Clinical response of early onset periodontitis to periodontal therapy supported by adjunctive tetracycline and metronidazole: long term follow-up

ABSTRACT

Early onset periodontitis EOP is infected periodontal disease, affecting individuals younger than thirty-five years old. It is characterized by a rapid rate of bone loss and disease progression with defects in host response and specific etiological microbial flora. The purpose of the study is to evaluate the response of different types of EOP not associated with systemic diseases and with Papillion- Lefevre syndrome to periodontal therapy in long-term follow-up patients 9 from 6 families were studied, exhibiting localized EOP [LEOP] and generalized EOP [GEOP] aged from 3-21 years old. Clinical and radiographic examination were performed. Initial phase of treatment composed of oral hygiene instructions, hygiene instructions, scaling and root planning, subgingival irrigation with anti microbial agent and surgery. Adjunctive antibiotic tetracycline in LEOP or metronidazole + amoxycillin in GEOP. Scaling and root planning, antibiotics and the anti-inflammatory agent ibuprofen were administrated in phases of maintenance. More clinical and radiographic improvement was evident in LEOP. GEOP was characterized by an increased tendency of teeth loss during the temporary denture and acute phases. Adjunctive therapy with metronidazole gave more adequate response than tetracycline in GEOP, and acute phases of LEOP. Topical application of metronidazole was effective in resolution of persistent periodontal pockets. Puberty was associated with recurrence of inflammatory gingival overgrowth, that was controlled by ciproflex administration. lboprofen reduced dermatic hyperkeratosis of Papillon-Lefevre syndrome. Conclusion:. Periodic periodontal treatment changes the type of lesion and reduces number of infected teeth. Period of clinical improvement did not signify complete resolution of EOP. Antibiotic administration may introduce modification in periodontal environment and determine the type of response