J Periodontal Implant Sci.  2014 Aug;44(4):201-206. 10.5051/jpis.2014.44.4.201.

Outcomes of nonsurgical periodontal therapy in severe generalized aggressive periodontitis

• Bouziane A
• Benrachadi L
• Abouqal R
• Ennibi O

• KMID: 2212014
• DOI: http://doi.org/10.5051/jpis.2014.44.4.201

Abstract

PURPOSE
Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis.
METHODS
Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets > or =7 mm and clinical attachment level (CAL) of sites with attachment loss > or =5 mm were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values.
RESULTS
Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases.
CONCLUSIONS
These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.

Keyword

Aggressive periodontitis; Periodontal debridement; Treatment outcome

MeSH Terms

Aggressive Periodontitis*
Humans
Inflammation
Periodontal Debridement
Periodontitis
Prognosis
Tooth
Treatment Outcome

Figure

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  Figure 1 Initial state of one of the severe generalized aggressive periodontitis cases.

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  Figure 2 Severe angular alveolar bone loss and furcation defect degree II at 36. Probing depth: 3.3.13 (Buccal), 3.2.11 (Lingual).

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  Figure 3 Improved pocket depth at re-evaluation. Probing depth: 2.2.7 (Buccal), 2.2.6 (Lingual).

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  Figure 4 Stability of the lesion 5 years after the aetiological treatment. Probing depth: 3.2.2 (Buccal), lingual 3.3.3.

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  Figure 5 Radiographic improvement of the lesion.

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  Figure 6 Diagram demonstrating changes in pocket depth in millimeters (median and quartiles) at baseline, re-evaluation, and posttreatment after using Friedman and Wilcoxon tests. *P=0.05, re-evaluation vs. initial. †P=0.05, posttreatment vs. initial. ‡P=0.12, re-evaluation vs. posttreatment. PD: probing depth.

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  Figure 7 Diagram demonstrating changes in clinical attachment loss (CAL) in millimeters at baseline, at re-evaluation, and posttreatment after using Friedman and Wilcoxon tests. *P=0.05, re-evaluation vs. initial. †P=0.05, posttreatment vs. initial. ‡P=0.27, re-evaluation vs. posttreatment.

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