Periodontal disease as a biofilm infectious disease is considered. Periodontal disease-associated bacteria formed biofilm in periodontal pockets or on the surface of cementum. Planktonic bacteria from biofilm invade into periodontal tissues and lead to inflammation and destruction of tissues directly and indirectly by eliciting the host defense mechanism. Supragingival dental plaques (biofilm) are easily removed by professional mechanical tooth cleaning, while subgingival dental plaques and bacteria invading into periodontal tissues are difficult to remove. Therefore, the development of a method for periodontal disease based on the concept that regards periodontal disease as a biofilm infectious disease is needed. Hereby, I report the effect of antibiotics on an in vitro biofilm model of periodontal disease and the systemic administration of azithromycin for early-onset (aggressive) periodontitis like a treatment resistant periodontitis.