Classic Periodontal Disease Reaches Remission

The Challenge:

Several years of periodontal neglect revealed significant disease.

The Background:

• Age: 48
• Sex: Female
• Medical History: Autoimmune arthritis, chronic sinusitis
• Last Dental Exam: 10/04/2018
• Chief Complaint: Broken lower left molar with swelling. However, a recent course of antibiotics for the sinus infection reduced the swelling temporarily.
• Clinical Assessment: Per the cone-beam computed tomography (CBCT) systems scan, several teeth have periapical abscesses on #2 and 14 and furcation involvement on #18 and #19.
• Periodontal Assessment: Generalized moderate to heavy radiographic subgingival calculus with generalized horizontal bone loss with localized vertical bone loss.

The Solution:

• Date of MyPerioPath^® (Pre-Therapy) Test: 10/04/2018
• Periodontal Therapy: Scaling and root planing (SRP) was performed 1/2 mouth each time with 1 week in between. SRP consisted of ultrasonic and iodine flush.
• Systemic Antibiotic Used: The patient started Amoxicillin and Metronidazole per MyPerioPath results after the first 1/2 SRP was completed. Instructed the patient to take a probiotic 2 hours after and 2 hours before the systemic antibiotic dose.
• Home Care: Antiseptic mouth rinse 2x/daily swishing for 30 seconds and not rinsing for 30 minutes after. Use proxybrush daily and electric toothbrush 2x/day.
• Date of MyPerioProgress^® (Post-Therapy) Test: 1/15/2019

Additional Comments: Several extractions were completed following the periodontal therapy.

The Result:

At the post-therapy appointment, the tissue appeared pale pink and firm. There was no soft plaque present, the patient was compliant with the home care instructions. The success of this case is directly related to the patient's compliance of completing all proposed treatment in a timely manner. She had failing teeth due to localized severe periodontal disease; by removing the teeth and starting the systemic antibiotics in conjunction with SRP, we were able to stabilize her periodontal health. With comprehensive treatment completed in a chronological order, there was not any time for cross contamination or re-growth of bacteria, therefore eradicating the periodontal infectious bacteria.

About the Author:

Kristi Williamson, graduated from OIT in 2007 and has obtained an expanded functions and laser certification as a Registered Dental Hygienist. She has worked for Dr Mayes since 2013. Kristi is happily married with two kids and was born and raised in the Grande Ronde Valley.