{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:47:34Z","timestamp":1782265654531,"version":"3.54.5"},"reference-count":80,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Objectives: To compare the adjunctive efficacy of a MicroRepair\u00ae mouthwash containing an antibacterial complex (ABX), composed of cetylpyridinium chloride, magnolol, and honokiol, with 0.12% chlorhexidine (CHX) in the management of generalized plaque-induced gingivitis, assessing clinical periodontal parameters, salivary activated matrix metalloproteinase-8 (aMMP-8) levels, and patient-reported outcomes over 6 months. Methods: A randomized, controlled, parallel-group clinical trial included 40 systemically healthy adults with generalized gingivitis and was reported in accordance with CONSORT 2025 guidelines. Following professional oral hygiene according to the Guided Biofilm Therapy (GBT) protocol, participants were randomly allocated to ABX or 0.12% CHX, used twice daily for 14 days. Clinical parameters, including Full-Mouth Bleeding Score (FMBS, primary outcome), Full-Mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Gingival Recession (REC), and Modified Lobene Stain Index (MLSI), were recorded at baseline, 2 weeks, 1, 3, and 6 months. Salivary aMMP-8 levels were assessed at baseline and 2 weeks. Heavy smokers were excluded, and smoking status was evaluated as a potential covariate. Non-parametric tests were applied (p &lt; 0.05). Results: Both groups showed significant reductions in FMBS and FMPS over time (p &lt; 0.05), with no intergroup differences for the primary outcome at any follow-up at the patient level. Patient-level analyses did not reveal consistent differences across secondary parameters. At the tooth level, lower FMPS values were observed in the trial group at 2 weeks and 1 month (p &lt; 0.05), with earlier PPD reduction. CAL, and REC remained stable. Salivary aMMP-8 levels decreased significantly in both groups without intergroup differences. Patient-reported outcomes were comparable. Smoking status was balanced between groups and was not significantly associated with treatment allocation or the main clinical outcomes. Conclusions: No significant differences were observed between ABX and CHX for the main clinical and molecular outcomes, supporting its potential use as an adjunct in gingivitis management.<\/jats:p>","DOI":"10.3390\/dj14060383","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:03:23Z","timestamp":1782263003000},"page":"383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Status and Salivary aMMP-8 Evaluation of 0.12% Chlorhexidine Versus MicroRepair\u00ae ABX Mouthwash in the Non-Surgical Management of Plaque-Induced Gingivitis: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2760-0124","authenticated-orcid":false,"given":"Andrea","family":"Scribante","sequence":"first","affiliation":[{"name":"Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy"},{"name":"Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1690-4904","authenticated-orcid":false,"given":"Maurizio","family":"Pascadopoli","sequence":"additional","affiliation":[{"name":"Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0867-5398","authenticated-orcid":false,"given":"Matteo","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7962-2712","authenticated-orcid":false,"given":"Cinzia","family":"Casu","sequence":"additional","affiliation":[{"name":"Oral Biotechnology Laboratory (OBL), Department of Molecular Biology, University of Cagliari, 09121 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Massazzi","sequence":"additional","affiliation":[{"name":"Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2457-4415","authenticated-orcid":false,"given":"Andrea","family":"Butera","sequence":"additional","affiliation":[{"name":"Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17038","DOI":"10.1038\/nrdp.2017.38","article-title":"Periodontal diseases","volume":"3","author":"Kinane","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"\u0141asica, A., Golec, P., Laskus, A., Zalewska, M., G\u0119daj, M., and Popowska, M. (2024). Periodontitis: Etiology, conventional treatments, and emerging bacteriophage and predatory bacteria therapies. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1469414"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/prd.12579","article-title":"Conventional diagnostic criteria for periodontal diseases (plaque-induced gingivitis and periodontitis)","volume":"95","year":"2024","journal-title":"Periodontol. 2000"},{"key":"ref_4","first-page":"S74","article-title":"Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium","volume":"89","author":"Chapple","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1111\/jcpe.70083","article-title":"Clinical efficacy of interventions based on professional mechanical plaque removal","volume":"53","author":"Farina","year":"2026","journal-title":"J. Clin. Periodontol."},{"key":"ref_6","first-page":"S116","article-title":"Mechanical and chemical plaque control","volume":"44","author":"Figuero","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/prd.12332","article-title":"Contemporary practices for mechanical oral hygiene","volume":"84","author":"Graetz","year":"2020","journal-title":"Periodontol. 2000"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lukac, Z., Maric, B., Kapetanovic, J., Mandic, M., Musa Leko, I., and Bosnjak, A.P. (2025). Effectiveness of iTOP education. Dent. J., 13.","DOI":"10.3390\/dj13090404"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.1111\/jcpe.12366","article-title":"Primary prevention of periodontitis: Managing gingivitis","volume":"42","author":"Chapple","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_10","first-page":"e28613","article-title":"Status quo in mechanical plaque control then and now: A review","volume":"14","author":"Toshniwal","year":"2022","journal-title":"Cureus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/jcpe.70061","article-title":"Effect of adjunctive use of commercial daily mouthwashes on periodontal health: An umbrella review","volume":"53","author":"Koromantzos","year":"2026","journal-title":"J. Clin. Periodontol."},{"key":"ref_12","first-page":"CD008676","article-title":"Chlorhexidine mouthrinse as an adjunctive treatment for gingival health","volume":"3","author":"James","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.identj.2022.01.005","article-title":"Chlorhexidine in dentistry","volume":"72","author":"Ouanounou","year":"2022","journal-title":"Int. Dent. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2042098619854881","DOI":"10.1177\/2042098619854881","article-title":"Adverse events of mouthrinses","volume":"10","author":"Tartaglia","year":"2019","journal-title":"Ther. Adv. Drug Saf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1038\/sj.ebd.6401232","article-title":"Chlorhexidine mouthwash plaque levels","volume":"18","author":"Richards","year":"2017","journal-title":"Evid. Based Dent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103497","DOI":"10.1016\/j.jdent.2020.103497","article-title":"Uses of chlorhexidine","volume":"103","author":"Brookes","year":"2020","journal-title":"J. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"103768","DOI":"10.1016\/j.jdent.2021.103768","article-title":"Effects of chlorhexidine mouthwash on the oral microbiome","volume":"113","author":"Brookes","year":"2021","journal-title":"J. Dent."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S74","DOI":"10.1016\/j.identj.2023.08.010","article-title":"Mouthwash microbiome effects","volume":"73","author":"Brookes","year":"2023","journal-title":"Int. Dent. J."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Inchingolo, A.M., Marinelli, G., Colonna, V., Pennacchio, B.F.P., Giorgio, R.V., Inchingolo, F., Di Venere, D., Palermo, A., Minervini, G., and Inchingolo, A.D. (2025). Efficacy and safety of natural versus conventional toothpastes and mouthwashes in gingivitis management: A systematic review. Hygiene, 5.","DOI":"10.3390\/hygiene5030038"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.jobcr.2024.06.006","article-title":"Clinical and microbial evaluation of mouthwash containing Achyranthes aspera and Trachyspermum ammi: A randomized controlled non-inferiority trial","volume":"14","author":"Kumar","year":"2024","journal-title":"J. Oral Biol. Craniofac. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/odi.13254","article-title":"Effect of herbal mouthrinses on dental plaque formation and gingival inflammation: A systematic review","volume":"27","author":"Santi","year":"2021","journal-title":"Oral Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Aslam, Z., Wu, J., Wang, Z., Anderson, N.K., Estrin, N.E., and Romanos, G.E. (2025). Efficacy of Herbal vs. Chlorhexidine Mouthwash in Experimental Gingivitis: A Cross-over Clinical and Microbiological Study. Dent. J., 13.","DOI":"10.3390\/dj13120608"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"51","DOI":"10.22514\/jocpd.2024.103","article-title":"Comparative anti-plaque and anti-gingivitis efficiency of Triphala versus chlorhexidine mouthwashes in children: A systematic review and meta-analysis","volume":"48","author":"Minervini","year":"2024","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mahapatra, A., Panda, S., Tumedei, M., Panda, S., Das, A.C., Kumar, M., and Del Fabbro, M. (2025). Clinical and Microbiological Evaluation of 0.2% Tea Tree Oil Mouthwash in Prevention of Dental Biofilm-Induced Gingivitis. Dent. J., 13.","DOI":"10.3390\/dj13040149"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"107","DOI":"10.22514\/jocpd.2024.064","article-title":"Comparative evaluation of probiotic solutions on surface roughness and microhardness of different restorative materials and enamel","volume":"48","author":"Karatas","year":"2024","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Scribante, A., Pellegrini, M., Pascadopoli, M., Natoli, V., Poma, V., and Butera, A. (2026). Comparison Between Natural Products and Chlorhexidine in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials. Dent. J., 14.","DOI":"10.3390\/dj14020110"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"60","DOI":"10.22514\/jocpd.2024.008","article-title":"Investigating the relationship between dental cavities and protective factors among children aged 0\u20135 years","volume":"48","author":"Dontsop","year":"2024","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Grassi, L., Maisetta, G., Esin, S., and Batoni, G. (2017). Combination Strategies to Enhance the Efficacy of Antimicrobial Peptides against Bacterial Biofilms. Front. Microbiol., 8.","DOI":"10.3389\/fmicb.2017.02409"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Hawas, S., Verderosa, A.D., and Totsika, M. (2022). Combination Therapies for Biofilm Inhibition and Eradication: A Comparative Review of Laboratory and Preclinical Studies. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.850030"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e00576-20","DOI":"10.1128\/AAC.00576-20","article-title":"Cetylpyridinium Chloride: Mechanism of Action, Antimicrobial Efficacy in Biofilms, and Potential Risks of Resistance","volume":"64","author":"Mao","year":"2020","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1021\/acsabm.2c01080","article-title":"One-Pot Preparation of Cetylpyridinium Chloride-Containing Nanoparticles for Biofilm Eradication","volume":"6","author":"Brezhnev","year":"2023","journal-title":"ACS Appl. Bio Mater."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1021\/acsinfecdis.9b00190","article-title":"A Bisphenolic Honokiol Analog Outcompetes Oral Antimicrobial Agent Cetylpyridinium Chloride via a Membrane-Associated Mechanism","volume":"6","author":"Ochoa","year":"2020","journal-title":"ACS Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Frolov, N., Detusheva, E., Fursova, N., Ostashevskaya, I., and Vereshchagin, A. (2022). Microbiological Evaluation of Novel Bis-Quaternary Ammonium Compounds: Clinical Strains, Biofilms, and Resistance Study. Pharmaceuticals, 15.","DOI":"10.3390\/ph15050514"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Enax, J., Fandrich, P., Schulze Zur Wiesche, E., and Amaechi, B.T. (2025). The Whitening Efficacy of a Hydroxyapatite Toothpaste and a Blue Covarine Toothpaste: A Comparative In Vitro Study. Dent. J., 13.","DOI":"10.3390\/dj13040143"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"173","DOI":"10.22514\/jocpd.2024.137","article-title":"Remineralization potential of a novel varnish: An in vitro comparative evaluation","volume":"48","author":"Gokce","year":"2024","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_36","first-page":"137","article-title":"Evaluation of two different remineralising toothpastes in children with drug-controlled asthma and allergic rhinitis: A randomised clinical trial","volume":"25","author":"Scribante","year":"2024","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"160","DOI":"10.22514\/jocpd.2024.089","article-title":"Comparison of the physical properties of glass ionomer modified with silver phosphate\/hydroxyapatite or titanium dioxide nanoparticles: In vitro study","volume":"48","year":"2024","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Butera, A., Maiorani, C., Gallo, S., Pascadopoli, M., Quintini, M., Lelli, M., Tarterini, F., Foltran, I., and Scribante, A. (2023). Biomimetic Action of Zinc Hydroxyapatite on Remineralization of Enamel and Dentin: A Review. Biomimetics, 8.","DOI":"10.3390\/biomimetics8010071"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"78","DOI":"10.22514\/jocpd.2024.128","article-title":"Clinical effectiveness and parental acceptance of silver diamine fluoride in preschool children: A non-randomized trial","volume":"48","author":"Buldur","year":"2024","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.sdentj.2023.05.018","article-title":"Nanohydroxyapatite in dentistry: A comprehensive review","volume":"35","author":"Pushpalatha","year":"2023","journal-title":"Saudi Dent. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1055\/s-0039-1695657","article-title":"Hydroxyapatite in oral biofilm management","volume":"13","author":"Meyer","year":"2019","journal-title":"Eur. J. Dent."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Florea, A.D., Dobrota, C.T., Carpa, R., Racz, C.P., Tomoaia, G., Mocanu, A., Avram, A., Soritau, O., Pop, L.C., and Tomoaia-Cotisel, M. (2023). Optimization of functional toothpaste formulation containing nano-hydroxyapatite and birch extract for daily oral care. Materials, 16.","DOI":"10.3390\/ma16227143"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Guerra-L\u00f3pez, J.R., Bianchi, A.E., Ramos, M.A., Ubertino, M., Ferraresi-Curotto, V., G\u00fcida, J.A., Barbaro, K., Zhukova, A.A., Grigorieva, V.Y., and Rau, J.V. (2025). Preparation of zinc-doped hydroxyapatite ceramics and evaluation of biocompatibility and antibacterial activity. J. Funct. Biomater., 16.","DOI":"10.3390\/jfb16030088"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Scribante, A., Cosola, S., Pascadopoli, M., Genovesi, A., Battisti, R.A., and Butera, A. (2025). Clinical and technological evaluation of the remineralising effect of biomimetic hydroxyapatite in a population aged 6 to 18 years: A randomized clinical trial. Bioengineering, 12.","DOI":"10.3390\/bioengineering12020152"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1111\/odi.14388","article-title":"Biomimetic hydroxyapatite paste for molar-incisor hypomineralization: A randomized clinical trial","volume":"29","author":"Butera","year":"2023","journal-title":"Oral Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"105429","DOI":"10.1016\/j.jdent.2024.105429","article-title":"Clinical evidence of caries prevention by hydroxyapatite: An updated systematic review and meta-analysis","volume":"151","author":"Pawinska","year":"2024","journal-title":"J. Dent."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Biesiadecki, S., Janeczko, M., Kozak, J., Homaj-Siudak, M., Szarpak, L., and Rahnama-Hezavah, M. (2026). Advanced diagnostic technologies and molecular biomarkers in periodontitis: Systemic health implications and translational perspectives. J. Clin. Med., 15.","DOI":"10.3390\/jcm15031142"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Boynes, S.G., Sofiyeva, N., Saw, T., Nieto, V., and Palomo, L. (2025). Assessment of salivary matrix metalloproteinase (MMP-8) and activated salivary matrix metalloproteinase (aMMP-8) in periodontitis patients: A systematic review and meta-analysis. Front. Oral Health, 6.","DOI":"10.3389\/froh.2025.1444399"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"104955","DOI":"10.1016\/j.archoralbio.2020.104955","article-title":"Evaluation of active matrix metalloproteinase-8 (aMMP-8) chair-side test as a diagnostic biomarker in the staging of periodontal diseases","volume":"124","author":"Eminigil","year":"2021","journal-title":"Arch. Oral Biol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Zalewska, E.A., \u0141awicka, R., Grygorczuk, P., Nowosielska, M., Kicman, A., and \u0141awicki, S. (2024). Importance of metalloproteinase 8 (MMP-8) in the diagnosis of periodontitis. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25052721"},{"key":"ref_51","first-page":"407","article-title":"Diagnostic potential of aMMP-8 PoCT in oral fluids: Insights from periodontitis and metabolic syndrome interplay","volume":"23","author":"Thomas","year":"2025","journal-title":"Eur. J. Dent."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e40402","DOI":"10.1016\/j.heliyon.2024.e40402","article-title":"Evaluating salivary MMP-8 as a biomarker for periodontal diseases: A systematic review and meta-analysis","volume":"10","author":"Domokos","year":"2024","journal-title":"Heliyon"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/idh.12533","article-title":"A Novel Biofilm Removal Approach (Guided Biofilm Therapy) Utilizing Erythritol Air-Polishing and Ultrasonic Piezo Instrumentation: A Randomized Controlled Trial","volume":"20","author":"Vouros","year":"2022","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Cyris, M., Festerling, J., Kahl, M., Springer, C., D\u00f6rfer, C.E., and Graetz, C. (2024). Guided Biofilm Therapy versus Conventional Protocol\u2014Clinical Outcomes in Non-Surgical Periodontal Therapy. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04898-z"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Gheorghe, D.N., Bennardo, F., Silaghi, M., Popescu, D.M., Maftei, G.A., B\u0103t\u0103iosu, M., and Surlin, P. (2023). Subgingival Use of Air-Polishing Powders: Status of Knowledge: A Systematic Review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12216936"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e081123","DOI":"10.1136\/bmj-2024-081123","article-title":"CONSORT 2025 statement: Updated guideline for reporting randomised trials","volume":"388","author":"Hopewell","year":"2025","journal-title":"BMJ"},{"key":"ref_57","first-page":"S159","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_58","doi-asserted-by":"crossref","unstructured":"Cafiero, C., Spagnuolo, G., Marenzi, G., Martuscelli, R., Colamaio, M., and Leuci, S. (2021). Predictive periodontitis: The most promising salivary biomarkers for early diagnosis of periodontitis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10071488"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Simon, F., Szab\u00f3, G., Ors\u00f3s, M., Mijiritsky, E., and N\u00e9meth, O. (2024). The effectiveness of individualized oral hygiene education in preventing dental diseases: A clinical study. J. Clin. Med., 13.","DOI":"10.20944\/preprints202405.1991.v1"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1055\/s-0044-1786865","article-title":"A reappraisal of the accuracy of the tactile method for the detection of the subgingival cementoenamel junction: An in vivo study","volume":"19","author":"Mokhagul","year":"2025","journal-title":"Eur. J. Dent."},{"key":"ref_61","first-page":"349","article-title":"Twenty-four month clinical outcomes of modified coronally advanced tunnel technique","volume":"97","author":"Herrmann","year":"2026","journal-title":"J. Periodontol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1111\/jerd.13373","article-title":"A randomized clinical study investigating the stain removal efficacy of two experimental dentifrices","volume":"37","author":"Parkinson","year":"2025","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_63","first-page":"183","article-title":"Comparative clinical evaluation of two essential oil-based mouthwashes with and without alcohol","volume":"21","author":"Basso","year":"2023","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"588","DOI":"10.3897\/folmed.64.e63528","article-title":"Randomised controlled trial comparing the clinical effectiveness of mouthwashes based on essential oils, chlorhexidine, hydrogen peroxide and prebiotic in gingivitis treatment","volume":"64","author":"Yaneva","year":"2022","journal-title":"Folia Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"269","DOI":"10.23736\/S0026-4970.20.04340-X","article-title":"One-year clinical outcomes following non-surgical treatment of peri-implant mucositis with adjunctive diode laser application","volume":"69","author":"Mariani","year":"2020","journal-title":"Minerva Stomatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1198\/1061860043515","article-title":"An algorithm for a letter-based representation of all-pairwise comparisons","volume":"13","author":"Piepho","year":"2004","journal-title":"J. Comput. Graph. Stat."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Limeback, H., Enax, J., and Meyer, F. (2023). Clinical evidence of biomimetic hydroxyapatite in oral care products for reducing dentin hypersensitivity: An updated systematic review and meta-analysis. Biomimetics, 8.","DOI":"10.3390\/biomimetics8010023"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"98","DOI":"10.18231\/j.ijpi.2019.021","article-title":"Clinical evaluation of zinc-carbonate hydroxyapatite nanocrystals mouthwash in controlling plaque induced gingivitis: A randomized clinical trial","volume":"4","author":"Asmari","year":"2019","journal-title":"IP Int. J. Periodontol. Implantol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"566","DOI":"10.4103\/jispcd.JISPCD_261_19","article-title":"Evaluate efficacy of desensitizing toothpaste containing zinc-carbonate hydroxyapatite nanocrystals: Non-comparative eight-week clinical study","volume":"9","author":"Khan","year":"2019","journal-title":"J. Int. Soc. Prev. Community Dent."},{"key":"ref_70","first-page":"298","article-title":"Clinical efficacy of nanosilver and chlorhexidine in the treatment of plaque-induced gingivitis: Randomized controlled clinical trial","volume":"7","author":"Madfa","year":"2018","journal-title":"J. Oral Res."},{"key":"ref_71","first-page":"S17","article-title":"Dental plaque-induced gingival conditions","volume":"89","author":"Murakami","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1111\/jcpe.12939","article-title":"Plaque-induced gingivitis: Case definition and diagnostic considerations","volume":"45","author":"Trombelli","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_73","first-page":"e67129","article-title":"Clinical features, etiopathogenesis, and therapeutic approaches of acute gingival lesions: A narrative review","volume":"16","author":"Bhagat","year":"2024","journal-title":"Cureus"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/j.1601-0825.1998.tb00266.x","article-title":"Plaque formation and gingivitis after supervised mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 6 months","volume":"4","author":"Lang","year":"1998","journal-title":"Oral Dis."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1111\/j.1600-051X.1986.tb01500.x","article-title":"Considerations in the statistical analysis of clinical trials in periodontitis","volume":"13","author":"Imrey","year":"1986","journal-title":"J. Clin. Periodontol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4103\/1735-3327.318939","article-title":"A multilevel analysis of a randomized clinical trial comparing adjunctive moxifloxacin versus amoxicillin\/metronidazole for the treatment of aggressive periodontitis","volume":"18","author":"Ardila","year":"2021","journal-title":"Dent. Res. J."},{"key":"ref_77","first-page":"7891323","article-title":"Matrix metalloproteinase-8 as an inflammatory and prevention biomarker in periodontal and peri-implant diseases","volume":"2018","author":"Alassiri","year":"2018","journal-title":"Int. J. Dent."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Luchian, I., Goriuc, A., Sandu, D., and Covasa, M. (2022). The role of matrix metalloproteinases (MMP-8, MMP-9, MMP-13) in periodontal and peri-implant pathological processes. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23031806"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"R\u00e4is\u00e4nen, I.T., Aji, N.R.A.S., Sakellari, D., Grigoriadis, A., Rantala, I., P\u00e4til\u00e4, T., Heikkil\u00e4, P., Gupta, S., and Sorsa, T. (2023). Active matrix metalloproteinase-8 (aMMP-8) versus total MMP-8 in periodontal and peri-implant disease point-of-care diagnostics. Biomedicines, 11.","DOI":"10.3390\/biomedicines11112885"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/j.1600-051X.2006.00946.x","article-title":"Effect of two new chlorhexidine mouthrinses on the development of dental plaque, gingivitis, and discolouration","volume":"33","author":"Lorenz","year":"2006","journal-title":"J. Clin. Periodontol."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/6\/383\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:33:48Z","timestamp":1782264828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/6\/383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":80,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["dj14060383"],"URL":"https:\/\/doi.org\/10.3390\/dj14060383","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]}}}