PERIODONTAL DISEASES IN CHILDHOOD AND ADOLESCENCE

Key words: Periodontitis, Gingivitis, Early onset periodontitis, Actinobacillus actinomycetemcomitans

Persistent gingival inflammation is frequent in childhood and adolescence. The main cause is the accumulation of plaque in the cervical portion of the teeth, and consequent bacterial growth. Gingivitis in children is usually limited to junctional epithelium and is less severe. In adolescence phlogosis is more important due to increased periodontal vascolarization. In periodontitis, alveolar bone lesions accompany the gingival lesion. Prepuberal periodontitis which accompanies eruption of permanent teeth and juvenile periodontitis are comprised in Early Onset Periodontitis (EOP) and represent approximately 1% of all cases. The prepuberal form is very severe, usually associated to neutrophil dysfunctions. Juvenile form includes 3 subgroups; the so-called attachment loss, which is limited to very few teeth; a localized form, usually affecting the incisors; and a generalized, often rapidly progressive form. In EOP, which certainly also has an immunogenetic background, Actinobacillus actinomycetemcomitans plays a very important role. Hypotheses on the patogenesis of EOP are discussed.