***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results The aim of the study was to investigate 1 ) whether laser treatment would enhance periodontal healing  after debridement , 2 ) if laser treatment would facilitate instrumentation , and 3 ) if laser treatment would provide sufficient analgesia . The used apparatus produced radiation equivalent to a Nd : YAG-laser and was equipped with a water spray . 27 individuals with periodontitis took part in the study . Single-rooted teeth in one quadrant were assigned test teeth by lot with contralateral teeth serving as controls . Test areas were first laser irradiated to produce analgesia . The root surfaces were treated with the laser set at higher power and scaled with curettes followed by lasing again . Control areas were treated by scaling alone .  Reduction of PPD and bleeding index after healing were similar in test and control areas . Laser treatment reduced the need of conventional anaesthetics , result ed in diminished bleeding and enhanced visual control at debridement . Thin calculus deposits were very easy to remove with h and instruments after lasing . The hemostatic effect of the laser may be an asset when performing periodontal scaling in individuals with a compromised coagulation mechanism Recent results of a limited clinical trial suggest that mechanical root scaling and root planing therapy alone may not be the most effective mode of treatment for patients affected by moderate to severe adult periodontitis . However , scaling and planing combined with laser therapy utilizing a low-powered pulsed Nd : YAG laser have been shown to be successful in the elimination of the bacteria commonly associated with the development of this oral condition . The double-blind , split mouth design study involved 10 human subjects r and omly assigned to one of three treatments : 1 ) scaling and root planing alone , 2 ) dental laser plus scaling and root planing , and 3 ) control only . This article presents the clinical results of the trial , which suggest that laser therapy is a viable adjunct to local , nonsurgical therapy such as scaling and planing BACKGROUND The Nd : YAG laser has recently been used in the treatment of periodontal disease . However , although a clinical reduction of probing depth and gingival inflammation to this new approach has been reported , it has not been fully evaluated . Interleukin-1 beta ( IL- 1beta ) , a potent stimulator of bone resorption , has been identified in gingival crevicular fluid ( GCF ) , which is closely associated with periodontal destruction . The aim of this study was to compare the effects of Nd : YAG laser treatment versus scaling/root planing ( SRP ) treatment on crevicular IL-1beta levels in 52 sample d sites obtained from 8 periodontitis patients . METHODS One or 2 periodontitis-affected sites with a 4 to 6 mm probing depth and horizontal bone loss from 3 adjacent single-root teeth in each of 4 separate quadrants were selected from patients for clinical documentation and IL-1beta assay . Sampling site(s ) from each diseased quadrant was r and omly assigned to one of the following groups : 1 ) subgingival laser treatment ( 20 pps , 150 mJ ) only ; 2 ) SRP only ; 3 ) laser treatment first , followed by SRP 6 weeks later ; or 4 ) SRP first , followed by laser therapy 6 weeks later . The GCF was collected and the amount of IL-1beta was assayed by enzyme-linked immunosorbent assay ( ELISA ) . Clinical parameters and GCF were measured at baseline and biweekly after therapy for 12 weeks . RESULTS An obvious clinical improvement ( marked decrease in the number of diseased sites with gingival index > or = 2 ) and reduction of crevicular IL- 1beta were found in all groups . The level of IL- 1beta was significantly lower in the SRP group ( P = 0.035 ) than in the laser therapy group for the duration of the 12 weeks . The laser combined SRP therapy group showed a further reduction of IL- 1beta ( 6 to 12 weeks after treatment ) than either laser therapy alone or SRP combined laser therapy . CONCLUSIONS Our data suggest that laser therapy appeared to be less effective than traditional SRP treatment . Of the 4 treatment modalities , inclusion of SRP was found to have a superior IL- 1beta response , when compared to other therapies without it . In addition , no additional benefit was found when laser treatment was used secondary to traditional SRP therapy The purpose of this study was to evaluate the effects of Nd : YAG laser treatment on root surfaces in vitro when used alone or in combination with conventional scaling and root planing . The study population consisted of 18 unerupted third molars , each with a 3 mm diameter treatment site outlined on the root surface . Three specimens were r and omly assigned to each of 6 different treatment groups : 1 ) untreated control ; 2 ) root planed only ; 3 ) laser treated only using 1.25 W of energy ; 4 ) laser treated only using 1.50 W of energy ; 5 ) laser treated with 1.25 W of energy followed by root planing ; and 6 ) laser treated with 1.50 W of energy followed by root planing . Following their respective treatment , all specimens were prepared for evaluation by scanning electron microscopy . Specimens from Group 2 , root planed only , exhibited a smear layer of scale-like texture with parallel instrument tracks result ing from curet use . Specimens treated by laser only , Groups 3 and 4 , featured various surface changes not observed in controls such as charring and carbonization of the cementum surface , r and omly distributed pitting and crater formation , and melting of the root mineral phase with subsequent resolidification as porous globules . Those specimens treated by laser followed by root planing , Groups 5 and 6 , exhibited surface characteristics similar to those noted in Group 2 specimens . Further , there were areas of exposed dentinal tubules result ing from a " peeling " of the cementum layer . The results of this in vitro study suggest that laser use during root preparation , even at relatively low energy levels , will result in physical changes to the root surface . ( ABSTRACT TRUNCATED AT 250 WORDS The purpose of this study was to compare the effects of scaling and Nd : YAG laser treatments with that of scaling alone on cementum and levels of Actinobacillus actinomycetemcomitans , Bacteroides forsythus , Porphyromonas gingivalis , and Treponema denticola . Study sample s consisted of 14 patients , age 30 to 75 years , 8 females and 6 males , with a total of 150 periodontally involved sites with probing depth > or = 5 mm . Group A consisted of 100 pockets that were subdivided into 4 equal groups that were treated with conventional scaling and pulsed Nd : YAG laser using an optic fiber of 300 microns and 4 different power levels as follows : Group 1 : P = 0.8 W , f = 10 Hz , E = 100 mJ/pulse ; Group 2 : P = 1.0 W , f = 1.0 Hz , E = 100 mJ/pulse ; Group 3 : P = 1.2 W , f = 12 Hz , E = 100 mJ/purse ; and Group 4 : P = 1.5 W , f = 15 Hz , E = 100 mJ/pulse . The time of each treatment was 60 sec per pocket in all 4 groups . Group B consisted of 50 pockets that were treated by conventional scaling alone and served as a control group . Microbiological sample s from group A were collected before scaling ; after scaling = before laser , just after laser , 2 weeks later , 6 weeks later , and 10 weeks later . Microbiological sample s from group B were collected before scaling , after scaling , 6 weeks later , and 10 weeks later . Microbiological analysis of all sample s was done by the Institute Für Angew and te Immunologie ( IAI ) method . The effects of laser on root surfaces were assessed by SEM examination and the sample consisted of 13 teeth from 5 different patients . Four sets of 3 teeth each were treated with Nd : YAG laser using 0.8 , 1.0 , 1.2 , and 1.5 W , respectively . One tooth was just scaled and not treated with laser to serve as a control . Microbiological analysis of Group A sample s indicated posttreatment reduction in levels of all 4 bacterial types tested compared to pretreatment levels and Group B controls . SEM examination of the specimens treated with Nd : YAG laser at different levels exhibited different features of root surface alterations AIM The aim of the study was to compare two methods of treatment for aggressive periodontitis : traditional surgical and Nd : YAG laser , evaluating their possible objective clinical advantages . MATERIAL S AND METHODS A total of 36 hemiarches of 18 patients were analysed , 10 males and 8 females of average age of 14 , selected according to predefined criteria . Overall we examined 70 radicular surfaces ( sites ) of 50 teeth . Each hemiarch to treat was r and omly assigned to one of two treatment groups . RESULTS AND CONCLUSION The results , analysed using the Friedman 's test , showed a clinical ly appreciable validity both for the surgical and the laser treatment , while the Wilcoxon signed-rank test did n't highlight any statistically significant difference between the two types of treatment . The laser itself appears as a valid alternative to conventional therapy , in relation to the young age of the patients and for individuals at increased anaesthesiological risk and /or with coagulation and platelet function disorders Application of a neodymium : yttrium-aluminum-garnet ( Nd : YAG ) laser was compared to conventional scalpel in dental soft tissue surgery . Two surgery sites on 29 patients were r and omly selected and treated . An additional 41 patients were exclusively treated with the Nd : YAG laser .  The surgical technique was then evaluated for periodontal pocket depths , degree of pain perceived , bleeding , inflammation , procedure time , and anesthesia . Surgical prognosis was made at the time of surgery and compared to actual healing 1 week and 1 month after surgery . No differences were observed between laser and scalpel surgery in terms of pocket depth reduction , postoperative pain , post-operative inflammation , and treatment time . However , operative and postoperative bleeding with laser surgery were significantly less than with conventional surgery . Anesthesia is required for scalpel surgery , the majority of laser-treated sites evoked minimal pain without anesthesia . These results indicate that the Nd : YAG laser can be used successfully for intraoral soft tissue applications are well tolerated without anesthesia and minimal bleeding compared to scalpel surgery The Nd : YAG laser efficacy associated with conventional treatment for bacterial reduction has been investigated throughout literature . The purpose of this study was to evaluate the bacterial reduction after Nd : YAG laser irradiation associated with scaling and root planning in class II furcation defects in patients with chronic periodontitis . Thirty-four furcation lesions were selected from 17 subjects . The control group received conventional treatment , and the experimental group received the same treatment followed by Nd : YAG laser irradiation ( 100 mJ/pulse ; 15 Hz ; 1.5 W , 60 s , 141.5 J/cm2 ) . Both treatments result ed in improvements of most clinical parameters . A significant reduction of colony forming unit ( CFU ) of total bacteria number was observed in both groups . The highest reduction was noted in the experimental group immediately after the treatment . The number of dark pigmented bacteria and the percentage of patients with Porphyromonas gingivalis , Prevotella intermedia , and Actinobacillus actinomycetemcomitans reduced immediately after the treatment and returned to values close to the initial ones 6 weeks after the baseline for both groups . The Nd : YAG laser associated with conventional treatment promoted significant bacterial reduction in class II furcation immediately after irradiation , although this reduction was not observed 6 weeks after the baseline Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to  
    Output:
    
The majority of the studies analyzed showed no beneficial effect of a pulsed Nd : YAG laser compared to conventional therapy ( ultrasonics and /or h and instrumentation ) in the initial treatment of patients with periodontitis .
This literature review suggests that there is no evidence to support the superiority of the Nd : YAG laser over traditional modalities of periodontal therapy