## 4 Discussion

Table 2: Periodontal and microbial parameters among the A + B groups and C group after treatment. T. donticola, T. forysthia, F. nucelatum, and C. rectus\". In effect, the conclusions of the authors were exactly the same as those published in 2016 from [PERSON] et al. [27]. The technologies based on real-time PCR allowed us to evaluate and compare the microbiological analysis before and after the treatment with the two protocols. The results of our research take on greater significance if we divide the population under study into two groups:  
* Test group (group A and group B);
* Control group (group C). Revealed in line with the efforts of the authors who, over the years, have investigated the qualitative and quantitative presence of bacteria involved in the onset and progression of periodontal and peri-implant disease, the data thus analyzed show the following:  
* There is a correlation between the severity of periodontitis and the total quantity of the bacterial load inside the periodontal pockets [1; 2; 32];
* Actinomycetemcomitans, being a pathogen responsible for the aggressive forms in adolescent patients, was found in minimal concentrations or even observed to be absent, which was in line with the chosen sample (2% of AA in adult periodontitis) [32];
* Real-time PCR proved to be a decisive technique for the objective of our study, allowing us to qualitatively and quantitatively detect the main anaerobes involved in periodontal disease [31; 32]. Subsequently, with the data obtained, by repeating the real-time PCR test, it was possible to determine the presence of any active sites after treatment and assist the patient in determining future recall intervals (follow-up). In conclusion, it can be stated that in the sample groups (groups A, B and C) at times T1, T2 and T3, respectively, a higher relative proportion (%) of _P. gingivalis, T. forysthia_ and _T. donticola_ was found, as well as a minor amount of _F. nucelatum_ ssp. and _P. intermedia_ and an almost zero relative proportion of _A. actinomycetemcomitans_. In particular, we found the following:  
* At T2 (microbiological sampling performed one week after the end of treatment with the respective protocols), there was a reduction of the average bacterial load of 80.3% in the subjects belonging to group A, a reduction in the average bacterial load of 81.4% in the subjects belonging to group B and a reduction in the bacterial load of 46.4% in the subjects belonging to group C;
* At T3 (microbiological sampling 9 months after the end of treatment with the respective protocols), there was a reduction in the average bacterial load of 59.9% (compared with T1) in the subjects belonging to group A, a reduction in the average bacterial load of 70.1% (compared with T1) in the subjects belonging to group B and a reduction in the average bacterial load of 8.9% (compared with T1) in the subjects belonging to group C.  
Therefore, it was shown that the use of the OHLLT protocol (group B) led to a greater reduction in the total bacterial count than the use of the LANAP protocol in the long term (group A). In the research, in the nonsurgical periodontal treatment, the use of LANAP and OHLLT protocols confirmed, in a microbiological evaluation with real-time PCR, an effective ability to reduce the bacterial load present inside the periodontal pockets [8; 9; 10; 11; 21; 22; 23; 24; 25; 26; 27; 28; 30; 31], compared with conventional debridement, made by conventional instruments [1; 2]. In particular, for the clinical measurements, we considered and measured the plaque index, bleeding on probing and probing depth at the beginning of treatment (T1) and after 9 months (T3). The plaque indexes, influenced by the same oral hygiene procedures in all groups, were equivalent in all groups. The bleeding on probing results at 9 months were equivalent for group A (97%) and group B (95%) and showed poor results for group C (48.8%).