Abstract
This is an 18-year follow-up report of a patient with generalized aggressive periodontitis who was treated by periodontal antimicrobial therapy. The prognosis of tooth 36 was judged as questionable at the first clinical examination. After adequate control of supragingival plaques, scaling and root planing by hand and an ultrasonic scaler with a furcation tip were performed. Then, after meticulous mechanical debridement,minocycline HCl ointment was applied topically into the periodontal pocket once a week for 4 consecutive weeks. After 3 months, the deepest probing pocket depth of tooth 36 improved from 6 mm to 3 mm. After the initial periodontal therapy, periodontal surgeries were carried out for teeth with a probing pocket depth of over 4 mm and bleeding on probing. After the surgeries, all the periodontal pockets became less than 3 mm, and the treatment strategy was shifted to supportive periodontal therapy (SPT). In SPT, microbial testing was performed as an aid to determine of the periodontal pathogens and selection of the most appropriate antibiotic. Because Aggregatibacter actinomycetemcomitans (A.a.) was detected by microbial testing, antimicrobial therapy with oral azithromycin was prescribed as an adjunct to meticulous debridement with the ultrasonic scaler. After completion of the antimicrobial therapy, A.a. was no longer detected at least until 15 months after the therapy. This case report suggests that antimicrobial therapy as an adjunct to meticulous mechanical debridement may be effective for the treatment of patients with generalized aggressive periodontitis. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 56(1)：65-71, 2014.
