Adjunct Antimicrobial Therapy and Periodontal Surgery to Treat Generalized Aggressive Periodontitis: A Case Report.
Here we report a case of generalized aggressive periodontitis treated with periodontal therapy including adjunct antimicrobial therapy and periodontal surgery. The patient was a 22-year-old woman who presented with the chief complaint of gingival recession. Baseline examination revealed generalized plaque deposition and gingival inflammation. Thirty-nine percent of the sites had a probing depth (PD) of 4-6 mm and 2% a PD of ≥7 mm; 63% exhibited bleeding on probing (BOP). Radiographic examination revealed vertical bone loss in the molars and horizontal bone loss in other teeth. Microbiological examination of subgingival plaque revealed the presence of Aggregatibacter actinomycetemcomitans and Tannerella forsythia. Oral health-related quality of life was assessed as a measure of patient-reported outcome. Based on a clinical diagnosis of generalized aggressive periodontitis, initial periodontal therapy and adjunct antimicrobial therapy were implemented. After reducing inflammation and subgingival bacteria, open flap debridement was performed for teeth with a PD of ≥4 mm. Reevaluation showed no sites with a PD of ≥5 mm, a minimal level of BOP, and a marked reduction in the level of the targeted periodontal pathogens. The patient's oral health-related quality of life was slightly worsened during supportive periodontal therapy (SPT). Implementation of adjunct antimicrobial therapy targeting periodontal pathogens and subsequent periodontal surgery resulted in improvement in periodontal and microbiological parameters. This improvement has been adequately maintained over a 2-year period. However, additional care is necessary to further improve the patient's oral health-related quality of life during SPT.
Department of Periodontology, Tokyo Dental College.
Daisuke
D
Irokawa
Asako
A
Makino-Oi
Takahisa
T
Fujita
Shigeki
S
Yamamoto
Sachiyo
S
Tomita
Atsushi
A
Saito
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000472:pathogenicity; D010520:Aggressive Periodontitis / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D017607:Aluminum Compounds / Q000627:therapeutic use; D016301:Alveolar Bone Loss / Q000209:etiology / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003481:Cuspid / Q000473:pathology; D003746:Dental Enamel Proteins / Q000627:therapeutic use; D003773:Dental Plaque / Q000382:microbiology / Q000628:therapy*; D003774:Dental Plaque Index; D003807:Dentin Sensitivity / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D017823:Furcation Defects / Q000209:etiology / Q000601:surgery; D005889:Gingival Recession / Q000209:etiology / Q000601:surgery; D005891:Gingivitis / Q000209:etiology / Q000628:therapy; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D008310:Malocclusion / Q000150:complications; D008911:Minocycline / Q000008:administration & dosage / Q000627:therapeutic use*; D008963:Molar / Q000473:pathology; D009910:Oral Hygiene / Q000193:education; D016871:Pasteurellaceae Infections / Q000382:microbiology / Q000628:therapy*; D010347:Patient Care Planning; D057747:Periodontal Debridement / Q000009:adverse effects / Q000379:methods; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D011788:Quality of Life; D017655:Silicon Compounds / Q000627:therapeutic use; D000070436:Tannerella forsythia / Q000472:pathogenicity; D014041:Tokyo; D016312:Treatment Refusal
D017607:Aluminum Compounds; D000900:Anti-Bacterial Agents; D003746:Dental Enamel Proteins; C588013:Nanoseal; D017655:Silicon Compounds; D008911:Minocycline; D005459:Fluorides