The Clinical Study Of Antibiotic Therapy As An Adjunctive Treatment In Generalized Aggressive Periodontitis

Aggressive periodontitis (AgP) is a group of clinical and laboratory findings in patients with chronic periodontitis were significantly different and relatively rare periodontitis. The disease is characterized by rapidly occurring in the short term and severe attachment loss and alveolar bone destruction, which showed a majority of young teeth loose, shift or even fall off. It not only affects the digestive function of the masticatory, also affected the patients mental health. generalized aggressive periodontitis(GAgP) of periodontal tissue destruction is more serious, full mouth dental disease is often violated. The incidence of it in China is higher than that of localized aggressive periodontitis(LAgP). At present, the treatment principles of GAgP is the same of chronic periodontitis. Supragingival scaling, subgingival scaling and root planing is essential. But because of the complexity of root surface morphology and microbial infection, mechanical therapy has its limitations. In addition, some microbes also can invaded the periodontal pocket epithelium or oral soft tissue. After the purely mechanical treatment, these periodontal pathogens can still plant and multiply rapidly in periodontal pockets or other soft tissue, causing re-infection, resulting in disease recurrence. Therefore, adjunctive antibiotics therapy will be able to significantly improve the clinical effect of mechanical treatment in aggressive periodontitis patients. It is contributed to remove or refrain pathogenic microorganisms more completely and create an environmental which can maintain long-term health of periodontal tissues. The application of antibiotics include local application and systemic administration. Both have its advantages and disadvantages. This research investigate the curative effect of adjunctive antibiotics therapy. To evaluate the clinical effect of local or systemic antibiotic as an adjunct to scaling and root planing in generalized aggressive periodontitis patients. Comparing the different routes of administration of the treatment effect.Objective To observation of local or systemic use of antibiotics in the treatment of GAgP the clinical effect. Comparing the different routes of administration of the treatment efficacy. To find a safe and effective method for the clinical treatment in GAgP.Methods Patients were randomly divided into the local application group, the systemic administration group and scaling and root planning group. Local application groups select minocycline hydrochloride put in the periodontal pockets. Systemic administration group select Amoxicillin and metronidazole for oral use. Scaling and root planning group did not use any drugs. Select plaque index (PLI) (Silness and L?e 1964), bleeding index (BI) (Mazza 1981), probing depth (PD) and clinical attachment loss (CAL) as clinical indicators. By observing the clinical parameters at baseline and 6 weeks after treatment to compare the effect of differences among the three groups.Results 1. After 6 weeks, three of the clinical periodontal index before treatment differences were significant (P<0.01);2. Except PLI, all indices of both local and systemic administration groups showed significant improvement (P<0.01) compared with scaling and root planning group after 6 weeks;3. After 6 weeks, BI, PD and CAL of local and systemic administration showed no difference (P>0.05);4. PLI differences between the three groups showed no significant (P>0.05). Conclusion 1. Scaling and root planing is certain effective in the patients suffered from generalized aggressive periodontitis;2. Antibiotic treatment as an adjunctive therapy of scaling and root planing can improve the clinical treatment of GAgP;3. Administration of the local or systemic antibiotic as the auxiliary treatment of generalized aggressive periodontitis both could improve clinical results。The difference between two groups was not significant.