Abstract
Early-onset periodontitis (aggressive periodontitis) is characterized by rapid attachment loss and alveo-lar bone loss, despite a healthy systemic condition. The severity of this disease is closely associated with both highly virulent pathogens and highly susceptible subjects. Although the tissue destruction takes place very rapidly, the progression of attachment loss and bone loss may be self-arresting in some patients. This case report describes the 18-year clinical history of an early-onset periodontitis patient who did not receive continuous treatment but who experienced the self-arrest of alveolar bone loss after puberty. The patient first visited the Orthodontic Department of Tokushima University Dental Hospital complaining of maloc-culusion when she was 11 years old. Clinical findings at that time showed moderate gingivitis with no alveolar bone loss. She refused orthodontic therapy because of the need to undergo tooth extraction prior to the therapy. She returned to our hospital when she was 17 years old, complaining of a pain in her lower left first molar. This time, severe generalized periodontitis was found, and a radiographic examination revealed marked alveolar bone loss in several teeth, including the lower left first molar. While local irrigation and medication relieved the pain, she visited our hospital once again at the age of 21 years, complaining of the same symptoms in the same molar. The lower left first molar was extracted at this time. When the patient was 29 years old, she returned to our hospital once again because of pulpitis of her upper molar. Although gingival inflammation and deep periodontal pockets were still present, the degree of alveolar bone loss had not changed since the examinations that were performed when she was 17 and 21 years old. These data indicate that periodontal destruction progressed while she was a teen-ager and then arrested, despite the absence of cause-related therapy. These results suggest that the progression of attach-ment and bone loss may be self-arresting in some patients. J Jpn Soc Periodontol, 45 : 279∼288, 2003.
