NONSURGICAL TREATMENT OF PATIENTS WITH PERIODONTAL-DISEASE

Objective. To determine whether the short-term use of systemic antimic robials (metronidazole or doxycycline) and locally delivered antimicro bials (metronidazole, chlorhexidine) in patients with advanced forms o f periodontal disease could prevent the normally necessary access surg ery. Study design. Ninety-four patients were randomly assigned with th e use of a double-blind protocol. Results. There was a 93% reduction i n the need for periodontal surgery about individual teeth and an 81% r eduction in the need for tooth extractions. Only 93 teeth of an initia l total of 783 teeth actually needed surgery or extractions. Eighty-on e percent of the patients entered into the maintenance phase of treatm ent without needing surgical treatments. Conclusion. These findings in dicate that a treatment paradigm based on the diagnosis and treatment of anaerobic infections is likely to be successful in those patients f or whom access surgery is recommended.