LAUSR

OBJECTIVE Evaluation of subgingival instrumentation (SI) in periodontitis stage III and IV, grade B and C with systemic antibiotics (AB) only after detection of Aggregatibacter actinomycetemcomitans. METHODS Patients of the Department of Periodontology of Goethe University Frankfurt/Germany were screened for microbiological testing between 2008 and 2018. All patients with aggressive and generalized severe chronic periodontitis were microbiologically tested and in case of subgingival A. actinomycetemcomitans, SI was combined with AB, in all other cases not (nAB). Clinical examinations were performed before (T0), 12.4 (9.4/15.1) weeks after SI (T1) and at last supportive periodontal care (T2; 3.1 [1.4/5.5] years after T1). Results at T1/T2 were assessed as "treat-to-target" endpoint (≤4 sites with probing pocket depths ≥5 mm). RESULTS 425 patients (280 stage III/145 stage IV, 95 grade B/330 grade C) provided complete data (AB 144/nAB 281) for T0 and T1, 332 (AB 121/nAB 211) for T2. At T1/T2 AB resulted in 53 (37%)/76 (63%) patients with "treat-to-target" endpoint, nAB in 76 (27%)/91 (43%) (p = 0.038/0.001). CONCLUSIONS In periodontitis stage III and IV, grade B and C with subgingival A actinomycetemcomitans, SI with AB resulted in higher rate of "treat-to-target" endpoint than exclusive SI in patients without A. actinomycetemcomitans. This article is protected by copyright. All rights reserved.