Picture based diagnosis case 1

Study the two radiographs which are of the same
patient at (a) 19 years and (b) 34 years of age.

1 . What is the most likely periodontal diagnosis at 34
years of age?

Generalised aggressive periodontitis. The severity
of bone resorption and the radiographic absence of
signs of resorption at 19 years preclude a diagnosis of
chronic periodontitis.

2 . What does the initial phase of treatment involve?

Initially conventional cause-related treatment
is instigated: instruction in toothbrushing and
use of adjunctive aids for interproximal and
subgingival cleaning, RSI, prophylaxis. Ultimately,
treatments such as surgery and the adjunctive use of
antimicrobials might be indicated, but conventional
treatment is first in line.

3 . The patient has a sister who is aged 29 years. What
advice might you offer?

Periodontal screening and radiographic examination.
There is evidence that certain subjects are at high risk
from developing aggressive periodontitis and this
risk may be under genetic control. Siblings should
be screened and affected individuals with children
warned that early signs may develop from around
puberty onwards

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