Aggressive periodontitis with a history of orthodontic treatment

Abstract

This report presents a 29-year-old aggressive periodontitis patient from Morocco with a history of orthodontic treatment. Despite all the first molars showing advanced bone loss, the maxillary anterior teeth did not show any periodontal destruction. The scientific literature rarely reports cases of aggressive periodontitis without involving maxillary anterior teeth. The treatment provided includes extraction of hopeless tooth, removal of overhanging restoration, scaling, root debridement, and regenerative periodontal therapy. The discussion highlights the dilemma during diagnosis of the case as either “iatrogenic periodontitis due to orthodontic treatment” or “localized aggressive periodontitis.” The age group of 15–35 years is the common age group for patients' seeking orthodontic treatment and the occurrence of aggressive periodontitis. Sound knowledge of periodontitis and identification of early signs of aggressive periodontitis through meticulous periodontal examination may help in earlier identification and minimalistic treatment. Education regarding periodontitis, especially aggressive periodontitis, is essential among orthodontists and general dentists. This case report aims to discuss the dilemma involved during diagnosis of localized aggressive periodontitis.

Orthodontic treatment in the presence of aggressive periodontitis

“… 11 A new periodontitis classification scheme has been adopted in 2018, in which forms of the disease previously recognized as “chronic” or “aggressive” are grouped under a single category (“periodontitis”) and are further characterized based on a multi-dimensional staging and grading system. 12 On the other side, recent studies 3 , 4 , 6 , 11 , 13 have continued to adopt the term aggressive periodontitis describing research samples and case reports involving orthodontic-periodontal treatments.…”

“…Therefore, education regarding periodontitis, especially AgP, is essential among orthodontists and general dentists. 3 …”

A Case of Mandibular Prognathism with Generalized Aggressive Periodontitis and Crowding

“…The common age range in patients requiring orthodontic treatment is the same as that in those with aggressive periodontitis: 15-35 years 10) . Detecting the signs of aggressive periodontitis early through careful periodontal examination facilitates early diagnosis, thus minimizing the requirement for periodontal treatment 10) . Therefore, orthodontists should have a good knowledge of periodontitis and be ready to adopt an interdisciplinary approach when treating such patients 1) .…”