Localised aggressive periodontitis in a 3-year-old-boy.

BACKGROUND: Localised aggressive periodontitis (LAgP), characterised by rapid attachment and bone loss, which may occur in children and adolescents, without clinical evidence of systemic disease.

CASE REPORT: Three-year-old boy was referred with excessive mobility of 83 and exfoliation of 73. Clinical examination revealed acceptable oral hygiene. Blood tests were performed to evaluate PMNs activity and the parents were advised to apply 0.2% chlorhexidine twice a day. One month later 83 was still excessively mobile. Blood tests were normal.

TREATMENT: A full mouth scaling and curettage were performed under general anaesthesia. Since 83 had been spontaneously exfoliated one day earlier, a biopsy was taken from its socket. The biopsy examination revealed granulation tissue with actinomyces colonies. A course of amoxicillin 250 mg three times a day for 7 days was prescribed. Cultures from periodontal pockets of the child's family members were found negative to Aggregatibacter actinomycetem comitans (Aa).

FOLLOW-UP: Examination 3 months later, no tooth mobility was observed and the cultures from the periodontal pockets were negative to Aa. Thereafter, the child was periodically reviewed every 3 months for 26 months with no signs of periodontal disease.

CONCLUSION: Amoxicillin combined with curettage around the involved teeth may be effective in LAgP treatment.