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Maintenance periodontal therapy after systemic antibiotic and regenerative therapy of generalized aggressive periodontitis. A case report with 10-year follow-up
Aggressive periodontitis (AgP) is an inflammatory disease characterized by rapid attachment loss and bone destruction. This case report presents the 10-year results in a subject with generalized AgP treated by a regenerative periodontal therapeutic approach and the adjunctive use of antibiotics, following a systematic maintenance periodontal therapy. The use of enamel matrix derivatives (EMD) and adjunctive antibiotic therapy to treat AgP yielded improvements in clinical parameters and radiographic bony fill. This combined therapeutic approach following a systematic supportive periodontal therapy supports the long-term maintenance of teeth with previous advanced periodontal defects, demonstrating successful stability after 10-years follow-up.
Clinical Relevance: The combined treatment protocol using EMD plus adjunctive antibiotic therapy, associated with a systematic supportive periodontal therapy, benefits the long-term maintenance of teeth with previous advanced periodontal defects in subjects presenting AgP, supporting this approach as an alternative in the treatment of AgP.
Article
Aggressive periodontitis (AgP) is considered a complex periodontal disease affecting the dentition with pronounced and rapid destruction of the periodontium and may result in loss of teeth and/or formation of advanced periodontal defects.1
Advantages in the use of systemic antibiotics in the therapy of AgP have been published,2 and studies have indicated that subjects with AgP significantly benefit from the adjunctive use of amoxicillin and metronidazole.3,4,5
Periodontal therapy should ideally not only resolve inflammation and arrest disease progression, but also regenerate lost periodontal attachment (ie formation of cementum, periodontal ligament and alveolar bone). The use of enamel matrix derivatives (EMD) proteins in the therapy of periodontal defects has demonstrated promising clinical outcomes for the treatment of periodontal lesions, such as intra-bony defects6 and furcation involvement.7 Additionally, histological findings have supported the use of enamel matrix derivative proteins to promote tissue regeneration in periodontal defects.8
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