{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:37:53Z","timestamp":1792787873226,"version":"4.5.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Schleswig-Holstein - Campus Kiel","id":[{"id":"https:\/\/ror.org\/01tvm6f46","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adequate plaque control is essential for successful non-surgical periodontal therapy (NSPT). App-supported powered toothbrushes (PT) may improve oral hygiene behaviour, but evidence of additional clinical benefit during NSPT in advanced periodontitis is limited. This secondary analysis of a prospectively registered four-arm randomized controlled trial compared an app-supported PT with an identical PT without app support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty-four patients with generalized stage III\u2013IV periodontitis were randomly assigned within the powered-toothbrush stratum to an app-supported PT (TPB,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923) or an identical PT without app support (CPB,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921) and analysed by intention-to-treat; missing data due to dropout (TPB\/CPB:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094\/\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093) were handled using last observation carried forward. All patients received standardized NSPT. Clinical parameters were assessed at baseline (T1) and after 5\u20136 months (T6). \u0394GBI was the registered primary outcome of the four-arm trial; \u0394PPD (T6\u2013T1), a prespecified secondary clinical outcome, was the principal outcome of this two-arm analysis. Questionnaire-based oral hygiene motivation was assessed at T1 and T6.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For the registered primary outcome, \u0394GBI did not differ significantly between groups (CPB: \u22127.12\u2009\u00b1\u200918.73%; TPB: \u22129.28\u2009\u00b1\u200916.91%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.573). Both groups showed significant reductions in mean PPD (CPB: \u22120.59\u2009\u00b1\u20090.57\u00a0mm; TPB: \u22120.67\u2009\u00b1\u20090.66\u00a0mm; both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with no significant between-group difference in \u0394PPD (mean difference: \u22120.08\u00a0mm, 95% CI\u2009\u2212\u20090.45 to 0.29;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.832). CAL improved significantly in CPB only, whereas GR increased more in TPB (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). No significant between-group differences were observed for CAL, PCR, GBI, or PPD distribution. During the post-treatment phase, both groups showed further improvements without intergroup differences. Questionnaire outcomes revealed no significant between-group differences after correction for multiple testing, although motivation for interdental cleaning improved significantly within TPB (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>App support did not provide additional clinical benefit over powered toothbrushing without app support during NSPT. Descriptive, non-significant trends toward more favourable post-treatment changes suggest a potential role in behavioural support and maintenance, potentially requiring integration of professional guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The fourarm randomized controlled trial was prospectively registered in the German Clinical Trials Register (DRKS00031539) on May 4, 2023. The present study reports a secondary analysis of its two poweredtoothbrush arms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-10002-4","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:13:56Z","timestamp":1790594036000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["App-supported powered toothbrushing during non-surgical periodontal therapy in stage III\u2013IV periodontitis: a secondary analysis of a randomized controlled trial"],"prefix":"10.1186","volume":"26","author":[{"given":"Ann-Christin","family":"Feige","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Cyris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Sutor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliane Amelie","family":"Schlenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof E.","family":"D\u00f6rfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"S\u00e4lzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8316-0565","authenticated-orcid":false,"given":"Christian","family":"Graetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"Suppl 22","key":"10002_CR1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/jcpe.13290","volume":"47","author":"M Sanz","year":"2020","unstructured":"Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, Sculean A, Tonetti MS, Participants EFPW, Methodological C. 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This study was prospectively registered in the German Clinical Trials Register (DRKS00031539) on 04th May 2023.Informed consent was obtained from all individual participants included in the study.","order":1,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. All participants were informed about the study and gave written informed consent before the start of the investigation.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1860"}}