# Initial clinical sign of juvenile periodontitis:
A. Pathological tooth migration and midline diastema
B. Tooth mobility and bone loss
C. Gingival enlargement and pus formation
D. Pain and bleeding
The correct answer is A. Pathological tooth migration and midline diastema.
Pathologic migration may continue after a tooth no longer contacts its antagonist. Pressures from the tongue, the food bolus during mastication, and the proliferating granulation tissue provide the force.
Pathologic migration is also an early sign of localized aggressive periodontitis. Weakened by the loss of periodontal support,the maxillary and mandibular anterior incisors drift labially and extrude, thereby creating diastemata between the teeth.
Reference: Carranza's Clinical Periodontology, 12th Edition, Page no: 306
