Chemotherapy in juvenile periodontitis.

Juvenile periodontitis has been described as a separate entity among the human periodontal diseases. Several forms of the disease based on the number and types of involved teeth as well as the age of the patient have been reported. The present review deals with the "classical" localized juvenile periodontitis (LJP). The etiology of LJP has been explained according to 3 theories: (1) a genetic (hereditary) defect in the host defense mechanism; (2) a specific infection; (3) a combination of 1 and 2. In all 3 alternatives, bacterial infection is the direct cause of the breakdown of the tissues. This is supported by reports of success following therapy aimed at eliminating the microbial challenge. Arguments favoring the use of chemotherapeutic agents as an adjunct to mechanical debridement, or instead of it, as well as arguments against such use are discussed. The conclusion seems to be dependent on which of the 3 theories of etiology the arguments are related to. If antibiotics are to be used, the choice of drug would depend on the sensitivity of the suspected pathogen(s). At present tetracycline seems to be the one suggested by most authors, but routine use of antibiotics in the treatment of LJP does not seem necessary and is not recommended.