Lokalize jüvenil periodontitisli hastalara uygulanan farklı tedavi yöntemlerinin etkinliğinin klinik ve mikrobiyolojik yöntemlerle değerlendirilmesi

Abstract

82 SUMMARY Juvenile periodontitis is a well defined clinical entitiy with onset during circumpubertal years. Actinobacillus actinomycetemcomitans has been associated with the etiology of juvenile periodontitis as the most probable cause of the disease. Therefore it has been stated that the eradication of Actinobacillus actinomycetemcomitans cannot be accomplished by scaling and root planing alone but only together with systemic tetracycline administration. The authors add that eradication may succeed with periodontal surgery. The administration of tetracycline combined with scaling and root planing and even with periodontal surgery has also been recommended by some authors. Here, a retrospective study of 10 localized juvenile periodontitis patients treated in a split mouth manner with 4 different treatment modalities scaling+root planing alone, scaling+root planing with topical minocycline administration, periodontal surgery alone and periodontal surgery with systemic administration of tetracycline is presented. Clinical and microbiological status of the patients were monitored for 3 months. Oral examination and plaque sampling was done at baseline, 4th, 8th and 12th weeks. Total bacteria and range of certain bacterial morphologies were counted on a phase contrast microscope and the detection of periodontopathogens was done by DNA-RNA blot hybridization technique. The data obtained was evaluated by statistical analysis. Our results on clinical data showed that there were no statistically significant difference between the different treatment modalities. Actinobacillus actinomycetemcomitans was detected in 90% of our patients and 43% of the sites showing clinical attachment loss before the treatment. Three months after the therapy it was found that sites treated with topical or systemic antibiotics in conjunction with conventional periodontal therapy were in a better condition both clinically and83 microbiologically. Actinobacülus actinomycetemcomitans, Campylobacter rectus and Porphyromonas gingivalis could not be detected in the sites treated with systemic antibiotic in conjunction with conventional periodontal therapy. It was determined that scaling+root planing alone must not be preferred for the treatment of LJP patients. However scaling+root planing with a controlled release topical minocycline administration can be effective in the suppression of certain periodontopathic bacteria. Therefore we concluded that LJP lesion where periodontal surgery is not a must can be treated effectively with controlled release topical minocycline in cojuntion with non surgical periodontal therapy.