What is the recommended treatment for aggressive periodontitis?

Aggressive periodontitis (now reclassified within the 2017 AAP/EFP classification as Stage III-IV, Grade C periodontitis) is characterized by rapid attachment loss and association with specific periodontal pathogens such as Aggregatibacter actinomycetemcomitans. Treatment requires mechanical debridement (SRP) combined with systemic antibiotics, because A. actinomycetemcomitans can invade soft tissue and is not eliminated by SRP alone. Common antibiotic regimens include amoxicillin + metronidazole or azithromycin. Antibiotics should never be used as a substitute for SRP — they are always adjunctive to mechanical therapy.