***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: BACKGROUND Two systematic review s have evaluated the quality of research and reporting of observational studies investigating the prevalence of , the incidence of and the risk factors for peri-implant diseases and of experimental clinical studies evaluating the efficacy of preventive and therapeutic interventions . MATERIAL S AND METHODS For the improvement of the quality of reporting for both observational and experimental studies , the STROBE and the Modified CONSORT recommendations were encouraged . RESULTS To improve the quality of research in peri-implant diseases , the following were recommended : the use of unequivocal case definitions ; the expression of outcomes at the subject rather than the implant level ; the implementation of study validation tools ; the reporting of potential sources of bias ; and the use of appropriate statistical methods . CONCLUSIONS In observational studies , case definitions for peri-implantitis were agreed . For risk factor determination , the progressive use of cross-sectional and case-control studies ( univariate analyses ) , to prospect i ve cohorts ( multilevel modelling for confounding ) , and ultimately to intervention studies were recommended . For preventive and interventional studies of peri-implant disease management , parallel arm RCTs of at least 6-months were encouraged . For studies of non-surgical and surgical management of peri-implantitis , the use of a composite therapeutic end point was advocated . The development of st and ard control therapies was deemed essential OBJECTIVE Our purpose was to measure the agreement , reliability , construct validity , and feasibility of a measurement tool to assess  systematic review s ( AMSTAR ) . STUDY DESIGN AND SETTING We r and omly selected 30 systematic review s from a data base . Each was assessed by two review ers using : ( 1 ) the enhanced quality assessment question naire ( Overview of Quality Assessment Question naire [ OQAQ ] ) ; ( 2 ) Sacks ' instrument ; and ( 3 ) our newly developed measurement tool ( AMSTAR ) . We report on reliability ( interobserver kappas of the 11 AMSTAR items ) , intraclass correlation coefficients ( ICCs ) of the sum scores , construct validity ( ICCs of the sum scores of AMSTAR compared with those of other instruments ) , and completion times . RESULTS The interrater agreement of the individual items of AMSTAR was substantial with a mean kappa of 0.70 ( 95 % confidence interval [ CI ] : 0.57 , 0.83 ) ( range : 0.38 - 1.0 ) . Kappas recorded for the other instruments were 0.63 ( 95 % CI : 0.38 , 0.78 ) for enhanced OQAQ and 0.40 ( 95 % CI : 0.29 , 0.50 ) for the Sacks ' instrument . The ICC of the total score for AMSTAR was 0.84 ( 95 % CI : 0.65 , 0.92 ) compared with 0.91 ( 95 % CI : 0.82 , 0.96 ) for OQAQ and 0.86 ( 95 % CI : 0.71 , 0.94 ) for the Sacks ' instrument . AMSTAR proved easy to apply , each review taking about 15 minutes to complete . CONCLUSIONS AMSTAR has good agreement , reliability , construct validity , and feasibility . These findings need confirmation by a broader range of assessors and a more diverse range of review BACKGROUND Chronic infections , such as periodontitis , are associated with increased risk of systemic diseases driven by a persistent low- grade systemic inflammation and metabolic changes . Severity of periodontitis has also been associated with increased systolic blood pressure ( BP ) . However , the issue remains poorly investigated . We aim ed to estimate the effect of periodontal therapy on traditional and novel cardiovascular risk factors in systemically healthy individuals who have periodontitis . METHODS We enrolled 40 otherwise healthy patients with severe chronic generalized periodontitis in a 6-month pilot intervention trial . Individuals were r and omized either to a st and ard course of periodontal therapy ( subgingival scaling and root planing ) or an intensive one ( including the adjunctive use of a locally delivered antimicrobial , IPT ) . RESULTS Compared to control , IPT produced significant reductions in a cluster of inflammatory markers at 1 ( P = .0406 ) and 2 ( P = .0060 ) months together with an improvement in lipid markers at 2 ( P = .0320 ) and 6 ( P = .0432 ) months after therapy . Intensive periodontal therapy produced greater reductions in IL-6 at 1 ( 0.4 + /- 0.2 ng/L difference , 95 % CI 0.03 - 0.9 , P = .0284 ) and 2 months ( 0.3 + /- 0.2 ng/L difference , 95 % CI 0.1 - 0.8 , P = .0284 ) , together with decreases in C-reactive protein ( 0.4 + /- 0.2 mg/L difference , 95 % CI 0.01 - 0.8 , P = .0438 ) and total cholesterol ( 0.3 + /- 0.1 mmol/L difference , 95 % CI 0.04 - 0.6 , P = .0254 ) . Moreover , a 7 + /- 3-mm Hg decrease in systolic BP was observed at 2 months in the IPT group ( 95 % CI 1 - 12 , P = .0211 ) , and this difference was greater in current smokers ( 14 + /- 5 mm Hg 95 % CI 3 - 25 , P = 0.0124 ) . Intensive periodontal therapy subjects exhibited a 1.53 % + /- 1.20 % ( 95 % CI 1.05 - 2.24 , P = .0290 ) and 2.00 % + /- 1.42 % ( 95 % CI 0.98 - 4.09 , P = .0568 ) decreases in cardiovascular risk scores ( Framingham ) at 2 and 6 months , respectively , when compared to those in the st and ard group . CONCLUSIONS Our findings suggest that intensive periodontal treatment  reduces systemic inflammatory markers and systolic BP , and improves lipid profiles with subsequent changes in cardiovascular risk when compared to st and ard therapy BACKGROUND This retrospective study was set to assess the influence of systemic and local bone and intra-oral factors on the occurrence of implant loss from abutment connection up to 2 years . MATERIAL S AND METHODS The files of 700 patients , have been collected r and omly from the total patient group treated by means of endosseous Brånemark system implants ( Nobel Biocare , Gothenburg , Sweden ) at the Department of Periodontology of the University Hospital of the Catholic University of Leuven . The end point observation was evaluating the loss of the implants 2 years after abutment installation . The study involved all implants that did not encounter early loss and implants for which it was possible to evaluate its status 2 years after abutment surgery . Thus , data of 412 patients ( 240 females ) provided with 1514 implants were analyzed . For each patient , the medical history was carefully checked . Data collection and analysis were mainly focused on endogenous factors such as hypertension , coagulation problems , osteoporosis , hypo- hyperthyroidism , chemotherapy , diabetes type I or II , Crohn 's disease , some local factors [ e.g. bone quality and quantity , implant ( length , diameter , location ) , type of edentulism , PTV , radiotherapy ] , smoking habits , and breach of sterility during surgery . RESULTS Radiotherapy , implant ( diameter and location ) , and higher PTV at implant insertion and abutment connection , all affected significantly the implant loss . CONCLUSION Implant location in the oral cavity and radiotherapy seem predominant to explain the occurrence of implant loss . On the other h and , smoking and systemic health factors do not seem to be prominent players in the etiology of late implant loss BACKGROUND Peri-implant marginal bone-level ( MBL ) alteration represents one of the parameters included in the criteria for determining implant health . OBJECTIVE Factors affecting peri-implant MBL alteration for  4-implant-supported fixed m and ibular prostheses ( 4-ISFMP )  were assessed . MATERIAL & METHODS A 3-year prospect i ve , cohort study was conducted on 44 m and ibularly edentulous patients treated with 4-ISFMP .  Peri-implant MBL alteration  was evaluated radiographically at the 12- , 24- and 36-month follow-ups considering to patient-related risk factors [ age , gender , diabetes mellitus , smoking , cardiovascular disease ( CVD ) , rheumatic disorders ( RD ) ] and implant/prosthesis-related features ( implant location , keratinized gingiva , denture cantilever length , prosthesis supporting zone , opposing dentition ) as well as to peri-implant biological parameters ( plaque- , bleeding- , calculus index ) . RESULTS 148/176 implants ( 37 patients , drop-out : 15 % ) were followed for 3 years showing significant ( p < 0.001 ) annual differences of MBL alterations over time . The univariate analysis demonstrated differences of MBL alterations for smokers ( p = 0.014 ) , for patients with CVD ( p = 0.001 ) and RD ( p = 0.011 ) . In the 3-year multivariate analysis , MBL alteration was influenced by time ( p < 0.001 ) and showed relationship with risk factors as smoking ( p < 0.002 ; OR = 18.965 ) , CVD ( p < 0.021 ; OR = 5.172 ) , RD ( p < 0.006 ; OR = 50.171 ) and plaque-index ( p = 0.034 ; OR = 3.252 ) . CONCLUSIONS Although peri-implant MBL alteration increased annually , significant odds ratios , were found for patients -related risk factors identifying them potentiating the alterations AIM This study aim ed to assess the influence of systemic and local bone and intra-oral factors on the occurrence of early TiUnite implant failures . MATERIAL AND METHODS A total of 283 consecutive patients ( 187 females ; mean age 56.2 ) , who received a total of 720 TiUnite implants , at the Department of Periodontology of the University Hospital of the Catholic University of Leuven , were prospect ively followed . The following aspects were particularly assessed : hypertension , cardiac problems , gastric problems , osteoporosis , hypo- or hyperthyroid , hypercholesterolaemia , asthma , diabetes types I or II , Crohn 's disease , rheumatoid arthritis , chemotherapy , hysterectomy and intake of medication ( antidepressants , steroids , hormone replacement ) , radiotherapy of the concerned area , breach of sterility during surgery , implant parameters , bone ( quality , quantity , dehiscence or perforation ) , type of edentulism , antibiotics prescription , fenestration of the implant in the sinus/nasal cavity , immediate implant placement , apical lesion detection and insertion torque . RESULTS AND CONCLUSION A global failure rate of 1.9 % was recorded . Owing to the very few failures , no definitive conclusion concerning statistical significance can be achieved . However , a tendency for more failures was noticed for apical lesions , vicinity with natural dentition , smoking , hormone replacement , gastric problems , Crohn 's disease , diabetes I and radical hysterectomy BACKGROUND Population -based clinical and laboratory studies have reported findings providing support for a possible relationship between periodontal disease and cardiovascular disease . The Periodontitis and Vascular Events ( PAVE ) pilot study was conducted to investigate the feasibility of a r and omized secondary prevention trial to test whether treatment of periodontal disease reduces the risk for cardiovascular disease . METHODS Five clinical centers recruited participants who had documented coronary heart disease and met study criteria for periodontal disease . Eligible participants were r and omized to receive periodontal therapy provided by the study or community dental care .  Follow-up telephone calls and clinic visits were planned to alternate at 3-month intervals after r and omization , with all participants followed until at least the 6-month clinic visit . Participants were followed for adverse events and periodontal and cardiovascular outcomes . RESULTS A total of 303 participants were r and omized . Recruitment that involved active participation of a cardiologist with responsibility for the patients worked best among the strategies used . Of those who had not withdrawn , 93 % completed the 6-month contact . During follow-up , 11 % of the 152 subjects in the community dental care group reported receiving periodontal therapy outside of the study . CONCLUSIONS If appropriate recruitment strategies are used , this pilot study demonstrated that it is feasible to conduct a secondary prevention trial of periodontal therapy in patients who have had coronary heart disease . If a community dental care group is used , sample size estimation needs to take into account that a non-trivial proportion of participants in this group may receive periodontal therapy outside of the study PURPOSE The objectives of this study were to evaluate implant survival and success in the elderly population and to assess indicators and risk factors for success or failure of  dental implants in older adults ( aged 60 years and older ) . MATERIAL S AND METHODS This historical prospect i ve study was developed from a cohort of patients born prior to 1950 who received dental implants in a single private 
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No study directly related to MetS was found , there was inconsistent and controversial evidence regarding association with cardiovascular disease .
A higher risk of peri-implantitis was detected in people with hyperglycemia .