Juvenile Periodontitis
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Introduction
An uncommon disease characterized by peridontal destruction, often in the absence of overt gingival inflammation
Epidemiology
- Prevalence 1:1000; male = female
- Onset at puberty or earlier
Clinical features
- Affects the first permanent molar and incisors
- Actinobacillus, Actinomycetes comitans has been isolated from the affected sites
- Results in drifting and loss of the first permanent molar and incisors
Investigation
Radiology may reveal marked bone loss interdentally, inter-radicularly and apically
Complications
- Tooth loss
Malocclusion
- Temporomandibular Joint (TMJ) dysfunction syndrome
Non-drug Treatment
- Control of plaque bacteria by use of antiseptic solution
- Establishing a healthy gingival and periodontal attachment
- Oral hygiene instruction and motivation
- Regular scaling and polishing
- Root planing
- Splinting of mobile tooth
- Periodontal surgery
- Bone regenerative techniques e.g using polytetrafluoroethylene (PTFE) membranes, Bio-Oss, bio-membrane
Drug Treatment
- Metronidazole
- Adult: 200mg orally every 8 hours for 5 days
- Child
- 1-3: 50mg orally every 8 hours
- 3-7 years: 100mg every 12 hours
- 7-10 years: 100mg every 8 hours
- 10-18 years: 200mg every 8 hours
Plus
- Tetracycline
- Adult: 250mg orally daily for up to 21 days
- Child under 12 years: metronidazole and amoxicillin (or erythromycin for those sensitive to penicillin)
Precaution
- Tetracyclines should not be given to children under 12 years