Periodontal Therapy in Young Adults With Severe Generalized Periodontitis

Abstract

This study evaluated the effect of periodontal therapy on clinical and microbiological parameters in 23 subjects with severe generalized early onset periodontitis. Therapy consisted of oral hygiene instruction and root planing and scaling, followed 3 months later by open flap debridement. Subjects were monitored for both clinical measures and levels of Actinobacillus actinomycetemcomitans and Porphyromas gingivalis as identified by indirect immunofluoresence. Clinical and microbiological evaluations were done at the start of the study, 3 months after the completion of root planing and scaling and 3 months after open flap debridement. Mean probing depth was reduced by both root planing and scaling and open flap debridement and the level of reduction demonstrated by both phases of therapy was similar to reductions found in studies that utilized subjects with chronic adult periodontitis. In contrast, reductions in attachment level due to the two phases of therapy, demonstrated in previous studies of subjects with adult periodontitis were not found in the young adult subjects with severe periodontal disease utilized in this study. Levels of A. actinomycetemcomitans were not significantly affected by root planing and scaling, but were reduced by open flap debridement. P. gingivalis was virtually eliminated by root planing and scaling, demonstrating that the two bacterial types respond differently to periodontal therapy. These changes in microbiological parameters were similar to those found in studies of localized juvenile periodontitis subjects, where surgery or antibiotics have been shown to be necessary to reduce levels of A. actinomycetemcomitans.

Analysis of genetic polymorphisms at the interleukin‐10 loci in aggressive and chronic periodontitis

“…Conversely, AP patients were selected only if there was evidence (from dental history and/or old radiographs) that the onset of the disease occurred under 35 years of age and that they were systemically healthy. Subjects with generalized aggressive periodontitis were defined, as previously described, as patients with > 5 mm of attachment loss at a minimum of one site in > 8 teeth, three of which were other than first molars and incisors (Gunsolley et al 1994). Only six of 18 patients with AP presented the generalized form.…”

Diminished Treatment Response of Periodontally Diseased Patients Infected with the JP2 Clone ofAggregatibacter(Actinobacillus)actinomycetemcomitans

“…Some previously published studies have even demonstrated that A. actinomycetemcomitans is a pathogen which is able to invade periodontal tissues but evade mechanical-chemical therapies (27,32,33). It is well established in the literature that A. actinomycetemcomitans-associated periodontitis requires periodontal therapy composed of a three-step strategy: (i) subgingival plaque control by mechanical debridement, (ii) administration of systemic antibiotics, and, as required, (iii) gingival flap surgery (14). Especially, the combination of metronidazole plus amoxicillin (amoxicilline) has been shown to improve the clinical and microbial parameters of patients infected with A. actinomycetemcomitans since it was first reported by van Winkelhoff et al (42).…”

Prevalence of aggressive periodontitis in school attendees in Uganda

“…1996). The treatment of patients with advanced disease is difficult and the regeneration of lost tissue is challenging (Gunsolley et al. 1994, Gustke 1998).…”