Before enrollment, the randomized allocation of maxillary contra-lateral quadrants was determined with a coin-toss method in each subject by the investigator (Q.Y.). All patients received proper oral hygiene instruction and full-mouth supragingival scaling at the first visit. After 2 weeks, baseline recording of clinical parameters and microbiological sampling were performed by the examiner (Y.W.) who was blinded to the allocation. Then, the subgingival treatments were performed by the operator (J.Z.) and accomplished in 4 sessions arranged 1 week apart in each patient. As the split-mouth study design, the left or right maxillary quadrant sites with PD ≥ 4 mm was scaled and root planed with either EGCG solution or distilled water as coolants of the ultrasonic scaler. The sequence of each quadrant treatment was as follows: removing massive calculus and subgingival plaque with ultrasonic scaling (P3 Scaler Tip, SKL), thorough scaling and root planing to the bottom of periodontal pockets with hand instrumentation (Gracey Standard Curettes, Hu-Friedy®, Chicago, United States) until tooth surfaces were smooth and hard, then ultrasonic scaling at least 1 min per tooth (New-type Scaler Tip). Average 30–40 min was demanded for each quadrant where local infiltration anesthesia was conducted if necessary. The volume of either EGCG solution or distilled water consumed in each treatment was approximately 300–500 mL. The patients were informed to report if any discomfort related to the treatment was felt within 1 week.

The patients were recalled 3 and 6 months after treatment. All clinical parameters were recorded as baseline and microbiological samples were taken by the examiner (Y.W.), and the oral hygiene was reinforced when necessary. If there still existed study sites associated with PD ≥ 4 mm, the patients would receive ultrasonic scaling using the new-type scaler tip at a frequency of 24–33 kHz in accordance with the former allocation.

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