PERIODONTAL THERAPY IN YOUNG-ADULTS WITH SEVERE GENERALIZED PERIODONTITIS

THIS STUDY EVALUATED THE EFFECT OF periodontal therapy on clinical and microbiological parameters in 23 subjects with severe generalized ear ly onset periodontitis. Therapy consisted of oral hygiene instruction and root planing and scaling, followed 3 months later by open flap deb ridement. Subjects were monitored for both clinical measures and level s of Actinobacillus actinomycetemcomitans and Porphyromas gingivalis a s identified by indirect immunofluoresence. Clinical and microbiologic al evaluations were done at the start of the study, 3 months after the completion of root planing and scaling and 3 months after open flap d ebridement. Mean probing depth was reduced by both root planing and sc aling and open flap debridement and the level of reduction demonstrate d by bath phases of therapy was similar to reductions found in studies that utilized subjects with chronic adult periodontitis. In contrast, reductions in attachment level due to the two phases of therapy, demo nstrated in previous studies of subjects with adult periodontitis, wer e not found in the young adult subjects with severe periodontal diseas e utilized in this study. Levels of A. actinomycetemcomitans were not significantly affected by root planing and scaling, but were reduced b y open flap debridement. P. gingivalis was virtually eliminated by roo t planing and scaling, demonstrating that the two bacterial types resp ond differently to periodontal therapy. These changes in microbiologic al parameters were similar to those found in studies of localized juve nile periodontitis subjects, where surgery or antibiotics have been sh own to be necessary to reduce levels of A. actinomycetemcomitans.