{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:14:08Z","timestamp":1793146448640,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with periodontitis can exhibit persistent periodontal pockets with bleeding representative of inflammation. This clinical study aimed to evaluate the effectiveness of a chitosan brush in improving residual periodontal pockets in patients who had already undergone causative therapy for periodontitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010six patients with stage III or IV periodontitis, showing residual pockets that bled on probing, were randomly assigned to 2 groups. The test group received debridement using both an ultrasonic scaler and a chitosan brush, while the control group received only ultrasonic scaling. Clinical parameters\u2014probing pocket depth (PPD), clinical attachment level (CAL), recession (REC), and bleeding on probing (BoP)\u2014were assessed at baseline, 6\u00a0weeks, 3 months, and 6 months posttreatment. Gingival crevicular fluid (GCF) was also collected to measure matrix metalloproteinase\u20108 (MMP\u20108) levels, a marker of inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Results showed significant improvements in clinical parameters over time in both groups. Probing depth and clinical attachment loss significantly improved from baseline to 3 months, with slight increases observed from 3 to 6 months. However, no significant differences between groups were found in these parameters. Gingival recession increased in both groups, with no group difference. BoP improved gradually in the test group, while in the control group, it initially decreased but increased again by 6 months, with a significant difference between groups at 6 months (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.007). MMP\u20108 levels decreased in both groups from baseline to 3 months but increased thereafter, with no significant difference between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, the chitosan brush, when added to mechanical debridement, led to better improvement in BoP compared to ultrasonic scaling alone, but did not show superior results for other clinical parameters or MMP\u20108 levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>The trial is registered at the US National Library of Medicine ClinicalTrials.gov (NCT06127069).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>After periodontal therapy, patients with periodontitis may still have persistent periodontal pockets with bleeding on probing, indicating ongoing inflammation. However, retreating these pockets can be unpredictable. This study investigated the effectiveness of a new chitosan brush for treating these pockets. Results showed that its use did not improve all clinical parameters, but significantly reduced bleeding\u2014indicating less inflammation\u2014at the treated sites 6 months after therapy. The absence of bleeding is crucial in preventing disease progression. Maintaining clinically healthy sites during the maintenance phase is essential for long\u2010term positive outcomes and helps reduce the risk of further gum disease progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70010","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T17:09:41Z","timestamp":1762535381000},"page":"685-696","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Management of residual periodontal pockets using an oscillating chitosan device: A randomized clinical trial"],"prefix":"10.1002","volume":"97","author":[{"given":"Georgia","family":"Tseleki","sequence":"first","affiliation":[{"name":"Department of Preventive Dentistry Periodontology and Implant Biology School of Dentistry Aristotle University of Thessaloniki  Thessaloniki 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