Agresywne zapalenie przyzębia – wyzwanie diagnostyczne

*Agata Orzechowska

Summary
Aggressive periodontits (AP) is a rare disease of complex etiology. It should be differentiated with manifestations of systemic diseases as well as chronic periodontitis. The differentiation may be difficult due to the varied nature of AP, this is why it is also allowable to modify the diagnosis even during the therapy. The existing classification of periodontal diseases set by the AAP in 1999 established criteria of AP diagnosis. Clinically, the use of those criteria is not always unmistakable. One of the most disputable is the microbiological composition of dental plaque as well as the relation between occurrence of specific bacteria and particular forms of periodontitis. It has been well known, that chronic periodontits is caused by sheer volume of non-specific plaque, while the aggressive periodontits develops due to presence of specific pathogens – mainly A. actinomycetemcomitans. The latest data reveals that the presence of particular bacteria does not have to be connected with the form of periodontal disease but with its severity determined with pocket depth.
The etiology of AP consists invariably of the immunological factor. Some data suggest concomitant viral infection which may influence the periodontal tissues synergistically with bacteria.

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