{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:26:21Z","timestamp":1781789181364,"version":"3.54.5"},"reference-count":60,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:00:00Z","timestamp":1615334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Japanese Society of Periodontology","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Periodontal disease is a chronic inflammatory disease of the periodontal tissue. The periodontal inflamed surface area (PISA) is a proposed index for quantifying the inflammatory burden resulting from periodontitis lesions. This study aimed to investigate longitudinal changes in the periodontal status as evaluated by the PISA following the active periodontal treatment. To elucidate the prognostic factors of PISA, mixed-effect modeling was performed for clinical parameters, tooth-type, and levels of periodontal pathogens as independent variables. One-hundred-twenty-five patients with chronic periodontitis who completed the active periodontal treatment were followed-up for 24 months, with evaluations conducted at 6-month intervals. Five-times repeated measures of mean PISA values were 130+\/\u2212173, 161+\/\u2212276, 184+\/\u2212320, 175+\/\u2212417, and 209+\/\u2212469 mm2. Changes in clinical parameters and salivary and subgingival periodontal pathogens were analyzed by mixed-effect modeling. Plaque index, clinical attachment level, and salivary levels of Porphyromonas gingivalis were associated with changes in PISA at the patient- and tooth-level. Subgingival levels of P. gingivalis and Prevotella intermedia were associated with changes in PISA at the sample site. For most patients, changes in PISA were within 10% of baseline during the 24-month follow-up. However, an increase in the number of bleeding sites in a tooth with a deep periodontal pocket increased the PISA value exponentially.<\/jats:p>","DOI":"10.3390\/jcm10061165","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T13:27:20Z","timestamp":1615382840000},"page":"1165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prospective Longitudinal Changes in the Periodontal Inflamed Surface Area Following Active Periodontal Treatment for Chronic Periodontitis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0814-0572","authenticated-orcid":false,"given":"Yoshiaki","family":"Nomura","sequence":"first","affiliation":[{"name":"Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7151-1292","authenticated-orcid":false,"given":"Toshiya","family":"Morozumi","sequence":"additional","affiliation":[{"name":"Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0065-2207","authenticated-orcid":false,"given":"Atsushi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Tokyo Dental College, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5766-1286","authenticated-orcid":false,"given":"Atsutoshi","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8588, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Kakuta","sequence":"additional","affiliation":[{"name":"Department of Oral Microbiology, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5156-9729","authenticated-orcid":false,"given":"Fumihiko","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Division of Dental Anesthesiology, Department of Oral Surgery, Ohu University School of Dentistry, Koriyama 963-8611, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fusanori","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Section of Periodontology, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Takai","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiso","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, Koriyama 963-8611, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Tabeta","sequence":"additional","affiliation":[{"name":"Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8514, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Umeda","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Osaka Dental University, Hirakata 573-1121, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Minabe","sequence":"additional","affiliation":[{"name":"Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka 238-8580, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuo","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Sugano","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Nihon University School of Dentistry, Tokyo 101-8310, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9130-7256","authenticated-orcid":false,"given":"Nobuhiro","family":"Hanada","sequence":"additional","affiliation":[{"name":"Department of Translational Research, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4248-1415","authenticated-orcid":false,"given":"Nobuo","family":"Yoshinari","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Sekino","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo 102-8159, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Takashiba","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soh","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of life Dentistry at Niigata, The Nippon Dental University, Niigata 951-8580, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2675-484X","authenticated-orcid":false,"given":"Toshiaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Sugaya","sequence":"additional","affiliation":[{"name":"Division of Periodontology and Endodontology, Department of Oral Health Science, Hokkaido University Graduate School of Dental Medicine, Sapporo 060-8586, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2767-844X","authenticated-orcid":false,"given":"Yorimasa","family":"Ogata","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Numabe","sequence":"additional","affiliation":[{"name":"Department of Periodontology, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo 102-8159, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taneaki","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, School of Medicine, Keio University, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nomura, Y., Morozumi, T., Nakagawa, T., Sugaya, T., Kawanami, M., Suzuki, F., Takahashi, K., Abe, Y., Sato, S., and Makino-Oi, A. (2017). Site-level progression of periodontal disease during a follow-up period. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0188670"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1177\/154405910308200310","article-title":"Unification of the \u201cburst\u201d and \u201clinear\u201d theories of periodontal disease progression: A multilevel manifestation of the same phenomenon","volume":"82","author":"Gilthorpe","year":"2003","journal-title":"J. Dent. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/j.1600-051X.1984.tb01305.x","article-title":"New concepts of destructive periodontal disease","volume":"11","author":"Socransky","year":"1984","journal-title":"J. Clin. Periodontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1902\/jop.1998.69.3.357","article-title":"Evaluating the Burst Hypothesis at a Site-Specific Level Using the Lack-of-Fit Test","volume":"69","author":"Hujoel","year":"1998","journal-title":"J. Periodontol."},{"key":"ref_5","first-page":"79","article-title":"An application of multilevel modelling to longitudinal perio-dontal research data","volume":"18","author":"Gilthorpe","year":"2001","journal-title":"Community Dent. Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"328","DOI":"10.5051\/jpis.2017.47.5.328","article-title":"Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions","volume":"47","author":"Park","year":"2017","journal-title":"J. Periodontal Implant. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.molmed.2014.11.004","article-title":"Polymicrobial synergy and dysbiosis in inflammatory disease","volume":"21","author":"Lamont","year":"2015","journal-title":"Trends Mol. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1111\/j.1600-051X.2006.00972.x","article-title":"Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in Brazil","volume":"33","author":"Chambrone","year":"2006","journal-title":"J. Clin. Periodontol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1111\/j.1600-051X.2007.01052.x","article-title":"Long-term effects of supportive therapy in periodontal patients treated with fibre retention osseous resective surgery. II: Tooth extractions during active and supportive therapy","volume":"34","author":"Carnevale","year":"2007","journal-title":"J. Clin. Periodontol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/j.1600-051X.2004.00519.x","article-title":"Tooth loss during maintenance following periodontal treatment in a periodontal practice in Norway","volume":"31","author":"Fardal","year":"2004","journal-title":"J. Clin. Periodontol."},{"key":"ref_11","first-page":"631","article-title":"The predictability of periodontal treatment as measured by tooth loss: A retrospec-tive study","volume":"29","author":"McLeod","year":"1998","journal-title":"Quintessence Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1902\/jop.1997.68.10.963","article-title":"Tooth Loss Due to Periodontal Abscess: A Retrospective Study","volume":"68","author":"McLeod","year":"1997","journal-title":"J. Periodontol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"311","DOI":"10.14219\/jada.archive.2002.0170","article-title":"The nonsurgical treatment of patients with periodontal disease: Results after five years","volume":"133","author":"Loesche","year":"2002","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1902\/jop.1987.58.4.231","article-title":"Tooth Loss in Maintenance Patients in a Private Periodontal Practice","volume":"58","author":"Wilson","year":"1987","journal-title":"J. Periodontol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1902\/jop.1989.60.9.516","article-title":"Tooth Loss in Patients with Moderate Periodontitis After Treatment and Long\u2013Term Maintenance Care","volume":"60","author":"Wood","year":"1989","journal-title":"J. Periodontol."},{"key":"ref_16","first-page":"207","article-title":"Tooth loss in periodontal patients","volume":"67","author":"Matthews","year":"2001","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1034\/j.1600-051x.2000.027011824.x","article-title":"Initial extractions and tooth loss during supportive care in a periodontal population seeking comprehensive care","volume":"27","author":"Tonetti","year":"2000","journal-title":"J. Clin. Periodontol."},{"key":"ref_18","first-page":"CD009376","article-title":"Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis","volume":"1","author":"Manresa","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/j.1600-051X.2008.01249.x","article-title":"Periodontal inflamed surface area: Quantifying inflammatory burden","volume":"35","author":"Nesse","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"11","DOI":"10.17219\/dmp\/103417","article-title":"Does metabolic control affect salivary adipokines in type 2 diabetes mellitus?","volume":"56","author":"Teke","year":"2019","journal-title":"Dent. Med. Probl."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4099","DOI":"10.1007\/s00784-019-02846-8","article-title":"Relationship between periodontal inflammation and calcium channel blockers induced gingival overgrowth\u2014A cross-sectional study in a Japanese population","volume":"23","author":"Matsuda","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1002\/JPER.18-0560","article-title":"Periodontitis is associated with systemic inflammation and vascular endothelial dysfunction in patients with lacunar infarct","volume":"90","author":"Leira","year":"2019","journal-title":"J. Periodontol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1002\/JPER.17-0684","article-title":"Platelet indices (mean platelet volume and platelet distribution width) have correlations with periodontal inflamed surface area in coronary artery disease patients: A pilot study","volume":"89","author":"Temelli","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1902\/jop.2017.160748","article-title":"Comparison of Endothelial Function in Healthy Patients and Patients with Chronic Periodontitis and Myocardial Infarction","volume":"88","author":"Punj","year":"2017","journal-title":"J. Periodontol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1007\/s11684-016-0484-5","article-title":"Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population","volume":"11","author":"Khanuja","year":"2017","journal-title":"Front. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1111\/j.1600-051X.2009.01377.x","article-title":"Dose-response relationship between periodontal inflamed surface area and HbA1c in type 2 Diabetics","volume":"36","author":"Nesse","year":"2009","journal-title":"J. Clin. Periodontol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Iwasaki, M., Kimura, Y., Yamaga, T., Yamamoto, N., Ishikawa, M., Wada, T., Sakamoto, R., Ishimoto, Y., Fujisawa, M., and Okumiya, K. (2020). A population-based cross-sectional study of the association between periodontitis and arterial stiffness among the older Japanese population. J. Periodontal Res.","DOI":"10.1111\/jre.12835"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Aoyama, N., Fujii, T., Kida, S., Nozawa, I., Taniguchi, K., Fujiwara, M., Iwane, T., Tamaki, K., and Minabe, M. (2021). Association of Periodontal Status, Number of Teeth, and Obesity: A Cross-Sectional Study in Japan. J. Clin. Med., 10.","DOI":"10.3390\/jcm10020208"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Salhi, L., Albert, A., Seidel, L., and Lambert, F. (2020). Respective Effects of Oral Hygiene Instructions and Periodontal Nonsurgical Treatment (Debridement) on Clinical Parameters and Patient-Reported Outcome Measures with Respect to Smoking. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082491"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Echeverr\u00eda, J.J., Manau, G.C., and Guerrero, A. (1996). Supportive care after active periodontal treatment: A review. J. Clin. Periodontol., 23.","DOI":"10.1111\/j.1600-051X.1996.tb00509.x"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1111\/jre.12353","article-title":"Salivary pathogen and serum antibody to assess the progression of chronic periodontitis: A 24-mo prospective multicenter cohort study","volume":"51","author":"Morozumi","year":"2016","journal-title":"J. Periodontal Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kakuta, E., Nomura, Y., Morozumi, T., Nakagawa, T., Nakamura, T., Noguchi, K., Yoshimura, A., Hara, Y., Fujise, O., and Nishimura, F. (2017). Assessing the progression of chronic periodontitis using subgingival pathogen levels: A 24-month prospective multicenter cohort study. BMC Oral Health, 17.","DOI":"10.1186\/s12903-017-0337-x"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1902\/jop.2006.069001","article-title":"American Academy of Periodontology, Guidelines for the Management of Patients with Periodontal Diseases","volume":"77","author":"Krebs","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1002\/JPER.17-0721","article-title":"Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"89","author":"Papapanou","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.micres.2008.06.001","article-title":"Rapid quantification of periodontitis-related bacteria using a novel modification of Invader PLUS technologies","volume":"165","author":"Tadokoro","year":"2010","journal-title":"Microbiol. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"415","DOI":"10.7883\/yoken.65.415","article-title":"Quantification of Periodontopathic Bacteria in Saliva Using the Invader Assay","volume":"65","author":"Tada","year":"2012","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1128\/JCM.38.6.2362-2365.2000","article-title":"Quantitative real-time PCR for Porphyromonas gingivalis and total bacteria","volume":"38","author":"Lyons","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/j.1600-051X.1991.tb00066.x","article-title":"Relation of baseline microbial parameters to future periodontal attachment loss","volume":"18","author":"Haffajee","year":"1991","journal-title":"J. Clin. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.micpath.2013.04.006","article-title":"Prevalence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia in Japanese patients with generalized chronic and aggressive periodontitis","volume":"61\u201362","author":"Tomita","year":"2013","journal-title":"Microb. Pathog."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Nomura, Y., Otsuka, R., Wint, W.Y., Okada, A., Hasegawa, R., and Hanada, N. (2020). Tooth-Level Analysis of Dental Caries in Primary Dentition in Myanmar Children. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17207613"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Nakahodo, N., Nomura, Y., Oshiro, T., Otsuka, R., Kakuta, E., Okada, A., Inai, Y., Takei, N., and Hanada, N. (2020). Effect of Mucosal Brushing on the Serum Levels of C-Reactive Protein for Patients Hospitalized with Acute Symptoms. Medicina, 56.","DOI":"10.3390\/medicina56100549"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jds.2019.07.005","article-title":"Properties of manual toothbrush that influence on plaque removal of interproximal surface in vitro","volume":"15","author":"Otsuka","year":"2020","journal-title":"J. Dent. Sci."},{"key":"ref_43","first-page":"5948379","article-title":"Prevalence of Dental Caries in 5- and 6-Year-Old Myanmar Children","volume":"2019","author":"Nomura","year":"2019","journal-title":"Int. J. Dent."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2478408","DOI":"10.1155\/2018\/2478408","article-title":"Factors That Affect Oral Care Outcomes for Institutionalized Elderly","volume":"2018","author":"Nomura","year":"2018","journal-title":"Int. J. Dent."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5051\/jpis.2019.49.2.60","article-title":"Long-term assessment of periodontal disease progression after surgical or non-surgical treatment: A systematic review","volume":"49","author":"Cha","year":"2019","journal-title":"J. Periodontal Implant. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/jcpe.13041","article-title":"Time between recall visits and residual probing depths predict long-term stability in patients enrolled in supportive periodontal therapy","volume":"46","author":"Ramseier","year":"2019","journal-title":"J. Clin. Periodontol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1111\/j.1600-051X.2007.01184.x","article-title":"Tooth loss after active periodontal therapy. 1: Patient-related factors for risk, prognosis, and quality of outcome","volume":"35","author":"Eickholz","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1034\/j.1600-051X.2002.291208.x","article-title":"Tooth loss and pocket probing depths in compliant periodontally treated patients: A retrospective analysis","volume":"29","author":"Plagmann","year":"2002","journal-title":"J. Clin. Periodontol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1902\/jop.2013.130306","article-title":"Microbial Analysis of Subgingival Plaque Samples Compared to That of Whole Saliva in Patients with Periodontitis","volume":"85","author":"Haririan","year":"2014","journal-title":"J. Periodontol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Belstr\u00f8m, D., Sembler-M\u00f8ller, M.L., Grande, M.A., Kirkby, N., Cotton, S.L., Paster, B.J., and Holmstrup, P. (2017). Microbial profile comparisons of saliva, pooled and site-specific subgingival samples in periodontitis patients. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0182992"},{"key":"ref_51","first-page":"63","article-title":"Correlation between bacterial counts in saliva and subgingival plaque","volume":"12","author":"Testa","year":"1999","journal-title":"Acta Odontol Latinoam"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1007\/s00784-002-0177-0","article-title":"Correlations between bacterial levels in autologous subgingival plaque and saliva of adult Sudanese","volume":"6","author":"Darout","year":"2002","journal-title":"Clin. Oral Investig."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/j.1399-302X.1994.tb00047.x","article-title":"The most frequently isolated gram-negative anaerobes in saliva and subgingival samples taken from young women","volume":"9","author":"Asikainen","year":"1994","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"491","DOI":"10.2334\/josnusd.16-0573","article-title":"Characterization of specimens obtained by different sampling methods for evaluation of periodontal bacteria","volume":"59","author":"Okada","year":"2017","journal-title":"J. Oral Sci."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/ipd.12065","article-title":"Progression of periodontal inflammation in adolescents is associated with increased number of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and Fusobacterium nucleatum","volume":"24","author":"Yang","year":"2013","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1902\/jop.2006.77.1.61","article-title":"Increase in Probing Depth Is Correlated With a Higher Number ofPrevotella intermediaGenotypes","volume":"77","author":"Alves","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1902\/jop.2000.71.1.14","article-title":"Persistence Patterns ofPorphyromonas gingivalis, Prevotella intermedia\/ nigrescens, and Actinobacillus actinomycetemcomitans After Mechanical Therapy of Periodontal Disease","volume":"71","author":"Mombelli","year":"2000","journal-title":"J. Periodontol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1902\/jop.1996.67.2.130","article-title":"Repopulation of Periodontal Pockets by Microbial Pathogens in the Absence of Supportive Therapy","volume":"67","author":"Shiloah","year":"1996","journal-title":"J. Periodontol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1034\/j.1601-0825.9.s1.11.x","article-title":"Use of antimicrobial agents during supportive periodontal therapy","volume":"9","author":"Venezia","year":"2003","journal-title":"Oral Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/jre.12680","article-title":"Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial","volume":"54","author":"Yashima","year":"2019","journal-title":"J. Periodontal Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1165\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:33:35Z","timestamp":1760160815000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,10]]},"references-count":60,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jcm10061165"],"URL":"https:\/\/doi.org\/10.3390\/jcm10061165","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,10]]}}}