{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:21:11Z","timestamp":1787664071928,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n Periodontitis among nursing home residents is increasing as more older adults retain their dentition. Evidence on the impact of periodontal therapy on their oral microbiota is limited. We aimed to assess the effect of outreach\u2010based supra\u2010 and sub\u2010gingival instrumentation on the periodontal microbiome.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n In this secondary analysis of an RCT, 36 residents (mean age 85\u2009\u00b1\u20096\u2009years) with periodontitis had been randomised to supra\u2010 and sub\u2010gingival instrumentation (mean duration 14.3\u2009\u00b1\u20095.2\u2009min) or a 3\u2010month control. Supragingival and subgingival plaque samples were collected at baseline and 3\u2009months. Bacterial 16S rRNA sequencing and mixed\u2010effects modelling were used to assess alpha\/beta diversity, dysbiosis index and differential abundance between groups over time.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The intervention group showed clinical improvements, with bleeding on probing decreasing from 45%\u2009\u00b1\u200920% to 35%\u2009\u00b1\u200916% and probing pocket depth decreasing from 4.5\u2009\u00b1\u20090.5 to 4.0\u2009\u00b1\u20090.5\u2009mm. Dysbiosis was reduced compared with controls (\n \u03b2<\/jats:italic>\n \u2009=\u2009\u22121.97,\n p<\/jats:italic>\n \u2009=\u20090.0008). Beta\u2010diversity confirmed microbial shifts (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090.0075,\n p<\/jats:italic>\n \u2009=\u20090.025), characterised by decreases in differential abundance of\n Treponema<\/jats:italic>\n and\n Fretibacterium<\/jats:italic>\n and increases in\n Lactobacillus<\/jats:italic>\n and\n Actinomyces<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A pragmatic outreach\u2010based supra\u2010 and sub\u2010gingival instrumentation reduced microbial dysbiosis and improved periodontal parameters in institutionalised older adults, supporting its effectiveness in nursing home care.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n German Clinical Trials Register (DRKS) registration number: DRKS00029392<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jcpe.70193","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T13:15:53Z","timestamp":1787145353000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Causal Effect of Supra\u2010 and Sub\u2010Gingival Instrumentation on the Oral Microbiome of Elderly Periodontitis Patients Treated in Nursing Homes: Secondary Analysis of a Randomised Controlled Trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0169-2582","authenticated-orcid":false,"given":"Anna Greta","family":"Barbe","sequence":"first","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1072-4865","authenticated-orcid":false,"given":"Daniel","family":"Hagenfeld","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Operative Dentistry M\u00fcnster University Hospital M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1307-5672","authenticated-orcid":false,"given":"Carolin","family":"Walther","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia","family":"Beck","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6730-0038","authenticated-orcid":false,"given":"Fedja","family":"Farowski","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine University Hospital Cologne Cologne Germany"},{"name":"Department II of Internal Medicine, Infectious Diseases Goethe University Frankfurt, University Hospital Frankfurt Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J. G. T.","family":"Vehreschild","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine University Hospital Cologne Cologne Germany"},{"name":"Department II of Internal Medicine, Infectious Diseases Goethe University Frankfurt, University Hospital Frankfurt Frankfurt am Main Germany"},{"name":"German Centre for Infection Research, Partner Site Bonn\u2010Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2239-6010","authenticated-orcid":false,"given":"Sonja H. M.","family":"Derman","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7661-6931","authenticated-orcid":false,"given":"Sven Kleine","family":"Bardenhorst","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology University of Cologne Cologne Germany"},{"name":"Department of Clinical Epidemiology, Institute of Epidemiology and Social Medicine University of M\u00fcnster M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5294-8853","authenticated-orcid":false,"given":"Dirk","family":"Bleiel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Polyclinic for Operative Dentistry and Periodontology University of Cologne Cologne Germany"},{"name":"Joint Dental Practice, Dres. Pia und Dirk Bleiel Rheinbreitbach Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/hygiene5040050"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345231222800"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jper.70041"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345211035775"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010025\u201006943\u2010x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12383"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2025.107717"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520\u2010025\u201003110\u20108"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jre.13409"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jper.20\u20100764"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2023.11.001"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/idj.12329"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jper.23\u20100195"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aggp.2024.100061"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u20100757.2002.280102.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13264"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2020.07.009"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2307\/1218190"}],"container-title":["Journal of Clinical Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpe.70193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jcpe.70193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpe.70193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T12:43:43Z","timestamp":1787661823000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jcpe.70193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":18,"alternative-id":["10.1111\/jcpe.70193"],"URL":"https:\/\/doi.org\/10.1111\/jcpe.70193","archive":["Portico"],"relation":{},"ISSN":["0303-6979","1600-051X"],"issn-type":[{"value":"0303-6979","type":"print"},{"value":"1600-051X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]},"assertion":[{"value":"2026-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jcpe.70193"}}