Comparative Effects of Two Oral Antiseptics Used as an Adjuvant in the Treatment of Periodontitis

% BoP will be assessed at 6 surfaces (mesiobuccal, mid buccal, disto-buccal, mesio-oral, mid-oral, disto-oral.) in a dichotomous manner (Mühlemann & Son, 1971). Bleeding will be positive after 15 seconds of probing the gingival sulcus to the most apical stop. The percentage of the full mouth BoP will be reported.

% BoP will be assessed at 6 surfaces (mesiobuccal, mid buccal, disto-buccal, mesio-oral, mid-oral, disto-oral.) in a dichotomous manner (Mühlemann & Son, 1971). Bleeding will be positive after 15 seconds of probing the gingival sulcus to the most apical stop. The percentage of the full mouth BoP will be reported.

Tooth staining assessment by the Macpherson modification of the Lobene Stain Index (MLSI) (L. M. Macpherson, K. W. Stephen, A. Joiner, F. Schäfer, & E. Huntington, 2000) on index tooth (11, 12, 21, 22, 31, 32, 41, 42). If an incisor is missing, the nearest canine will serve as substitute where appropriate.

Full Mouth Plaque Score (FMPS) (O'Leary et al., 1972) will be measured as an indicator of oral hygiene on the mesial, distal, buccal and oral surfaces of each tooth.

The FMPS will be assessed with the following formula: Number of surfaces with plaque/Total number of surfaces x 100%

CAL measures the distance from the cemento-enamel junction of the tooth to the base of the periodontal pocket.

CAL will be measured at baseline and 2 months by recording the distance from the cervical line to the bottom of the probable pocket at 6 sites (Mesio-buccal, mid-buccal, disto-buccal, mesio-oral, mid-oral and disto-oral) for each of the study teeth.

PPD measures the distance from the free gingival margin to the base of the periodontal pocket. It will be measured at 6 sites (Mesio-buccal, mid-buccal, disto-buccal, mesio-oral, mid-oral and disto-oral) in the entire dentition.

A mouthwash-specific questionnaire consisting of 6 questions was constructed to assess the compliance and potential side effects associated with mouthwash use, including burning sensation, altered taste and unpleasant taste assessed on a visual analogue scale., taking reference from Navabi and coworkers (Navabi, Afshari, Kamyabi, & Mohammadi, 2024). A higher score indicates a poorer patient-perceived experience.

Oral health impact profile for chronic periodontitis (OHIP-CP). The OHIP-CP is a condition-specific OHRQoL instrument for patients with chronic periodontitis consisting of 18 questions (He, Wang, Wei, & Ji, 2017). Fifteen questions from the OHIP-CP Cantonese version was adopted from the translated and validated Chinese version of OHIP (Wong, Lo, & McMillan, 2002). The remaining 3 questions were translated through forward translation, backward translation, expert committee process to reach a consensus. A higher score indicated poor oral health-related quality of life.

Löe and Silness Gingival Index (1963) (Loe & Silness, 1963) will be performed on 4 gingival surfaces of index Ramfjord teeth (16, 21, 24, 36, 41, 44). Each of the four gingival areas (buccal, oral, mesial, distal) of the tooth is given a score from 0 to 3.

The scores of the 4 areas will be added and divided by 4 to give the GI for the tooth The scores for individual teeth may be grouped to have the GI for the group of teeth Finally, by adding the indices for the teeth and dividing by the total number of teeth examined, the Gl for the individual is obtained. The index for the subject is thus an average score for the areas examined.

Missing teeth from the Ramfjord index teeth (16, 21, 24, 36, 41, 44) will not be substituted.

Turesky modification of Quigley-Hein plaque index (TQHPI)(Turesky et al.,1970) on Ramfjord teeth (16, 21, 24, 36, 41, 44) will be performed.

Each tooth will be divided into 6 surfaces (mesiobuccal, mid buccal, disto-buccal, mesio-oral, mid-oral, disto-oral.) Each surface will be given a score. The score of all sites will be summed and divided by the number of sites to have the individual tooth index The subject mean plaque score will be calculated by summing all the plaque indices of teeth and dividing by the number of teeth.

Missing teeth from the Ramfjord index teeth (16, 21, 24, 36, 41, 44) will not be substituted.

This measure will assess the change in diversity of the microbial community in the sample (alpha diversity). A diversity index provides a mathematical measure that reflects the number of different species (richness) and the evenness of the species' abundances. It ranges from zero to infinity. A higher value means higer diversity.

It is a distance metrics that measures the beta-diversity. It quantifies the dissimilarity between microbial communitie/ the variation or differences in microbial communities between different samples. It ranges from 0 (identical communities) to 1 (completely different communities).

The concentrations of a panel of biomarkers (IL-1β, TNF-α, IL-6, MMP-8,TIMP-1, TIMP-2) found within the gingival cervicular fluid (GCF) will be assessed with multiplex immunoassays. Unit: ng/mL or as appropriate based on assay's standard.