Current concepts in juvenile periodontitis.

Juvenile periodontitis is one of the more debilitating periodontal diseases. The disease entity includes two manifestations of aggressive bone destruction, a localized and a generalized form, which affect adolescents at puberty. Recent studies have defined the prevalence of the disease with regard to locale, gender, and ethnicity. In addition, significant advances have been made in evaluating host response effects in juvenile periodontitis. Studies have identified changes in cell surface receptors on neutrophils, which appear to be related to both receptor density and structure. Various molecular techniques, including restriction fragment length polymorphism, have enabled researchers to identify clonal variants of Actinobacillus actinomycetemcomitans--the microorganism most closely associated with the disease. This may prove to be very useful in identifying virulence factors that have a role in disease initiation and progression. Treatment modalities using debridement, surgery, and anti-infective therapy have been proposed for management of the disease.