Inclusion criteria |
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   • Male or female |
   • 25 years of age or older |
   • Three or more periodontal pockets with a probing depth (PD) > 5 mm |
   • Have at least 16 natural teeth excluding third molars |
   • Provide informed consent and willingness to cooperate with the study protocol |
Exclusion Criteria |
   • History of antibiotic use in the previous three months |
   • Pregnant or lactating females |
   • Treatment with antihypertensive, antilipemic, antiarrhythmic, and other cardiovascular drugs |
   • Systemic diseases such as diabetes, HIV/AIDS, liver disease, chronic renal failure, tuberculosis, and autoimmune diseases |
   • Previous history of cardiovascular disease: Acute myocardial infarct, stable angina, unstable angina, heart failure, atrial fibrillation, AV blockade, peripheral vascular disease, and cerebrovascular accident |
   • Patients who received periodontal treatment within the last 6 months |
   • Patients who require antibiotic prophylaxis before examination or treatment |
   • Patients with some mental disability |