Localized aggressive periodontitis treatment response in primary and permanent dentitions

Abstract

Background: The comparative treatment response of children and young adults with localized aggressive periodontitis treatment (LAgP) affecting primary and permanent dentition is unknown. The objective of this study is to evaluate the influence of non-surgical periodontal therapy with adjunctive systemic antibiotics on the clinical outcome of children and young adults with primary versus permanent dentition affected by LAgP.

Methods: A cohort of 97 African American participants aged 5 to 21 years (30 males and 67 females; 22 primary and 75 permanent dentitions affected) diagnosed with LAgP were included. Patients presented with no significant medical history. All patients underwent periodontal therapy, which consisted of full-mouth mechanical debridement at baseline and the 3-, 6-, and 12-month appointments. Additionally, all patients were prescribed a 1-week regimen of systemic antibiotics at the initial appointment. Clinical parameters were analyzed, including probing depth, clinical attachment level (CAL), bleeding on probing, and percentage of visible plaque.

Results: Overall, periodontal therapy was found to be effective in improving the clinical outcomes of both primary and permanent dentitions. Although baseline CALs were similar between the groups, the reduction in mean CAL at 3, 6, and 12 months and reduction in percentage plaque at 3 months were significantly greater in primary dentition compared with permanent dentition.

Conclusions: Non-surgical therapy with systemic antibiotics is effective for LAgP in both primary and permanent dentitions. A greater reduction in CAL in LAgP of primary dentition may suggest that younger children may carry a greater propensity for positive treatment outcomes and healing potential compared with children/young adults with permanent dentition.

Trial registration: ClinicalTrials.gov NCT01330719.

Keywords: Adolescent; aggressive periodontitis; dental scaling; oral health; primary dentition; root planing..

Conflict of interest statement

The authors state no potential conflict of interest with the authorship and/or publication of this article.

Figures

Figure 1

Diagram of study inidicating number of patients included/excluded and attrition.

Figure 2

Figures (A–J) illustrate clinical parameters over time for compliant patients from baseline to 12 months post-treatment. (A) Mean PD, in primary dentition. (B) Mean PD, permanent dentition. (C) Mean CAL, primary dentition. (D) Mean CAL, permanent dentition. (E) Percent sites with PD >4mm, primary dentition. (F) Percent sites with PD >4mm, permanent dentition. (G) Percent BoP, primary dentition. (H) Percent BoP, permanent dentition. (I) Percent plaque, primary dentition. (J) Percent plaque, permanent dentition. Bars depict significant reductions from baseline timepoints by Kruskal-Wallis test with Dunn’s multiple comparisons (*p<.05>

Figure 3

Data compares reduction levels in all clinical parameters between groups (primary dentition in white bars and permanent dentition in shaded bars) at each timepoint. (A) Mean PD (B) Mean CAL. (C) Percent PD>4mm. (D) Percent BOP (E) Percent plaque. Significant decrease in reductions between groups are illustrated with horizontal lines, inter-quartile range (box), 5th–95th percentiles (whiskers), at 3 months, 6 months and 12 months after treatment. P values: ***<0.0001; **<0.005; *<0.05 Unpaired T-test.