Real-time qPCR evaluation of amino acids buffered sodium hypochlorite gel as an adjunct to non-surgical periodontal treatment: a randomized clinical trial

This study aimed to evaluate the effects of non-surgical periodontal therapy (SRP) and SRP with an amino acid-buffered hypochlorite solution (NaOCl/AA + SRP) on subgingival plaque bacteria. Quantitative changes in Porphyromonas gingivalis, Fusobacterium nucleatum, Campylobacter rectus and Pan Bacteria 3 assay were determined by real-time qPCR from GCF obtained from deep periodontal pocket in twelve weeks observation period. Both treatment strategies led to significant clinical improvements over time. During the first week, we observed a significant twofold decrease in the levels of P. gingivalis and C. rectus following SRP treatment. Similarly, at 12 weeks, the between-group difference in log₂ P. gingivalis DNA levels (SRP vs NaOCl/AA + SRP) was -0.79 (95% CI -1.35 to -0.23; p = 0.006), indicating a significantly greater reduction following SRP alone. The adjunctive application of NaOCl/AA gel to SRP also resulted in reduced levels of P. gingivalis, C. rectus, or F. nucleatum; however, not as pronounced. Additionally neither treatment strategy significantly affected the total amount of bacterial DNA. In patients with low PD, a significant reduction in P. gingivalis expression was observed during the first week of therapy across both study groups. Conversely, in patients with high PD, a significant reduction in bacterial DNA expression was evident only in the SRP group. In conclusion, a single 30 s NaOCl/AA gel application did not demonstrate additional benefit over SRP alone under the applied protocol.