This investigation evaluated the efficacy of obtaining baseline culture and sensitivity data on a routine basis from the patient with
adult periodontitis. Patients diagnosed with chronic
adult periodontitis, rapidly progressive
periodontitis, or refractory
periodontitis were followed for up to 6 years. More than 95% of patients with chronic
adult periodontitis were successfully treated with mechanical
therapy alone. Approximately one half of the patients with rapidly progressive
periodontitis were treated successfully without
antibiotics. All of the patients with refractory
periodontitis required systemic
antibiotics as part of treatment. Most patients with chronic
adult periodontitis exhibited one or two species of organisms at baseline, and these organisms were eliminated or reduced to low levels by mechanical
therapy. In contrast, patients with rapidly progressive or refractory
periodontitis consistently demonstrated multiple species and required systemic
antibiotics in conjunction with mechanical
therapy to alter the subgingival microbial milieu. Routine culturing and
antibiotic therapy is contraindicated in patients with chronic
adult periodontitis, but may be beneficial for successful treatment of patients with rapidly progressive or refractory
periodontitis.