Further periodontal healing after azithromycin

Further improvement in periodontal health after a single course of azithromycin has occurred since the first posting about this patient (A case of rapid improvement in gingival health).  The patient had been prescribed azithromycin at the initial consultation, given the severity of his periodontal condition and its inflammatory nature. 

Initial presentation

At his second visit a week later, significant improvement in gingival health was reported by the patient and obvious clinically.  At this time the lower anterior teeth were cleaned.

The patient returned 5 weeks later at which time the images below were taken.  Although no periodontal treatment had been given for the upper teeth, there has been further resolution of inflammation and pocketing.  Plaque and calculus has reformed around the lower anterior teeth.  There seems to be better gingival resolution around the upper teeth than the lowers.

It seems that the azithromycin is toning down the responses of the tissues to dental biofilm, resulting in resolution of gingival inflammation, gingival recession and pocket depth reduction.  The patient also reported that previously loose teeth were no longer mobile.

6 weeks after azithromycin

6 weeks after azithromycin showing periodontal healing on the
buccal and palatal aspects of the upper right anterior teeth;
no periodontal treatment had been given to these teeth.