{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:02:19Z","timestamp":1790744539948,"version":"4.1.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"\n Background<\/jats:title>\n \n This single-center pilot randomized clinical study compared the efficacy of biweekly and triweekly 1.41% hydrogen peroxide (H\n 2<\/jats:sub>\n O\n 2<\/jats:sub>\n ) shock treatments, combined with continuous 0.0141% H\n 2<\/jats:sub>\n O\n 2<\/jats:sub>\n disinfection, for controlling microbial contamination and biofilm formation in dental unit waterlines (DUWLs).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Eight dental chair units (DCUs) were randomized to Group A (triweekly shock treatment,\n n<\/jats:italic>\n \u2009=\u20094) or Group B (biweekly shock treatment,\n n<\/jats:italic>\n \u2009=\u20094). After standardized baseline biofilm removal using BRS\u00ae, total viable counts (TVCs) and biofilm architecture assessed qualitatively by scanning electron microscopy (SEM), were monitored for 6 weeks. One randomly selected DCU (group A1 and B1) from each group underwent an exploratory additional 6-week observation, with the resulting data analyzed descriptively.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Group B maintained a 100% compliance rate (\u2264 100 CFU\/mL) throughout the 6-week period, whereas Group A showed a significantly lower compliance rate of 78.47%, with recurrent microbial rebound during the third week of each cycle. Biweekly shock treatment increased the probability of compliance by 21.53 percentage points compared with triweekly treatment (95% CI: 13.74\u201329.32, Wald\n \n \u03c7\n 2<\/jats:sup>\n <\/jats:italic>\n \u2009=\u200929.34,\n P<\/jats:italic>\n \u2009&lt;\u20090.001). Significant between-group differences in TVCs emerged by day 17 (\n P<\/jats:italic>\n \u2009&lt;\u20090.05). During the 12-week observation, Group B1 remained compliant, whereas Group A1 showed recurrent non-compliant TVCs during the third week of several cycles. SEM observations showed biofilm-like structures in the sampled tubing segment from Group A after 6 weeks, whereas no obvious mature biofilm-like structure was observed in the sampled segment from Group B.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Within the limitations of this single-center pilot study, continuous disinfection with 0.0141% H\n 2<\/jats:sub>\n O\n 2<\/jats:sub>\n combined with biweekly 1.41% H\n 2<\/jats:sub>\n O\n 2<\/jats:sub>\n shock treatment was associated with more consistent water-quality compliance than triweekly shock treatment after initial BRS\u00ae biofilm removal. These preliminary findings require confirmation in larger multicenter, year-round studies incorporating longer follow-up and microbial identification before any change to routine clinical protocols can be considered.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/froh.2026.1842649","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:51:17Z","timestamp":1790743877000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biweekly versus triweekly hydrogen peroxide shock treatment for controlling dental unit waterline contamination: a single-center pilot randomized clinical study"],"prefix":"10.3389","volume":"7","author":[{"given":"Jingcheng","family":"Wen","sequence":"first","affiliation":[{"name":"Dental Clinic office, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering 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Medical Devices","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chang","sequence":"additional","affiliation":[{"name":"Fifth Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanying","family":"Li","sequence":"additional","affiliation":[{"name":"Third Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Shuai","sequence":"additional","affiliation":[{"name":"Second Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiue","family":"Li","sequence":"additional","affiliation":[{"name":"Dental Clinic office, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices","place":["Beijing, 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