This case report describes the long-term follow-up of a patient with localized aggressive periodontitis over a 30-year period. A 16-year-old woman was referred for periodontal assessment after starting orthodontic treatment. The patient was treated initially by combined nonsurgical and antimicrobial therapy, and autotransplantation of maxillary third molars in place of maxillary first molars, followed by a regular supportive periodontal treatment program. This challenging case demonstrated that elimination of putative bacterial pathogens and long-term supportive periodontal treatments provide an effective treatment modality for localized aggressive periodontitis. Keywords: Aggregatibacter actinomycetemcomitans, aggressive periodontitis, autotransplantation, implant, nonsurgical