One-Stage Full-Mouth Disinfection as a Therapeutic Approach for Generalized Aggressive Periodontitis Mario Aimetti,* Federica Romano,* Nicoletta Guzzi,* and Gianfranco Carnevale* Background: Data concerning treatment outcomes in pa- tients with generalized aggressive periodontitis (GAgP) are lim- ited. The aim of this study is to investigate 6-month clinical and microbiologic outcomes of the one-stage full-mouth disin- fection (OSFMD) in the management of patients with GAgP. Methods: Twenty-seven patients with advanced GAgP were included in this prospective follow-up intervention study. Clin- ical and microbiologic parameters were collected at baseline and 3 and 6 months after the OSFMD. Patient-, tooth-, and site-level analyses were carried out. Subgingival samples from moderate (4 to 5 mm) and deep (‡6 mm) pocket sites were analyzed using a polymerase chain reaction for Aggrega- tibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Prevotella intermedia, Porphyro- monas gingivalis, Tannerella forsythia (previously T. forsy- thensis), and Treponema denticola. Results: The OSFMD resulted in significant improvements in all parameters. After 6 months, the whole-mouth probing depth (PD) decreased from 4.2 – 1.1 mm to 2.8 – 0.6 mm, and the clinical attachment level was reduced from 4.5 – 1.2 mm to 3.4 – 1.1 mm (P <0.001). When data were analyzed based on the frequency distribution of PD, the number of sites with PD ‡5 mm decreased by 61% from baseline values, and mean PD reductions of 1.5 and 2.5 mm were noted in moder- ate and deep pockets, respectively. At 6 months, percentages of moderate and deep sites free of pathogens were 40% and 27%, respectively. Conclusion: The OSFMD may be a viable approach to deal with severe GAgP. J Periodontol 2011;82:845-853. KEY WORDS Dental plaque/prevention and control; disinfection/methods; periodontitis/microbiology; periodontitis/therapy; therapeutic use. G eneralized aggressive periodontitis (GAgP) is a rapidly progressive dis- ease that affects otherwise healthy individuals 1 and is characterized by a pro- nounced episodic and rapid destruction of periodontal tissues, which may lead to edentulism early in life. 2,3 Patients with GAgP display an inadequate host response to periodontopathogenic bacteria that is due to the increased expression of a wide variety of immunologic and genetic risk factors. 4,5 The complex interplay between host risk factors and periodontal microbiota induces a high susceptibility to periodontal disease. 6 The treatment of this condition, as with chronic periodontitis, has centered on two fundamental approaches, namely oral hygiene instructions for supragingi- val plaque control and subgingival in- strumentation for the reduction and/or elimination of the pathogenic microbiota. 7 Over the last 10 years, many clinical trials have been carried out in an effort to assess, among other variables, whether it would be advantageous to change the standard 4- to 6-week period of non-surgical peri- odontal treatment to a full-mouth 24- hour approach. 8-10 The rationale for the latter non-surgical strategy was to pre- vent reinfection by periodontopathogens of the already treated periodontal sites from the remaining untreated pockets and intraoral bacterial reservoirs, such as the tongue, tonsils, and other mu- cous membranes, that could lead to a disease recurrence. 11-13 Based on these * Department of Periodontology, Dental School, University of Turin, Turin, Italy. doi: 10.1902/jop.2010.100468 J Periodontol • June 2011 845