early onset periodontitis/GJP

[wiggy]

Hi all,

I'm a non-smoker and was dx'ed with generalized juvenile periodontitis last year and underwent a full mouth SRP. I haven't had any flare-ups since, and my gums are healthy now. My concern are the huge anterior spaces where the papillae used to be (I have ahigh lip line when I smile). My dentist who is conservative in terms of management, but very good, recommended against crowns because that would cause further recession, and did not recommend implants because my teeth were still secure. I feel like I'm in purgatory regarding my treatment options. Any suggestions out there?

(interestingly, 2 of my med school classmates also had similar gum problems)

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[no2thdk999]

How old are you wiggy? Localized JP usually shows up between 10 and 15 as severe attachment loss around the 1st molars and incisors. If left untreated it can progress to generalized JP. It is thought to have genetic, bacterial, and host response issues and can progress in spite of meticulous oral hygiene. It can be a devastating disease process and is not a time to be conservative.

I would strongly recommend you find a periodontist that you and your dentist trust preferably one in an academic setting so you get the benefit of several minds. All degrees of periodontitis are like alcoholism without the social stigma. Once you have it, you have to deal with it for the rest of your life. These types of rare, rapidly progressing, or refractory cases are what specialists are made for. I'm sure your dentist means well but if you want to tip the scales in your favor as much as possible you're going to need all the help you can get. If all you had was one round of S/RP then either you don't really have GJP or your dentist is woefully under treating you. There are specific treatments for GJP that can be of benefit but your dentist might not be up to date on them.

As to your question, there are certain tissue regenerative procedures. However recreating tissue height is one of the harder things to do in dentistry. It's like trying to stack water. It's easier to do if you have walls to hold the tissue up but if you've got bone loss all the way across the arch it's a lot harder and less predicatable.

Bottom line I would see a specialist asap.


JMHO
Rob

 

[wigglytooth]

SDN is not a place for internet medical advice. See a periodontist. Closing thread.