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Each subject underwent professional flossing and subsequently used\n                    <jats:italic>LS<\/jats:italic>\n                    -nanofloss\/probiotic-free (control) nanofloss at two separate 14-day periods, always followed by a 14-day wash-out. Clinical assessments (subgingival plaque accumulation and gingival bleeding) were performed at five time points; subgingival plaque samples were collected at seven time points for quantitative analysis of total bacterial DNA,\n                    <jats:italic>L. salivarius<\/jats:italic>\n                    , a cariogenic bacterium\n                    <jats:italic>Streptococcus mutans<\/jats:italic>\n                    , and red complex periopathogens. Both nanofloss types significantly reduced plaque accumulation and gingival bleeding after 14 days (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), especially in the anterior regions; these improvements, however, regressed after the wash-out period.\n                    <jats:italic>L. salivarius<\/jats:italic>\n                    DNA was detected in 93.3% of samples after professional flossing, 36.7% after self-flossing, and 13.3% even after the wash-out period. The use of\n                    <jats:italic>LS<\/jats:italic>\n                    -nanofloss was associated with a significant reduction in red complex periopathogens (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The investigated\n                    <jats:italic>L. salivarius<\/jats:italic>\n                    -containing nanofloss proved to be an effective oral hygiene device for subgingival introduction of this probiotic strain. Its application reduced the relative quantity of red complex periopathogens in the subgingival environment, showing potential to prevent the development of periodontitis. The trial was registered retrospectively on 2\/9\/2025 as NCT07149493.\n                  <\/jats:p>","DOI":"10.1007\/s12602-025-10898-4","type":"journal-article","created":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T03:17:01Z","timestamp":1767496621000},"page":"6662-6675","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Probiotic-Containing Nanofiber-Based Dental Floss Suppresses Subgingival Red Complex Periopathogens: A Randomized Double-Blind Crossover Trial"],"prefix":"10.1007","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9859-3198","authenticated-orcid":false,"given":"Filip","family":"Hromcik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1122-4125","authenticated-orcid":false,"given":"Pavla","family":"Holochova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9723-9493","authenticated-orcid":false,"given":"Jan","family":"Bohm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5758-3206","authenticated-orcid":false,"given":"Eva","family":"Kuzelova Kostakova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7098-3693","authenticated-orcid":false,"given":"Zdenek","family":"Pokorny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5679-0513","authenticated-orcid":false,"given":"Filip","family":"Ruzicka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0953-3615","authenticated-orcid":false,"given":"Petra","family":"Borilova Linhartova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,4]]},"reference":[{"key":"10898_CR1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1111\/prd.12388","volume":"87","author":"A Radaic","year":"2021","unstructured":"Radaic A, Ganther S, Kamarajan P, Grandis J, Yom SS, Kapila YL (2021) Paradigm shift in the pathogenesis and treatment of oral cancer and other cancers focused on the oralome and antimicrobial-based therapeutics. 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At the time of ethics approval and initiation (February 2022), the study was not classified as a clinical trial. However, subsequent interpretation of NIH guidelines suggests that the randomized, blinded, crossover design involving a health-related intervention meets the criteria for interventional clinical research. Accordingly, the investigators now recognize that the study should be registered as a clinical trial. The research team is submitting this retrospective registration to ensure transparency and support future publication. No participant-level outcomes have been modified post hoc, and all data were collected prospectively under full ethical oversight.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Retrospective Registration Note"}}]}}