Mechanical periodontal therapy is usually sufficient to treat the majority of periodontal diseases. But, in the case of certain aggressive periodontitis, antimicrobial medication must be combined with conventional non-surgical therapy.
-Certain microorganisms attach to periodontal tissues and invade them.
-Certain microbes are hard to eliminate because of their location (hard-to-reach areas).
-Certain pathogens are resistant to mechanical periodontal therapy.
Choice of antibiotic:
It depends on the bacteria responsible and the extent of the infection. After determining the nature of the microorganism in question with a bacterial culture, an effective antibiotic is selected.
Methods of administration:
- Systemic administration
For some patients, systemic antibiotics may be prescribed to be taken orally, to help treat their periodontal disease.
- Aggressive periodontitis.
- Nonresponse to the mechanical treatment.
- Patients with a history of endocarditis or prosthetic valve (prophylactic antibiotherapy is necessary).
- In case of suppuration, during the initial treatment.
2. Local administration
It consists in the insertion of the syringe or water jet to disinfect the pockets using an antibiotic or nonsteroidal anti-inflammatory drug.
- Perturbation of the subgingival flora.
- Sanitization and oxygenation the pocket.
- Stabilization of the bone lysis.
- Prevention of reinfection.
- As a complement to the mechanical treatment for pockets < 5mm.
- After drainage of a periodontal abscess.
- Disinfection of pocket before surgery.
- Interradicular lesion.