Antibiotics in the management of aggressive periodontitis

Abstract

Aggressive periodontitis, although not rare, is a fairly unknown condition. Little is known about its optimal management. While majority of patients with common forms of periodontal disease respond predictably well to conventional therapy (oral hygiene instructions (OHI), non-surgical debridement, surgery, and Supportive Periodontal therapy (SPT)), patients diagnosed with aggressive form of periodontal disease often do not respond predictably/favorably to conventional therapy owing to its complex multi-factorial etiology. Protocols for treating aggressive periodontitis are largely empirical. There is compelling evidence that adjunctive antibiotic treatment frequently results in more favorable clinical response than conventional therapy alone. This article mainly focuses on the role of adjunct use of pharmacological agents in improving the prognosis and treatment outcome of aggressive periodontitis patients.

Functionalised nanoscale coatings using layer-by-layer assembly for imparting antibacterial properties to polylactide-co-glycolide surfaces

“…In addition, the risk of undesired side effects caused by high systemic doses or resistance development can be reduced [3,4]. It is therefore beneficial to use local delivery systems that control the release of their agents and guarantee lasting drug concentrations in the pocket in spite of high sulcular fluid rates [3]. Among antibiotics, metronidazole (MET) is highly effective for the management of anaerobic infections, such as intraabdominal and gynecologic infections, septicemia, endocarditis, bone and joint infections, central nervous system infections, respiratory tract infections, skin and skin-structure infections.…”

“…For instance, the conventional treatment of periodontitis by scaling and root planing is advantageously accompanied by the adjuvant administration of antibiotics, which can be applied by systemic or local administration [3]. Compared to systemic drug delivery, local administration in periodontology is considered to be more effective, since the pathogen-specific drug can be placed directly in the periodontal pocket achieving effective concentrations for a sufficiently long period of time.…”

“…Compared to systemic drug delivery, local administration in periodontology is considered to be more effective, since the pathogen-specific drug can be placed directly in the periodontal pocket achieving effective concentrations for a sufficiently long period of time. In addition, the risk of undesired side effects caused by high systemic doses or resistance development can be reduced [3,4]. It is therefore beneficial to use local delivery systems that control the release of their agents and guarantee lasting drug concentrations in the pocket in spite of high sulcular fluid rates [3].…”

A Judicious Treatment Approach for the Management of Localized Aggressive Periodontitis: A Case Report

“…With more advanced cases, treatment comprises of a more comprehensive approach including debridement, local and systemic antibiotics, and regenerative therapy. The responsiveness of aggressive periodontitis to conventional periodontal treatment is however unpredictable and the overall prognosis for these patients are poorer than for patients with chronic periodontitis [4]. In this report we present a novel technique for management of a case of localized aggressive periodontitis (LAP).…”

“…The bone defect in tooth 46 was filled with Puros ® (Zimmer Dental, USA) allograft and GTR (Biomend) ® (Zimmer Dental, USA) membrane. Management of tooth 31 was bespoked by incorporating platelet rich fibrin (PRF) obtained by centrifuging 5ml of patient's own blood at 2700rpm for 13 minutes with Puros allograft (Figures 5 and 6) [4]. Flaps were approximated using interrupted black silk (4-0) sutures.…”