In healthy periodontal tissues, the distance from the amelocemental junction (ACJ) to the alveolar bone crest is typically in the order of 1mm in young people. If the distance between the ACJ and alveolar bone crest is more than 2-3mm then there is a possible suggestion of AgP. In addition to that, presence of angular or vertical bone loss (especially at 6s) and arrowhead or furcation lesions are also a strong suggestion of AgP. Strong family association
It is also important for a dental practitioner to check for family history of periodontal disease for each patient. This is because AgP may have an autosomal dominant inheritance pattern which suggests that up to 50% of siblings could be affected if one parent has the disease. Careful interpretation of the history is required but it may provide vital evidence in diagnosing AgP. If a case of Agp is diagnosed, it is important to screen the patients family members as well for AgP. Early detection of AgP allows intervention to be carried out before extensive periodontal destruction has taken place which further simplifies treatment. Treatment
Following the initial assessment and diagnosis of AgP, a treatment plan is usually developed for each individual undergoing therapy. As the overall treatment concepts and goals for AgP are not significantly different from that of chronic periodontitis, the different treatment phases (cause related therapy; re-examination for response to therapy; definitive therapy; and maintenance) are similar for both types of periodontitis.
For instance, diabetes is proved to be associated with periodontitis- it is a major risk factor when glycaemic control is poor. The rate of loss of attachment and bone loss is rapid.Loss of attachment refers to the destruction of periodontium whereas the bone refers to the alveolar bone supporting the teeth. The loss can be determined by using a calibrated periodontal probe and taking radiographs of the dentition. Usually the loss of attachment is greater than 2mm per year. Aggressive periodontitis runs in the patients family.Familial aggregation of aggressive periodontitis is often discovered by taking a thorough medical history of the patient. The patient is said to have a high genetic susceptibility to aggressive periodontitis. Many studies have shown that genetic factors contribute to the pathogenesis of this disease. In this case, the manifestation of aggressive periodontitis is believed to be the result of genetic mutation, combined with environmental factors. Secondary features
Secondary features are characteristics which are frequently seen but not always present in every patient diagnosed with aggressive periodontitis. The severity of periodontal tissue destruction is out of proportion to amount of bacteria present.The amount of bacteria is often indicated by the level of dental plaque. This feature implies that when aggressive periodontitis is present, loss of attachment and bone loss tend to occur even if the plaque level is low. High levels of Aggregatibacter (or Actinobacillus) actinomycetemcomitans and, in some populations, Porphyromonas gingivalis.These gram-negative microbes are considered the chief aetiological agent of aggressive periodontitis.