Occurrence and appearance of cementum hypoplasias in localized and generalized juvenile periodontitis

The occurrence and appearance of cementum hypoplasias have been studied on teeth affected by juvenile periodontitis. Scanning electron microscopy showed the presence of cementum hypoplasias on the root surface of all extracted first molars and one incisor from nine patients with localized juvenile periodontitis and on most extracted teeth from two patients with generalized juvenile periodontitis. No hypoplasias were found on the extracted third molars. The alveolar bone loss in these patients seemed to be correlated to the frequency and extension of the hypoplastic areas in the associated teeth. The distribution of the teeth affected by localized juvenile periodontitis showed a symmetric distribution in the jaws. The patients with generalized juvenile periodontitis showed considerable deposits of dental calculus and wide areas of root resorption. The disturbance of cementum formation may have been caused by hereditary systemic factors, which subside with increasing age of the patient. The clinical appearance of juvenile periodontitis may therefore be influenced by the age at onset, the duration, and the frequency of such systemic factors, giving rise to a localized form and a more generalized form. One such factor may be a varying degree of hypophosphatasia.