Hypochlorous Acid in Non-Surgical Periodontal Therapy

Periodontitis is a chronic inflammatory disease associated with dental plaque and characterized by the progressive destruction of the tooth-supporting tissues. The principal features of periodontitis include clinical attachment loss (CAL), alveolar bone loss, periodontal pocket formation, gingival bleeding, and the subsequent loss of periodontal tissue support. The current gold standard for the management of periodontal disease comprises oral hygiene instruction (OHI), non-surgical periodontal therapy (NSPT), periodontal surgery when indicated, and supportive periodontal therapy (SPT). In addition, various antimicrobial agents are used as adjuncts to periodontal treatment. One such agent, hypochlorous acid (HOCl), is a potent antimicrobial with high affinity against Gram-negative bacteria within the subgingival biofilm. Hypochlorous acid is commercially available in mouthwash and spray formulations, which patients may use as adjunctive therapies following periodontal treatment. In the present project, hypochlorous acid will be applied by the clinician using a dental device during periodontal treatment in a clinical setting. Changes in both clinical and biochemical outcomes, including high-sensitivity C-reactive protein (hs-CRP), C-reactive protein (CRP), antistreptolysin O (ASO), and oncostatin M (OSM), will be recorded and compared with those obtained following conventional periodontal treatment performed using purified water. The novelty of the proposed study lies in the first-time use of hypochlorous acid as an irrigant in place of purified water during scaling and root planing (SRP), with the aim of evaluating its effects on both clinical and biochemical parameters. This project is expected to attract the attention of researchers investigating the treatment of periodontitis and may facilitate publication in high-impact international peer-reviewed journals as well as presentation at prestigious scientific congresses. Furthermore, it will contribute to the training of qualified researchers in periodontology and support the completion of a doctoral dissertation. The findings may also provide preliminary data for future studies aimed at developing hypochlorous acid-based adjunctive therapeutic approaches for the management of periodontitis.

Inclusion Criteria: 1. Individuals aged 18 to 65 years. 2. Systemically healthy individuals. 3. Diagnosis of Stage I or Stage II periodontitis according to the 2017 Classification of Periodontal Diseases. 4. Probing pocket depth (PPD) ≤5 mm and clinical attachment loss (CAL) ≤4 mm. 5. Presence of a sufficient number of teeth for periodontal evaluation. 6. Willingness to participate and ability to provide written informed consent. Exclusion Criteria: 1. Patients with contraindications to the use of ultrasonic instrumentation. 2. Pregnant or lactating women. 3. Patients receiving anti-inflammatory or antibiotic therapy. 4. Patients with systemic diseases or medical conditions. 5. Patients receiving continuous medication for any medical condition. 6. Patients who have undergone periodontal treatment within the previous 6 months. 7. Patients presenting with acute dental pain (e.g., pulpitis or apical/periodontal abscess). 8. Individuals who smoke or consume alcohol. 9. Presence of fewer than 15 teeth.