surgical therapy, and regenerative surgical therapy. after treatment, patient care and regular maintenance check-ups are important to completely eradicate the disease and present its recurrence. this is done through plaque control and removal: twice daily toothbrushing and daily interdental cleaning; chlorhexidine mouthwash can also be effective. the patient should also present to a dentist for maintenance check-ups at least every three months for an in-office check-up and if necessary, plaque control. aggressive periodontitis aggressive periodontitis involves inflammation of the gingiva and rapid and severe destruction of the periodontal ligament, alveolar bone and surrounding structures. unlike chronic periodontitis, it often occurs in patients with good oral health and plaque control and can be genetic. patients generally appear clinically healthy. it can be localized, which generally has a circumpubertal onset, or generalized, which usually occurs in individuals above the age of 35. treatment is determined on the severity of the disease and the age of the patient. supragingival (above gums) and subgingival (under gums) debridement and antibiotics are sometimes necessary. to maintain the treatment and prevent reoccurrence of disease, patient care is necessary. this involves good oral hygiene like for all other forms of periodontitis and gingivitis. brushing twice a day and interdental cleaning are necessary in maintaining a healthy periodontium and preventing the continuation of periodontal destruction. regular periodontal check ups are also necessary every 3–6 months. periodontitis as a manifestation of systemic disease periodontitis may be caused by systemic disease. there are currently at least 16 systemic diseases that have been linked with periodontal disease, such as diabetes mellitus, haematological disorders such as acquired neutropenia and leukaemia, down syndrome, etc. treatment and prevention are very important concepts in the management and maintenance of periodontitis as a manifestation of systemic disease. treatment can consist of either surgical or non-surgical treatment depending on severity. after treatment, patient compliance is important, which includes oral hygiene: tooth brushing twice a day and interdental brushing at least once a day; chlorohexidine mouthwash may also be helpful.