[The clinical and etiological study on juvenile periodontal disease]

Seven juvenile periodontally diseased patients were evaluated for clinical, microbiologic and local or systemic host factors. Three patients showed the localized from of periodontitis clinically and radiographically and by deep periodontal pockets associated with the molars and incisors. Four were in the generalized froms, in which in most cases all teeth were affected. The results in both diseased froms on the predominant cultivable subgingival microflora, the composition of which was not different from that in adult periodontitis, consisted of significantly increased proportions of Gram-negative anaerobic rods, Bacteroides sp. and B. gingivalis, Haemophilus sp. and H. actinomycetemcomitans were detected in 1/3 of the localized and 2/4 of the generalized periodontitis. They were of no value in distinguishing activity that enhanced disease in the generalized from. Elevated serum IgG responses were noted with B. gingivalis. No markedly functional abnormalities of neutrophils from peripheral blood have been demonstrated, however it might function with systemic factors, like an insulin-dependent diabetes. Morphologic characteristics of the oral and periodontal tissue in localized periodontitis were that the pattern of destruction was confined to specific teeth groups characterized by extensive the bucco-lingual width ratio of the dental crown to alveolar bone width. These observations indicate that the generalized form of juvenile periodontitis lesions were associated not only with the presence of subgingival bacteria, but also with conditions such as local morphologic and systemic or constitutional factors, individual variation in relation to destructive and protective aspects of the defense mechanisms.