***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: Several types of air turbine scalers have recently been introduced as an alternative to ultrasonic equipment in periodontal therapy . The aim of this investigation was to compare clinical , periodontal healing after scaling with the Titan S air turbine scaler and h and instruments .  Twelve patients referred to the School of Dental Hygiene , Jönköping , Sweden , for treatment of moderately advanced periodontitis participated in the study . After examination , diagnosis , treatment planning , and information , the teeth of the left and right quadrants were r and omly assigned to Titan S or h and instruments scaling ( " split mouth design ") . The treatment was given by 6 dental hygiene students . Final re-examination was performed 3 months after instrumentation . After treatment , a marked improvement of periodontal conditions , expressed as number of tooth surfaces with plaque , number of sites with probing pocket depth greater than or equal to 4 mm and percentage of sites showing bleeding on probing to the bottom of the pocket , was obtained . No difference in results was observed when comparing Titan S and h and instrumentation . The time required for instrumentation was , however , shorter for Titan S than for h and instruments . Based on the results of this study , it may be concluded that , in patients with moderately advanced periodontitis , periodontal healing after scaling with the Titan S and h and instruments is comparable Several studies have found incomplete calculus removal during periodontal treatment with traditional h and curets , sonic , and ultrasonic instruments . This study evaluated the speed and effectiveness of subgingival calculus removal with new diamond-coated ultrasonic tips on single-rooted teeth . Single session subgingival scaling and root planing was performed on 80 teeth with 5 to 12 mm probing depths in 15 patients . Each patient provided groups of 4 teeth that were r and omly treated with either h and curets ( H AND ) ; st and ard smooth ultrasonic tip ( US ) ; or fine grit ( FINDIAM ) or medium grit ( MEDDIAM ) diamond-coated ultrasonic tips . The time taken to reach the therapeutic endpoint of a clean , smooth root surface in a defined region on each tooth with each instrument by the 3 therapists with differing experience levels was recorded . The teeth were then atraumatically extracted , stored in a surfactant , photographed at 10X , and the percent of calculus present in the area of the pocket or on a comparable control surface calculated by histometric point counting . ANOVA and paired t tests showed that mean percent remaining calculus on treated versus control surfaces was H AND 4.6 + /- 5.3 versus 57.5 + /- 28.2 , US 4.7 + /- 6.4 versus 54.4 + /- 25.9 , FINDIAM 4.3 + /- 5.2 versus 37.5 + /- 22.1 , and MEDDIAM 3.4 + /- 4.2 versus 50.7 + /- 20.1 , respectively ( all P < 0.01 ) . The mean time in seconds to reach the clinical endpoint ranged from H AND 289 + /- 193 , US 194 + /- 67 , FINDIAM 167 + /- 71 , to MEDDIAM 147 + /- 92 . All powered instruments were significantly faster than H AND ( P < 0.05 ) , but did not differ from each other . On a 0 = " smooth " to 3 = " rough " scale , most often H AND result ed in " smooth " surfaces ( 10/20 ) , the powered tips of all types " slight " surface roughness ( 10/20 each ) , and US the most " moderate " roughness ( 7/20 ) . There were no differences in percent calculus remaining , surface roughness , or time spent among the 3 treating clinicians despite their varying experience levels . The results of this study showed that percent calculus remaining was < 5 % with all the instruments given time ad libitum on a given root surface . Root roughness was generally slightly greater with all 3 powered tips . All of the powered instruments took significantly less time than the H AND . Both DIAM tips took less time than US . Diamond-coated ultrasonic tips appeared to be much more efficient than H AND or US in removing calculus in moderate-deep probing depths on single-rooted teeth in vivo As practitioners strive to improve the delivery of patient care , it is increasingly important that they find it easier to identify studies with the highest level of evidence . Once found , there must be some assurance that the studies were carried out satisfactorily and the methodology was sound . To assist in meeting this challenge , the Consoli date d St and ards of Reporting Trials ( CONSORT ) guidelines were developed by a team of dedicated journal editors , epidemiologists , and statisticians . They determined the st and ards for authors reporting the findings of controlled clinical trials . CONSORT comprises a checklist and a flow diagram ( Figs 1 and 2 ) to help improve the quality of reports of r and omized controlled trials ( RCTs ) . It offers a st and ard way for research ers to report their findings . The checklist includes items , based on evidence , that should be addressed in the report ; the flow diagram gives readers a clear picture of the progress of all participants in the trial , from the time they are r and omized until the end of their involvement . The intent is to make the experimental process transparent , flawed or not , so that users of the data can more appropriately evaluate the validity for their purpose s. The key elements start when the research er su bmi ts an article for review and completes the st and ardized forms . The completed checklist should accompany the manuscript through the review process and identify the page on which each item is addressed . The completed flow diagram should appear as a figure in the manuscript . Nearly a year ago , the AJO-DO m and ated a structured abstract with each su bmi ssion ; this is one of the first items on the CONSORT checklist . There are good reasons for this change and for all other requests listed . According to Sharma and Harrison , “ the quality of information provided in journals with structured abstract s is greater than in those with nonstructured abstract s. ” These authors concluded that the quality of information in an abstract improves when a journal changes to a structured format . AIM The aim of this study was to evaluate in vivo the effectiveness of scaling and root planing of a power-driven mechanism compared with h and instruments and ultrasonic insert alone with a split-mouth design after 3 and 6 months . METHODS Healing events after initial periodontal therapy were investigated in 20 patients with moderate-to-severe adult periodontitis .  Plaque index ( PlI ) , bleeding on probing ( PBI ) , probing pocket depth ( PPD ) , probing attachment level ( PAL ) and number of moderate and deep pockets ( NMP , NDP ) were recorded at baseline and 3 and 6 months after treatment . Oral hygiene instruction was provided for each patient . R and omly assigned quadrants per patient were scaled and root planed with h and instrumentation ( curettes , hoes and files ) , with reciprocating power-driven instruments , with ultrasonic scaler alone and with the combined use of ultrasonic scaler and power-driven inserts . The Friedman test was applied to test the significance of difference between the various methods of root instrumentation . Repeated measures of analysis of variance ( manova ) were used to analyse the time effect on the different treatments . RESULTS At the 6-month evaluation , all groups in the scaling and root planing treatment presented with an improvement in the measured clinical parameters , as compared with baseline . No statistical differences ( p>0.05 ) were observed in the assessed periodontal indices among the study sites between the four groups for either treatment . CONCLUSIONS Under our experimental conditions , this clinical study demonstrates that mechanized root planing with power-driven instruments , as effective as the usual procedures ( h and and sonic instruments ) , represents a satisfactory and alternative means of nonsurgical root therapy 
    Output:
    
The use of a letter grade scale allowed an objective analysis of the quality of evidence .
A checklist-driven model that assesses and applies evidence to dental practice may substantially improve dentists ' decision making skill