juvenile periodontitis
Introduction
Introduction to adolescent periodontitis Juvenile periodontitis (JP) refers to a special type of periodontitis that occurs in adolescence, which is the main type of early-onset periodontitis (EOP). The etiology of the disease is not fully understood, but a large number of studies have shown that microbial and immune function defects are closely related to the occurrence of the disease. Studies have found that Actinobacillus actinomycetemcomitans (Aa) is the main pathogen of JP, they Its role is: a. killing human leukocytes by producing certain cytokines, inhibiting the chemotaxis of neutrophils, thereby preventing white blood cells from reaching the infected site. b. They can produce endotoxin, enzymes and the like to degrade connective tissue, prevent collagen synthesis and promote bone resorption. c. The bacteria can also directly invade the periodontal connective tissue and destroy the periodontal tissue. basic knowledge The proportion of illness: 21% Susceptible people: teenagers Mode of infection: non-infectious Complications: Diabetic periodontitis
Cause
Adolescent periodontitis
The etiology is not fully understood, but a large number of studies have shown that microbial and immune function defects are closely related to the occurrence of the disease. Studies have found that actinobacillus actinomycetemcomitans (Aa) is the main pathogen of JP, their role It is: a. killing human leukocytes by producing certain cytokines, inhibiting the chemotaxis of neutrophils, thereby preventing white blood cells from reaching the infected site. b. They can produce endotoxin, enzymes and the like to degrade connective tissue, prevent collagen synthesis and promote bone resorption. c. The bacteria can also directly invade the periodontal connective tissue and destroy the periodontal tissue. d.Aa can trigger the host's immune response. Studies have shown that the Aa antibody in the serum of JP patients is significantly elevated, and a large number of specific antibodies are also produced in the gums and enter the periodontal pocket to reach a level higher than the serum. The main reaction with the carbohydrate antigen of Aa is the IgG2 subclass, which plays a protective role.
In addition, a higher proportion of capnocytophaga can be isolated from the subgingival plaque of JP, but in recent years it has been found to be unique to JP and can be isolated in the normal population, so it is The special meaning of JP has not been emphasized.
In addition, a large number of studies have shown that patients with this disease have many leukocyte dysfunction, and this defect is familial, and some of the patient's siblings may also have JP, or have no leukocyte function defects without periodontitis.
Prevention
Juvenile periodontitis prevention
(1) Master the correct method of brushing, 3 times a day, 3 minutes each time.
(2) After the meal, rinse your mouth before going to bed and keep your mouth clean.
(3) Clean food debris, soft dirt, plaque, floss, toothpicks, and toothbrush that are difficult to remove.
(4) Regular inspections, .
Complication
Adolescent periodontitis complications Complications diabetes type periodontitis
Severe periodontitis is one of the risk factors for high blood sugar in diabetic patients.
The incidence of coronary heart disease in patients with periodontitis is 20% higher than that in the normal population. The incidence of coronary heart disease in men with periodontitis or edentulous men under 50 years old is 70% higher than that in the general population, and fatal bone disease is severe in patients with severe alveolar bone resorption. The incidence of cardiac arrest was 2 and 3 times higher than that of the normal population.
Symptom
Symptoms of periodontitis in adolescents Common symptoms Teeth with hot and cold pains, tooth displacement, tooth decay, bleeding gums, black line molars, gums, atrophy, pharyngitis, glossitis, gingivitis
The disease can be divided into localized juvenile periodontitis (LJP) and diffuse type (generalized juvenile periodontitis (GJP). The former lesion is limited to the first molar and incisor, and the latter lesion has affected most of the teeth in the mouth. Most patients are limited in the early stage, and as the age increases, the lesion develops into a diffuse type. Its clinical features are mainly:
First, age, gender
The disease mainly occurs in young people from puberty to 25 years old. Some patients start to develop from 11 to 13 years old, but because of early asymptomatic, the doctor is often around 20 years old, more women than men, about 3:1.
Second, gingival inflammation and oral health
The degree of early periodontal damage in patients with this disease is not proportional to oral hygiene, that is, the patient's oral hygiene is better, the gum inflammation is lighter, but deep periodontal pockets and bone resorption are already present.
Third, good teeth
The typical predilection sites of this disease are the first permanent molar and the upper and lower maxillary incisors, while the canine and premolar regions are rarely affected, and the incidence is mostly bilaterally symmetric, and GJP can invade most of the teeth.
Fourth, early tooth loose shift
In the case of gingival inflammation is not obvious, the incisors and the first molars may appear loose, chewing weakness, accompanied by tooth displacement, more common in the upper anterior teeth in a fan-shaped arrangement, the rear teeth shift lighter, easy to cause food impaction.
Five, periodontal pocket and alveolar bone changes
The periodontal pocket formed by adolescent periodontitis is narrow and deep. X-ray films show that the first molar alveolar bone is mostly vertical absorption or curved with horizontal absorption, and the anterior alveolar bone is mostly horizontal or arc. Shape absorption.
Sixth, fast progress
Some people have statistically developed the disease 3 to 4 times faster than adult periodontitis. Patients often need to pull their teeth or their teeth fall off at the age of 20 to 30.
Seven, family history
There are many people in the family who suffer from this disease. The patient's siblings have 50% chance of getting sick. The maternal inheritance is more. Some people think that it may be related to leukocyte function defects, or may be X-linked or autosomal dominant.
Examine
Adolescent periodontitis examination
Complete medical history, local physical examination, X-ray and laboratory examination if necessary.
Diagnosis
Diagnosis and diagnosis of juvenile periodontitis
Early periodontitis should be distinguished from marginal gingivitis. When a periodontal abscess occurs, it should be differentiated from alveolar abscess.
