{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:19:22Z","timestamp":1787635162536,"version":"build-2736575974"},"reference-count":56,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003970","name":"Isfahan University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dental Hygiene"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The major role of chronic periodontal diseases in impairing human oral health shows the importance of seeking the most efficient implement to address this prevalent issue. The objective of this study is to compare nonsurgical treatment tools, including Gracey's curette, sonic\/ultrasonic, and laser instruments, considering their effect on subgingival microbial flora and clinical indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following a search in six databases, clinical studies using Gracey's curette, sonic\/ultrasonic, or laser monotherapy were included. The data extraction table was designed based on specified parameters and network meta\u2010analysis was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen articles were included in the review, from which 14 studies were eligible for network meta\u2010analysis. The results indicate that changes in bleeding on probing and gingival index are not significantly affected by therapeutic technique. However, clinical attachment level changes are more satisfactory in ultrasonic\u2010 and laser\u2010treated groups 1\u2009month postoperatively (MD\u2009=\u2009\u22120.3875, \u22120.2700 respectively). The difference from baseline is significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0001). After 3\u2009months, the impact of Gracey's curette on plaque index changes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.0000), as well as the effect of Erbium laser on pocket probing depth (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0069), is significantly greater than that of other instruments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The selected nonsurgical method can affect the ultimate result of periodontal therapy. For instance, clinical attachment level shows greater susceptibility to ultrasonic devices in a short\u2010term period. Despite that, changes in bleeding on probing, gingival index, and microbiological parameters do not show significant diversity subsequent to different treatments. Taken together, clinicians can adopt a suitable method depending on their purpose, equipment, and skill.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The International Prospective Register of Systematic Reviews (PROSPERO): CRD42024544540<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/idh.70155","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:39:02Z","timestamp":1787632742000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Laser Therapy, Mechanical Scaling, and Scaling With Hand Instruments in Microbiological and Clinical Indices Alteration After Nonsurgical Periodontal Treatment: A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5678-8365","authenticated-orcid":false,"given":"Zohreh","family":"Afshari","sequence":"first","affiliation":[{"name":"Department of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9114-7175","authenticated-orcid":false,"given":"Javad","family":"Abbasi","sequence":"additional","affiliation":[{"name":"School of Dentistry Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4395-0948","authenticated-orcid":false,"given":"Arefeh","family":"Esfandpour","sequence":"additional","affiliation":[{"name":"Research Committee Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2035-5290","authenticated-orcid":false,"given":"Sima","family":"Kiani","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry Isfahan University of Medical Sciences  Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"issue":"7","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1111\/j.1600-051X.1984.tb01344.x","article-title":"Long\u2010Term Effect of Surgical\/Non\u2010Surgical Treatment of Periodontal Disease","volume":"11","author":"Lindhe J.","year":"1984","journal-title":"Journal of Clinical Periodontology"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1601-5037.2007.00217.x","article-title":"Sonic and 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