What is the recommended treatment for a patient diagnosed with aggressive periodontitis?

Aggressive periodontitis (now classified as Stage III-IV, Grade C periodontitis per the 2017 AAP/EFP classification) is characterized by rapid bone loss, often in younger patients, with Aggregatibacter actinomycetemcomitans (Aa) playing a key pathogenic role. This organism is intracellular and tissue-invasive, making mechanical debridement alone insufficient. Meta-analyses confirm that SRP combined with systemic antibiotics (preferably metronidazole + amoxicillin or metronidazole alone) produces significantly greater clinical attachment gain and pocket depth reduction compared to SRP alone. Prophylaxis alone is completely inadequate for this aggressive form.