The use of antibiotics in the treatment localized juvenile periodontics
Browne, Dexter R.
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Treatment studies of Localized juvenile periodontitis (LJP) have revealed a direct relationship between the elimination of Actinobacillus actinomycetemcomitans (A.a.) from the deep pocket epithelium, and disease cessation. To evaluate the successful treatment outcome in LJP patients, we compared pre and post treatment levels in A.a. in this patient population to treatment outcome. Ten LJP patients were randomly divided into two groups, with one group receiving antibiotic therapy (a combination of metronidazole and amoxicillin) and the other receiving no antibiotic. Both groups received full polymorphonuclear leukocyte (PMN) chemotaxis evaluation, microbiologic screening, oral hygiene instruction (OHi) and full mouth scaling and root-planing (S/RP) prior to surgical therapy. The surgical protocol included open flap debridement without resective or regenerative therapy. Using the DNA checkerboard method A.a. levels were measured, from samples obtained before and after treatment. The findings demonstrate that A.a. serotype b was the dominant strain throughout the clinical trial and all the patients n=10 (100%) expressed depressed PMN chemotaxis at baseline and at 24-months. The sites surgically treated yielded a mean probing depth reduction of 1.48mm (antibiotic) and 0.66mm (non-antibiotic) respectively. The treatment groups responded well to therapy and there was no statistical difference between both groups. The study suggests that LJP cases respond positively to therapy and that the judicious use of antibiotic therapy can provide improvement.
Thesis (M.Sc.D.)--Boston University, Henry M. Goldman School of Dental Medicine, 1999 (Periodontology and Oral Biology).Includes bibliographical references (leaves 67-78).
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