Microbiological and Clinical Results of Antimicrobial Therapy in Aggressive Periodontitis Patients in Relation to two Application Modalities

In the treatment of aggressive periodontitis additional systemic administration of antibiotics is still under discussion. Objective: The objective of the present study was to evaluate the clinical and microbiological effects of systemic administration of antibiotics at different points of time as an adjunct to surgical treatment of aggressive periodontitis. Method: Compared was the efficacy of antibiotics applied i. immediately after finishing the modified Widman flap surgery and ii. 3 month after surgical therapy. The selection of an appropriate antimicrobial agent (Amoxicillin & Metronidazole vs Metronidazole) was based on the patients’ microbial profiles. 11 otherwise healthy patients aged 17- 42 years suffering from aggressive periodontitis were included in this clinical controlled split-mouth study. After initial periodontal therapy two quadrants of each patient were randomly assigned to the two different treatment groups. Pocket depth (PD), attachment level (AL), and bleeding on probing (BOP) were recorded at baseline, after initial periodontal therapy, 3 and 12 months post-treatment. In addition subgingival plaque samples were taken from the deepest pocket of each quadrant using paper points, and A. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus were identified by PCR. Results: The results showed a significant reduction in mean PD, AL, and BOP 3 month after treatment remaining stable for one year in both groups. A significant decrease of the percentage of patients positive for periodontal pathogens was also noted in the same pattern. No statistical significant differences in any clinical and microbiological parameters could be found over this one year post therapeutical observation period between both groups. Conclusion: It is concluded that the adjunctive application of antibiotics immediately after surgical therapy is not necessary. In cases of multiple surgeries the administration of antibiotics at the end of the surgical series can be recommended.