A Modern Approach to Treat Molar/Incisor Pattern Periodontitis—Review

Abstract

Molar–incisor pattern periodontitis (MIPP) is a severe form of periodontal disease characterized by rapid attachment loss and bone destruction affecting the molars and incisors. Formerly referred to as aggressive periodontitis, the terminology for this condition was revised after the 2017 workshop on the classification of periodontal and peri-implant diseases and conditions. Despite the modification in nomenclature, the treatment strategies for MIPP remain a critical area of investigation. The core principles of MIPP treatment involve controlling local and systemic risk factors, managing inflammation, and arresting disease progression. Traditional non-surgical periodontal therapy, including scaling and root planing, is commonly employed as an initial step together with the prescription of antibiotics. Surgical intervention may be necessary to address the severe attachment loss. Surgical techniques like resective and regenerative procedures can aid in achieving periodontal health and improving esthetic outcomes. This review article aims to provide an overview of the current understanding and advancements in the treatment modalities of MIPP. Through an extensive analysis of the existing literature, we discuss various modern therapeutic approaches that have been explored for managing this challenging periodontal condition.

IL-23/IL-17 axis levels in gingival crevicular fluid of subjects with periodontal disease: a systematic review

“…Periodontitis is the sixth most common osteolytic disease affecting humans [ 6 ] and currently has a prevalence of 62.3%, and in its most severe form can affect up to 23.6% of the world’s population [ 7 ]. For didactic purposes, periodontitis is classified into chronic and aggressive [ 8 , 9 ].…”

Case Report of a 4-Year-Old Girl with Stage IV Grade C Localized Periodontitis (Pre-Puberal Localized Aggressive Periodontitis) Affected by Misrecognition and Late Diagnosis

“…Stage IV grade C localized periodontitis (formerly known as localized aggressive periodontitis (LAP)/localized juvenile periodontitis) is a rare form of inflammatory periodontal disease occurring in clinically healthy individuals (with a 0.06% prevalence in European white individuals and an up to 2.6% prevalence in African Americans) [ 1 , 2 , 3 , 4 , 5 ]. Early-age onset and rapid progressive bone and periodontal ligament (PDL) loss around very specific teeth (first, the molars and incisors) correlated with low/no calculus or oral plaque deposits and surrounding periodontal tissues with almost no inflamed aspects upon clinical inspection are some of the main pathognomonic signs [ 1 , 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. One radiological characteristic is deep “U”-shaped bone loss [ 1 , 6 ].…”

“…Early-age onset and rapid progressive bone and periodontal ligament (PDL) loss around very specific teeth (first, the molars and incisors) correlated with low/no calculus or oral plaque deposits and surrounding periodontal tissues with almost no inflamed aspects upon clinical inspection are some of the main pathognomonic signs [ 1 , 2 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. One radiological characteristic is deep “U”-shaped bone loss [ 1 , 6 ].…”

“…Periodontitis can be predictably treated in the initial stages (stressing the importance of disease recognition) [ 5 ]. The overall treatment of and goals for LAP and chronic periodontitis patients are similar (systemic initial diagnosis, re-evaluation, and surgical management, followed by maintenance and restorative phases); it is important to control local and systemic risk factors, manage inflammation, and arrest disease progression [ 6 , 10 , 16 , 17 , 18 , 19 ]. Treating LPP patients is challenging due to the rapid progression of disease and the smaller periodontal attachment area when compared with permanent teeth [ 5 ].…”

“…Treating LPP patients is challenging due to the rapid progression of disease and the smaller periodontal attachment area when compared with permanent teeth [ 5 ]. The aim is to stop periodontal loss (both of PDL and bone) to regain as much as possible by establishing a healthy periodontium, to retain as many teeth and for as long as possible, and to avoid/minimize the spread of the condition to permanent teeth [ 5 , 6 , 10 , 17 ].…”