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Periodontics · single question

Same case (localized aggressive periodontitis). Which of the following should be a treatment recommendation?

  1. Vitamin C tablets
  2. Local antibiotics
  3. Peridex rinse
  4. Systemic antibiotics
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Correct answer: D. Systemic antibiotics

Localized aggressive periodontitis (associated with Aa) requires SYSTEMIC antibiotics in addition to mechanical debridement, because Aa invades the gingival tissue and cannot be eliminated by scaling alone. The standard protocol is systemic amoxicillin 500mg + metronidazole 250-500mg for 7-8 days combined with SRP. Local antibiotics (Arestin) alone are insufficient as they cannot penetrate tissue. Chlorhexidine (Peridex) is adjunctive. Vitamin C has no specific evidence-based role.
  • A. INCORRECT. Vitamin C supplementation has no specific role in the treatment of localized aggressive periodontitis.
  • B. INCORRECT. Local antibiotics (e.g., minocycline microspheres/Arestin) are used as adjuncts in CHRONIC periodontitis — they cannot reach the tissue-invasive Aa bacteria responsible for aggressive periodontitis.
  • C. INCORRECT. Chlorhexidine (Peridex) rinse is a useful antimicrobial adjunct but cannot penetrate gingival tissue to eliminate tissue-invasive Aa. It is not the primary treatment recommendation.
  • D. CORRECT. SYSTEMIC antibiotics (amoxicillin + metronidazole) combined with SRP are the established treatment for localized aggressive periodontitis. Aa invades tissues and cannot be eliminated by scaling alone — systemic antibiotics are essential.

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