Classical versus contemporary treatment planning for aggressive periodontal disease

This case report presents a patient with a history of generalized aggressive periodontitis who has been maintained with the same periodontal prostheses for the past 40 years.

A 39-year-old healthy woman extremely susceptible to inflammatory periodontal disease presented to our office in 1968. Non-surgical therapies were completed to evaluate tissue response and the patient's compliance with oral debridement. A prosthetic consultation was completed and accepted before periodontal surgery was initiated. Several teeth were deemed untreatable and removed at the time of consultation and construction of the provisional maxillary and mandibular prostheses.

Clinical decisions were based on this patient's existing periodontal status, the restorability and the strategic value of specific teeth, the occlusal jaw relationship, and the esthetic concerns of the patient. She has been compliant with periodontal maintenance performed every 3 months since the conclusion of active treatment in 1969.

A periodontally compromised dentition punctuated by teeth with limited clinical roots and significant edentulous span requiring splinting was treated successfully with traditional therapies. The result has endured for 40 years with no additional loss of teeth.