2025 Volume 67 Issue 2 Pages 85-94
Aggressive periodontitis is a rapidly progressive form of periodontitis that occurs relatively early in life, between the ages of 10 and 30 years. It has been reported that familial aggregation/infection with specific periodontopathic bacteria is often observed in this type of periodontitis. Although the usage of adjunctive antibiotic therapy might be considered in periodontal treatment, conventional periodontal treatment without antibiotics has also been reported to result in successful healing of periodontal tissue.
The patient reported herein is a 27-year-old woman who visited our hospital with the chief complaint of gingival bleeding at the time of tooth brushing. Clinical examination revealed the presence of deep periodontal pockets across both the maxillary and mandibular arches. The percentages of teeth with a probing pocket depth (PPD) of 4-5 mm and ≧6 mm were 30.4% and 14.3%, respectively. Bleeding on probing (BOP) was positive in 75.6% of teeth. A dental radiograph showed a pattern of severe localized incisor and first molar bone resorption that is typically observed in localized aggressive periodontitis. Especially, vertical bone resorption reached almost the tooth apex in #11. Because of gingival redness, noticeable swelling and bleeding from gingival margin, and also the high plaque control record (PCR) percentage at the start of initial periodontal therapy, the patient was given instructions on oral hygiene once a week, and concurrently received initial periodontal treatments such as scaling and root planing (SRP). As a result of the treatment, the gingival inflammation improved and the number of sites with a PPD of ≧4 mm decreased to one. Thus, periodontal surgery was not performed and the patient was transitioned to supportive periodontal therapy (SPT). The condition of the periodontal tissue has remained satisfactory even at one and half years after the start of SPT. This clinical case demonstrates that severe aggressive periodontitis can improve with conservative treatment alone, including strict plaque control and SRP, without surgery.
