Interventions
calculus
PLAQUE
The interventions in groups A and B comprised full-mouth scaling and root surface debridement completed within 6 weeks, operating one scaling session of 45 min, 4 sessions of root planning. The scaling session consisted of ultrasonic supra- and subgingival debridement of soft and hard deposits of bacterial plaque and calculus. After completing the measurements, all pockets with PPD ≥ 4 mm were scaled, and root planed under local anesthesia with Gracey curettes (Hu-Friedy®) and ultrasonic instruments (Piezon® 250; Electro Medical Systems SA) by the same clinicians. After all mechanical treatment sessions, in group A, the patients rinsed for 1 min with 15 mL of ozonized oil mouthwash (Ialozon Blu; Gemavip, Cagliari, Italy), and after mechanical instrumentation. Patients in group B did not received mouthwash. Oral hygiene instructions were given and scaling and root surface debridement was performed with piezoelectric and hand instruments. Upon leaving each session, participants were subjected to oral hygiene instruction by emphasizing the use of manual or electric toothbrushes twice daily, tongue cleaning via brushing or scraping to reduce potential pathogenic organisms residing on the dorsum of the tongue, interproximal cleaning to disrupt plaque formation. We established sequential treatment plan with three steps of gaseous ozone therapy after the instrumentation by ultrasonic devices. As our previous research [