Treatment of juvenile periodontitis without antibiotics

20 patients with juvenile periodontitis (JP) were treated with oral hygiene instruction, scaling and root planing, possibly with flap surgery but with no antibiotics. The patients were monitored after 6 to 12 years. Re-examination revealed that no probing depth of 7 mm or more existed any longer, and that sites with probing depth of 4 to 6 mm had decreased from 237 to 46. The bone loss scores had changed from 18% (range 2.0 to 48.1) to 14% (range 0 to 44.4) and the bleeding on probing scores from 39% (range 0 to 100) to 10% (range 0 to 40). Actinobacillus actinomycetemcomitans (A.a.) had neither been cultivated nor serologically tested at the initial examination. At the re-examination, it was found in 2 patients out of 20 at 5 sites. 7 patients, the 2 with positive cultures included, had elevated titers to A.a. strain Y4 in whole or parotid saliva or both. It is concluded that there is a marked improvement in the periodontal condition of these patients, and that good periodontal health in patients with JP can be reached without antibiotics.