to people's health in spite of its rare clinical incidence. A great deal of researches has been done on the etiology, many risk factors have been found. But so far the etiology has not been fully elucidated, although a lot of theories have been established. This restricts the progress of its prevention and treatment at a large extent. In this article, the current situation and progression of the etiology, pathology, diagnosis, treatment and prognosis of aggressive periodontitis is reviewed, and a typical case with aggressive periodontitis is reported.The causes of aggressive periodontitis are complicated, and multiple disciplines involved for the etiological studies, including microbiology, molecular biology, genetics and cellular biology, et al. Recently, with the notable progress of science and technology, medical science research has leaped up to molecular biological level. And with the development of molecular biology, molecular genetics and celluar biology, relevant thought and technology have also been well enrolled in periodontitis research. A lot of researches have been done in the exploration of etiology of aggressive periodontitis, and splendid achievements have been accomplished.Microbial infection is usually regarded as the major cause of aggressive periodontitis. But disputes on the main pathogens of aggressive periodontitis exist. One point of view strongly insists A. actinomycetemcomitons (Aa) as the most important pathogen of aggressive periodontitis. But gradually, it has been realized that aggressive periodontitis is caused by a group of microorganism. Varieties of those microorganisms are significantly racial diversified. Isolating rate of Actinobacillus actinomycetemcomitons is remarkably higher in European and American than in Eastern Asian, whereas Porphyromonas gingivalis (P. gingivalis, Pg) is easier to be found in Eastern Asian, such as Chinese, Japanese and Korean. At the same time, some other microorganisms such as Fusobacterium nucleatum, Prevotella intermedia and Treponema can also be isolated from periodontal pockets of aggressive periodontitis patients, which indicates that those microorganisms are related to the development and progression of aggressive periodontitis.Besides the effects of microorganisms, changes of host's capability of defense to invasion of those microorganisms, over-production of proinflammatory cytokines by host cells responsing to the invasion of the microorganisms, immune defect, genetic factors, systemic diseases, unhealthy behavior and stress, all these factors contribute to development of aggressive periodontitis.Diagnosis of aggressive periodontitis mainly depends upon their clinical characteristics, such as rapid attachment loss, destruction of supported bone, obviously mobility of teeth, discordance of plaque accumulation with periodontal destruction, and familial aggregation of this kind of patients. X ray is very useful to making diagnosis of aggressive periodontitis. Furthermore, microbiological detection and leukocyte function test are sometime also meaningful.Early diagnosis, perfect initial therapy and promotion and instruction about oral hygiene maintenance are the key points to the successful treatment of aggressive periodontitis. Assistant medication is also necessary to the therapy. Flap surgery and regeneration surgery which includes bone grafts and guided tissue regeneration are often meaningful to restore the lost periodontal attachment and the destructed periodontal tissue. To aggressive periodontitis patients, it is the most important to keep a long-term strict plaque control and regular return to their dentist in time.