Rare case of generalised aggressive periodontitis in the primary dentition

Generalised aggressive periodontitis (AP) in the prepubescent age is an exceptionally rare disease in the primary dentition of otherwise healthy children. Characteristics of AP are gingival inflammation, deep periodontal pockets, bone loss, tooth mobility and even tooth loss. The most common way of treating this disease is the extraction of all the involved primary teeth.

A 4-year-old girl presented with signs of severe gingival inflammation. Clinical examination revealed deep pockets, increased tooth mobility and bone loss. Microbiological testing revealed the presence of a typical periopathogenic flora consisting of Aggregatibacter actinomycetemcomitans and the typical members of the red complex (Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola). The patient underwent tooth extraction of all primary teeth except the primary canines, followed by thorough root debridement and treatment with systemic antibiotics (amoxicillin plus metronidazole).

Regular clinical and microbiological examinations over 4 years showed no signs of recurrence of a periodontitis, even in the erupted permanent teeth.

Early diagnosis and consequent early treatment of aggressive periodontitis can stop the disease and therefore avoid the development of a periodontal disease in the permanent dentition. A close collaboration between specialists of different disciplines is required for a favourable outcome.