As a result, to date, the authors are only aware of single methodologically sound

epidemiological study of aggressive periodontitis that was performed in a population of young Israeli
army recruits.
Thus, to be able to assess the prevalence of aggressive periodontitis in other populations,
demmer and papapanou proposed the use of the generally accepted case definition (see the chapter 5)
for periodontitis that was proposed by a working group of the U.S. Centers for Disease Control and
Prevention and the American Academy of Periodontology in combination with the age of the study
subject. Specifically, they assessed available studies for the proportion of subjects 25 years old or
younger who suffered from moderated or severe periodontitis as well as the proportion of subjects
between the ages of 26 and 35 years who suffered from severe periodontitis, both according to the
definition proposed by the U.S. Centers for Disease Control and Prevention.
Localized Aggressive Periodontitis
The prevalence of LAP in an Israeli army population between the ages of 18 and 30 years old was 4.3%.
In this cohort, presence of LAP was highly correlated with North African Origin and current smoking.
In addition to these recent data, there exist several studies on the prevalence of localized
juvenile periodontitis (LJP) among diverse population. LJP is the predecessor of LAP, although the two
conditions are not exactly interchangeable. The prevalence of this disease in geographically diverse
adolescent population was estimated at less than 1%. Most reports suggested a low prevalence of about
0.2%. Two independent radiographic studies of 16-year-old adolescents (one in Finland and the other in
Switzerland) followed the strict diagnostic criteria delineated by Baer and reported a prevalence rate of
0.1%. A clinical and radiographic study of 7266 English adolescents who were 15 to 19 years old also
showed a prevalence rate of 0.1%. In the United States, a national survey of adolescent between the
ages of 14 and 17 years reported that 0.53% had LJP. Blacks were at much higher risk for LJP, and black
male teenagers were 2.9 times more likely to have the diseases than black female adolescents. By
contrast, white female teenagers were more likely to have LJP than white male adolescents. Several
other studies have found the highest prevalenceof LJP among black males, who are followed in
descending order by black females, white females, and white males.
LJP was reported to affect both males and females, and it is seen most frequently in the period
between puberty and 20 years of age. Some studies have suggested a predilection for female patients,
particularly in the youngest age groups, whereas other reported no male or female differences in
incidence when studies are designed to correct for ascertainment bias.
Generalized Aggressive Periodontitis
Among the young Israeli army recruits, it was found that 1.8% suffered from GAP. When using
extrapopulation, as proposed by Demmer and Papapanou, a prevalence of about 1% to a maximum of
15% in individuals aged 25 to 35 years was found, depending on the study.
Specifically, data from German Study of Health in Pomerania indicated an extrapolated
prevalence within different age groups of 13% (29 years) and 7% (30 to 39 years), whereas the highest
extrapolated prevalence was found in the Erie Country Study, with up to 15% of individuals aged 25 to
35 years being affected.

As indicated previously, the use of prior epidemiological data for the heterogeneous
predecessors of GAP(Generalized juvenile periodontitis and rapidly progressive periodontitis) to assess
GAP prevalence is not possible, because these entities are not interchangeable with GAP. By contrast,
LJP---altough still different from LAP, by definition---can be used as a surrogate for LAP.