Periodontal Maintenance Therapy and Generalized Aggressive Periodontitis: Brief Review of the Literature and Case Report

This case report presents an unusual variant of generalized aggressive periodontitis that was managed by nonsurgical therapy which included the use of a novel tooth gel.Also, a brief review of the literature is offered as context for this unusual clinical case.The patient, a 40-year old Caucasian female, presented with advanced bone loss involving all teeth, intense inflammation of the attached gingiva and little obvious supra-or subgingival biofilm and dental calculus.Presence of systemic disease, high levels of periodontal microbial pathogens and IL-1α and IL-1β polymorphisms were evaluated and all determined to be negative.Gingival biopsy resulted in a diagnosis of nonspecific inflammation.Treatment consisted of 2-and 3-month intervals for periodontal maintenance appointments and eventually the introduction of an activated edathamil-based tooth gel.Over the subsequent 4-years the patient's periodontal status stabilized as manifested by no further loss of tooth supporting bone, a reduction in the percentage of periodontal pockets of 4-6 mm depth and a reduction in the percentage of sites exhibiting bleeding upon periodontal probing.The significance of this case report is to emphasize that, even in cases of severe generalized aggressive periodontitis, nonsurgical periodontal therapy can be effective.In addition, it appears that a novel tooth gel containing activated edathamil is effective at reducing gingival inflammation with a concomitant reduction in percent of sites that bleed on periodontal probing.