Diagnosis The diagnosis is localized juvenile periodontitis (LJP). This is the first case you have ever seen.

Localized Juvenile Periodontitis (LJP) is a form of early-onset periodontitis that occurs in otherwise healthy adolescents. Age of onset is around puberty. LJP is most frequently characterized by rapid loss of alveolar bone affecting more than one tooth in the permanent dentition, although its progression may also be slow/moderate. The amount of destruction is not commensurate with the amount of local deposits present although gingival inflammation and subgingival calculus have been associated with the development and progression of early-onset periodontitis.1-3,24 The localized form begins in the first molars and incisors and defects are usually bilateral, involving 2 sites with 3mm of attachment loss. There is often little clinical inflammation and very light dental plaque or calculus.1-3 The generalized form (GJP) also has been referred to as rapidly progressive periodontitis (RPP) and generalized early-onset periodontitis (G-EOP).4,5 It may be an extension of LJP although etiology and pathogenesis are not fully understood. Recently a new category of early-onset periodontitis has been identified as incidental - EOP.5,9,24