{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:32:44Z","timestamp":1792085564103,"version":"4.4.0"},"reference-count":76,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>In severe stages of periodontitis, conventional periodontal therapy and maintenance care are usually insufficient due to the viral and bacterial etiology; thus, a mechanical approach alone may not be sufficient to eliminate a substantial portion of subgingival pathogens, especially in deep periodontal sites. Background and Objectives: This single-blind, randomized clinical trial aimed to compare the clinical and microbiological efficacy of a low-cost protocol using povidone\u2013iodine and sodium hypochlorite formulations as adjuncts to non-surgical therapy for patients with stage IV periodontitis when compared with chlorhexidine, the most commonly employed substance to date for antimicrobial regimens in periodontal therapy. Materials and Methods: Forty-five patients were randomly divided into two groups: control (subgingival instrumentation, chlorhexidine-assisted) and test (antiviral medication, subgingival instrumentation with povidone\u2013iodine, sodium hypochlorite rinsing solution, and antibiotics). Clinical measurements and microbiological analyses were performed at baseline and after three months. Results: After three months, notable differences were found in the bacterial detection scores for Porphyromonas gingivalis (a significant reduction in detection frequency was observed in the test compared to the control (p = 0.021)), and there were significant reductions in detection in the test group for Tannerella forsythia and Treponema denticola, showing undetectable levels (p &lt; 0.0001 for both). In the test group, the pocket probing depth median value was reduced significantly (p = 0.0005); similarly, bleeding on probing showed a marked decrease (p &lt; 0.0001). However, changes in clinical attachment loss and full-mouth plaque score were not statistically significant. Conclusions: Using the proposed protocol, substantial improvements in clinical and microbiological parameters were obtained when compared with the current antimicrobial recommendations.<\/jats:p>","DOI":"10.3390\/dj12050144","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T11:31:52Z","timestamp":1715772712000},"page":"144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Low-Cost Protocol Using the Adjunctive Action of Povidone\u2013Iodine Irrigations and Sodium Hypochlorite Rinsing Solution in Step 2 of Periodontal Therapy for Patients with Stage III\u2013IV Periodontitis: A Single-Blind, Randomized Controlled Trial"],"prefix":"10.3390","volume":"12","author":[{"given":"Georgios","family":"Kardaras","sequence":"first","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8267-5404","authenticated-orcid":false,"given":"Ruxandra","family":"Christodorescu","sequence":"additional","affiliation":[{"name":"Department V Internal Medicine, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6184-3704","authenticated-orcid":false,"given":"Marius","family":"Boariu","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dental Medicine, TADERP Research Center, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darian","family":"Rusu","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alla","family":"Belova","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Chinnici","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8540-8149","authenticated-orcid":false,"given":"Octavia","family":"Vela","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viorelia","family":"Radulescu","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7458-4212","authenticated-orcid":false,"given":"Simina","family":"Boia","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan-Ioan","family":"Stratul","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bianchi, S., Mancini, L., Torge, D., Cristiano, L., Mattei, A., Varvara, G., Macchiarelli, G., Marchetti, E., and Bernardi, S. (2021). Bio-Morphological Reaction of Human Periodontal Ligament Fibroblasts to Different Types of Dentinal Derivates: In Vitro Study. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22168681"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1600-0757.2009.00325.x","article-title":"Human viruses in periodontitis","volume":"53","author":"Slots","year":"2010","journal-title":"Periodontology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S159","DOI":"10.1002\/JPER.18-0006","article-title":"Staging and grading of periodontitis: Framework and proposal of a new classification and case definition","volume":"89","author":"Tonetti","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1097\/QCO.0b013e3280964da0","article-title":"Herpesviral-bacterial synergy in the pathogenesis of human periodontitis","volume":"20","author":"Slots","year":"2007","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.tripleo.2008.06.012","article-title":"Detection of human cytomegalovirus in dental plaque from individual periodontal sites by real-time polymerase chain reaction","volume":"106","author":"Combs","year":"2008","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/j.1600-051X.2008.01301.x","article-title":"Human herpesvirus 7, Epstein-Barr virus and human cytomegalovirus in periodontal tissues of periodontally diseased and healthy subjects","volume":"35","author":"Rotola","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1600-0765.2004.00728.x","article-title":"Herpesviral-bacterial interrelationships in aggressive periodontitis","volume":"39","author":"Saygun","year":"2004","journal-title":"J. Periodontal Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/j.1600-0765.2007.01043.x","article-title":"Quantitative analysis of association between herpesviruses and bacterial pathogens in periodontitis","volume":"43","author":"Saygun","year":"2008","journal-title":"J. Periodontal Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/j.1600-0765.2004.00707.x","article-title":"Real-time PCR quantification of cytomegalovirus in aggressive periodontitis lesions using TaqMan technology","volume":"39","author":"Kubar","year":"2004","journal-title":"J. Periodontal Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Boia, E.R., Hu\u021b, A.R., Roi, A., Luca, R.E., Munteanu, I.R., Roi, C.I., Rivi\u0219, M., Boia, S., Duse, A.O., and Vulc\u0103nescu, D.D. (2023). Associated Bacterial Coinfections in COVID-19-Positive Patients. Medicina, 59.","DOI":"10.3390\/medicina59101858"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Song, Y., Liu, N., Gao, L., Yang, D., Liu, J., Xie, L., Dan, H., and Chen, Q. (2023). Association between human herpes simplex virus and periodontitis: Results from the continuous National Health and Nutrition Examination Survey 2009\u20132014. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03416-x"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Banks, J.M., Capistrano, K.J., Brandini, D.A., Zaidi, F., Thakkar, P., Rahat, R., Schwartz, J., and Naqvi, A.R. (2024). Herpesviruses and SARS-CoV-2: Viral Association with Oral Inflammatory Diseases. Pathogens, 13.","DOI":"10.3390\/pathogens13010058"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1601-0825.2005.01123.x","article-title":"Viruses in periodontal disease\u2014A review","volume":"11","author":"Cappuyns","year":"2005","journal-title":"Oral Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1399-302X.2009.00504.x","article-title":"Human cytomegalovirus and Epstein-Barr virus inhibit oral bacteria-induced macrophage activation and phagocytosis","volume":"24","author":"Lin","year":"2009","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jcpe.13290","article-title":"Treatment of stage I\u2013III periodontitis-The EFP S3 level clinical practice guideline","volume":"47","author":"Sanz","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"435","DOI":"10.2174\/1874210601812010435","article-title":"Twenty Years of Full-Mouth Disinfection: The Past, the Present and the Future","volume":"12","author":"Pockpa","year":"2018","journal-title":"Open Dent. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/j.1600-0757.2011.00429.x","article-title":"Low-cost periodontal therapy","volume":"60","author":"Slots","year":"2012","journal-title":"Periodontology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1034\/j.1600-0757.2002.290109.x","article-title":"Global risk factors and risk indicators for periodontal diseases","volume":"29","author":"Albandar","year":"2002","journal-title":"Periodontology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1111\/jcpe.12984","article-title":"Long-term treatment costs of chronic periodontitis patients in Germany","volume":"45","author":"Schwendicke","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/j.1600-0757.2012.00452.x","article-title":"Periodontal health and global public health","volume":"60","author":"Petersen","year":"2000","journal-title":"Periodontology"},{"key":"ref_21","unstructured":"The Economist Intelligence Unit (2024, April 01). Time to Take Gum Disease Seriously: The Societal and Economic Impact of Periodontitis. Available online: https:\/\/impact.economist.com\/perspectives\/sites\/default\/files\/eiu-efp-oralb-gum-disease.pdf."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Harris, C., Allen, K., Ramsey, W., King, R., and Green, S. (2018). Sustainability in Health care by Allocating Resources Effectively (SHARE) 11: Reporting outcomes of an evidence-driven approach to disinvestment in a local healthcare setting. BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-3172-0"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1002\/cre2.60","article-title":"Lack of adjunctive effect of 0.1% sodium hypochlorite mouthwash combined to full-mouth ultrasonic debridement on supragingival plaque, gingival inflammation, and subgingival microbiota: A randomized placebo-controlled 6-month trial","volume":"3","author":"Colombo","year":"2017","journal-title":"Clin. Exp. Dent. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1111\/jre.12151","article-title":"Periodontal effects of 0.25% sodium hypochlorite twice-weekly oral rinse. A pilot study","volume":"49","author":"Gonzalez","year":"2014","journal-title":"J. Periodontal Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1111\/jre.12219","article-title":"Gingival bleeding on probing: Relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse","volume":"50","author":"Gonzalez","year":"2015","journal-title":"J. Periodontal Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/jcpe.12578","article-title":"Local disinfection with sodium hypochlorite as adjunct to basic periodontal therapy: A randomized controlled trial","volume":"43","author":"Bizzarro","year":"2016","journal-title":"J. Clin. Periodontol."},{"key":"ref_27","first-page":"28","article-title":"Subgingival irrigation combined with scaling and root planing. Results of a study with chlorhexidine and sodium hypochlorite","volume":"28","author":"Kamagate","year":"2005","journal-title":"Odontostomatol. Trop."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1902\/jop.1982.53.2.63","article-title":"Histologic evaluation of gingival curettage facilitated by sodium hypochlorite solution","volume":"53","author":"Kalkwarf","year":"1982","journal-title":"J. Periodontol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S64","DOI":"10.1016\/j.identj.2023.08.009","article-title":"Antimicrobial Mouthwashes: An Overview of Mechanisms-What Do We Still Need to Know?","volume":"73","author":"Brookes","year":"2023","journal-title":"Int. Dent. J."},{"key":"ref_30","first-page":"190","article-title":"Effect of sodium hypochlorite solution on the subgingival microflora of juvenile periodontitis lesions","volume":"5","author":"Adcock","year":"1983","journal-title":"Pediatr. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"5331","DOI":"10.1007\/s00784-021-03841-8","article-title":"Changes in clinical parameters following adjunctive local sodium hypochlorite gel in minimally invasive nonsurgical therapy (MINST) of periodontal pockets: A 6-month randomized controlled clinical trial","volume":"25","author":"Ramaglia","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s00784-019-02949-2","article-title":"Short ultrasonic debridement with adjunctive low-concentrated hypochlorite\/amino acid gel during periodontal maintenance: Randomized clinical trial of 12 months","volume":"24","author":"Megally","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1007\/s00784-019-03060-2","article-title":"Anti-infective therapy of peri-implant mucositis with adjunctive delivery of a sodium hypochlorite gel: A 6-month randomized triple-blind controlled clinical trial","volume":"24","author":"Blasi","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"6639","DOI":"10.1007\/s00784-022-04618-3","article-title":"Clinical and microbiological effects of a single application of sodium hypochlorite gel during subgingival re-instrumentation: A triple-blind randomized placebo-controlled clinical trial","volume":"26","author":"Radulescu","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1034\/j.1600-0757.2002.2801123.x","article-title":"Effective, safe, practical and affordable periodontal antimicrobial therapy: Where are we going, and are we there yet?","volume":"28","author":"Slots","year":"2002","journal-title":"Periodontology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1034\/j.1600-0765.2000.035002108.x","article-title":"Primer for antimicrobial periodontal therapy","volume":"35","author":"Slots","year":"2000","journal-title":"J. Periodontal Res."},{"key":"ref_37","first-page":"297","article-title":"The ins and outs of periodontal antimicrobial therapy","volume":"30","author":"Jorgensen","year":"2002","journal-title":"J. Calif. Dent. Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1875-595X.2005.tb00025.x","article-title":"Periodontal antimicrobials--finding the right solutions","volume":"55","author":"Jorgensen","year":"2005","journal-title":"Int. Dent. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1111\/prd.12325","article-title":"Primer on etiology and treatment of progressive\/severe periodontitis: A systemic health perspective","volume":"83","author":"Slots","year":"2020","journal-title":"Periodontology"},{"key":"ref_40","first-page":"103","article-title":"In-Vitro Safety Evaluation of Sodium Hypochlorite (NaOCl) as Part of Step 2 and Maintenance Therapy Protocols in Patients with Periodontitis Stages III\u2013IV","volume":"21","author":"Kardaras","year":"2023","journal-title":"Oral Health Prev. Dent."},{"key":"ref_41","first-page":"8","article-title":"A classification of marginal tissue recession","volume":"5","author":"Miller","year":"1985","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1111\/j.1875-595X.2011.00111.x","article-title":"Effects of 0.05% sodium hypochlorite oral rinse on supragingival biofilm and gingival inflammation","volume":"62","author":"Chiappe","year":"2012","journal-title":"Int. Dent. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1111\/jcpe.12935","article-title":"A new classification scheme for periodontal and peri-implant diseases and conditions\u2014Introduction and key changes from the 1999 classification","volume":"45","author":"Caton","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1902\/jop.1972.43.1.38","article-title":"The plaque control record","volume":"43","author":"Drake","year":"1972","journal-title":"J. Periodontol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1007\/s00784-016-1711-9","article-title":"In-vitro activity of sodium-hypochlorite gel on bacteria associated with periodontitis","volume":"20","author":"Jurczyk","year":"2016","journal-title":"Clin. Oral Investig."},{"key":"ref_46","first-page":"5001","article-title":"Clinical, microbiological and oxidative stress evaluation of periodontitis patients treated with two regimens of systemic antibiotics, adjunctive to non-surgical therapy: A placebo-controlled randomized clinical trial","volume":"18","author":"Boia","year":"2019","journal-title":"Exp. Ther. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"392","author":"Disease","year":"2018","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Emery, D.C., Cerajewska, T.L., Seong, J., Davies, M., Paterson, A., Allen-Birt, S.J., and West, N.X. (2020). Comparison of Blood Bacterial Communities in Periodontal Health and Periodontal Disease. Front. Cell Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.577485"},{"key":"ref_49","unstructured":"The Economist Intelligence Unit (2024, April 01). Time to Put Money Where Mouth Is: Addressing Inequalities in Oral Health. Available online: https:\/\/impact.economist.com\/perspectives\/health\/time-put-your-money-where-your-mouth-addressing-inequalities-oral-health."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/jcpe.12416","article-title":"Effect of application of a PVP-iodine solution before and during subgingival ultrasonic instrumentation on post-treatment bacteraemia: A randomized single-centre placebo-controlled clinical trial","volume":"42","author":"Sahrmann","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1159\/000057735","article-title":"Thyroid function in nurses: The influence of povidone-iodine hand washing and gargling","volume":"204","author":"Nobukuni","year":"2002","journal-title":"Dermatology"},{"key":"ref_52","first-page":"5528210","article-title":"Povidone Iodine Disinfection Associated with Hypothyroidism and Potentially Contributing to Prolonged Kidney Failure","volume":"2021","author":"Vercammen","year":"2021","journal-title":"Case Rep. Crit. Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1902\/jop.2003.74.11.1634","article-title":"Prevalence of human herpesviruses in patients with aggressive periodontitis","volume":"74","author":"Yapar","year":"2003","journal-title":"J. Periodontol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1034\/j.1600-051X.2003.20002.x","article-title":"Herpesviral-bacterial interactions in aggressive periodontitis","volume":"30","author":"Kamma","year":"2003","journal-title":"J. Clin. Periodontol."},{"key":"ref_55","unstructured":"Newman, M.G., Takei, H., Klokkevold, P.R., and Carranza, F.A. (2018). Newman and Carranza\u2019s Clinical Periodontology: Newman and Carranza\u2019s Clinical Periodontology, Elsevier Health Sciences. [3rd ed.]."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Kany, S., Vollrath, J.T., and Relja, B. (2019). Cytokines in Inflammatory Disease. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20236008"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/978-3-030-96881-6_15","article-title":"Update on the Role of Cytokines as Oral Biomarkers in the Diagnosis of Periodontitis","volume":"1373","year":"2022","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1111\/jcpe.12595","article-title":"Cost-effectiveness of regular versus irregular supportive periodontal therapy or tooth removal","volume":"43","author":"Schwendicke","year":"2016","journal-title":"J. Clin. Periodontol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/jre.12805","article-title":"Periodontal disease and quality of life: Umbrella review of systematic reviews","volume":"56","author":"Wong","year":"2021","journal-title":"J. Periodontal Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/prd.12311","article-title":"Herpesvirus-bacteria synergistic interaction in periodontitis","volume":"82","author":"Chen","year":"2020","journal-title":"Periodontology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1159\/000481545","article-title":"Consensus on Wound Antisepsis: Update 2018","volume":"31","author":"Kramer","year":"2018","journal-title":"Ski. Pharmacol. Physiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.ajic.2018.05.007","article-title":"Needleless connector drying time-how long does it take?","volume":"46","author":"Slater","year":"2018","journal-title":"Am. J. Infect. Control"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.ajic.2019.11.030","article-title":"Peripheral intravenous catheter needleless connector decontamination study-Randomized controlled trial","volume":"48","author":"Slater","year":"2020","journal-title":"Am. J. Infect. Control"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1902\/jop.1989.60.7.402","article-title":"Scaling and root planing efficacy in multirooted teeth","volume":"60","author":"Fleischer","year":"1989","journal-title":"J. Periodontol."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Rams, T.E., and Slots, J. (2023). Antimicrobial Chemotherapy for Recalcitrant Severe Human Periodontitis. Antibiotics, 12.","DOI":"10.3390\/antibiotics12020265"},{"key":"ref_66","first-page":"281","article-title":"Povidone-iodine gel and solution as adjunct to ultrasonic debridement in nonsurgical periodontitis treatment: An RCT pilot study","volume":"45","author":"Sahrmann","year":"2014","journal-title":"Quintessence Int."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.sdentj.2009.10.004","article-title":"The use of povidone-iodine and hydrogen peroxide mixture as an adjunct to non-surgical treatment of slight to moderate chronic periodontitis","volume":"21","author":"Babay","year":"2009","journal-title":"Saudi Dent. J."},{"key":"ref_68","first-page":"1023","article-title":"The use of PVP-iodine as an adjunct to non-surgical treatment of chronic periodontitis","volume":"28","author":"Rosling","year":"2001","journal-title":"J. Clin. Periodontol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1902\/jop.2006.050095","article-title":"Povidone-iodine used as an adjunct to non-surgical treatment of furcation involvements","volume":"77","author":"Bittencourt","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1902\/jop.2017.170362","article-title":"Combination of Ultrasonic Decontamination, Soft Tissue Curettage and Submucosal Air Polishing with Povidone-Iodine Application for Non-Surgical Therapy of Peri-Implantitis: 12 Months Clinical Outcomes","volume":"89","author":"Stein","year":"2017","journal-title":"J. Periodontol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1902\/jop.2006.050154","article-title":"Periodontal debridement with povidone-iodine in periodontal treatment: Short-term clinical and biochemical observations","volume":"77","author":"Zanatta","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/jcpe.13264","article-title":"Adjunctive effect of systemic antimicrobials in periodontitis therapy: A systematic review and meta-analysis","volume":"47","author":"Teughels","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_73","first-page":"549","article-title":"Evaluation of a unique subgingival irrigation with 10% povidone-iodine after scaling and root planing: A randomized clinical trial","volume":"47","author":"Denez","year":"2016","journal-title":"Quintessence Int."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1034\/j.1600-0765.2003.02016.x","article-title":"Povidone-iodine as a periodontal pocket disinfectant","volume":"38","author":"Hoang","year":"2003","journal-title":"J. Periodontal Res."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1111\/jcpe.13676","article-title":"Clinical, microbiological, and immunological effects of 3- or 7-day systemic antibiotics adjunctive to subgingival instrumentation in patients with aggressive (Stage III\/IV Grade C) periodontitis: A randomized placebo-controlled clinical trial","volume":"49","author":"Cosgarea","year":"2022","journal-title":"J. Clin. Periodontol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/prd.12398","article-title":"Oral health\u2019s inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions","volume":"87","author":"Kapila","year":"2021","journal-title":"Periodontology"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/5\/144\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:42:56Z","timestamp":1760107376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/12\/5\/144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,15]]},"references-count":76,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["dj12050144"],"URL":"https:\/\/doi.org\/10.3390\/dj12050144","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,15]]}}}