***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 Scaling and root planing , osseous surgery , and modified Widman procedures are effective methods for treating periodontal diseases . Studies have been carried out to determine if these procedures are more effective than others in reducing clinical probing depths , while maintaining clinical attachment levels . The purpose of this report is to present 5-year results from a longitudinal study comparing scaling and root planing ( SRP ) , osseous surgery ( OS ) , and modified Widman ( MW ) therapies . The study has been completed for 12 years . METHODS Sixteen adult patients with moderate to advanced periodontal disease were treated with initial scaling and oral hygiene procedures in a private practice . Posthygiene data were used to compare changes in plaque and gingival indices , probing depth ( PD ) , clinical attachment levels ( CAL ) , and recession . Frequency distributions were used to compare changes at individual sites . The first published report was from baseline to one year . This follow-up report is from baseline through 5 years . RESULTS At 5 years , there were significant decreases in gingival and plaque scores . For the 3 procedures , there were significant decreases in baseline 4 to 6 mm PD ( P<0.0001 ) ; however , there were no differences between the methods . Similar findings were noted for PD initially greater than 7 mm . At 5 years , OS had the greatest number of 1 to 3 mm sites ( 332 sites , 73.2 % ) , while MW had the fewest number of 4 to 6 mm PD ( 98 sites , 21.8 % ) . SRP had the fewest 7 mm and greater sites ( 15 sites , 3.4 % ) . At 5 years , CAL loss for 1 to 3 mm PD was statistically significant for the 3 procedures . There were slight gains in CAL for 4 to 6 mm probing depths . These gains were not significant . Similar findings were seen for CAL for probing depths greater than 7 mm . OS had the greatest number of sites losing more than 2 mm of CAL ( 64 sites ) , followed by SRP ( 21 sites ) and MW ( 34 sites ) , respectively . CONCLUSIONS This 5-year clinical trial demonstrates that with good patient maintenance excellent clinical results can be achieved with various methods of treatment . Within the limits of this study , SRP , OS , and MW were effective at reducing probing depths with slight changes in clinical attachment levels AIM To evaluate the clinical , microbiological and immunological effects of systemic doxycycline as an adjunct to scaling and root planing ( SRP ) in chronic periodontitis patients with well-controlled type 2 diabetes . MATERIAL S AND METHODS Sixty-six patients compliant to oral hygiene ( Hygiene Index < 20 % ) allocated to either a test ( systemic doxycycline for 21 days ) or a control ( placebo ) group participated in the present r and omized controlled trial ( RCT ) . Clinical assessment s were recorded at baseline , 3 and 6 months after therapy and included clinical attachment level ( CAL ) , set as the primary outcome of the study , probing pocket depth ( PPD ) , recession ( RE ) and bleeding on probing ( BOP ) . At the same time points , counts of 15 subgingival species were evaluated by " checkerboard " DNA-DNA hybridization , gingival crevicular fluid sample s were analysed for matrix metalloproteinase-8 ( MMP-8 ) by ELISA and HbA1c levels were determined . Comparisons between and within groups were performed by non-parametric tests ( Mann-Whitney , Wilcoxon signed-ranks and z-test for proportions with Bonferroni corrections ) at the 0.05 level . RESULTS No major differences were noticed in clinical and microbiological parameters of periodontal disease or levels of MMP-8 between the two groups . CONCLUSIONS Adjunctive systemic doxycycline does not seem to significantly enhance the effects of SRP in well-controlled diabetes type 2 patients Purpose The purpose of study was to compare glycemic control using glycated hemoglobin levels ( HbA1c ) in diabetic patients with chronic generalized periodontitis ( CGP ) undergoing scaling and root planing ( SRP ) with and without systemic doxycycline . Methods Fifty subjects with type 2 diabetes mellitus ( T2DM ) and CGP receiving antidiabetic therapy were selected for study . The selected subjects were r and omly assigned to two groups ( test group [ TG ] and control group [ CG ] ) comprising 25 patients each . The TG received SRP followed by systemic doxycycline . The CG received treatment with SRP only . The periodontal parameters were recorded at baseline ( day zero ) , and every 1 month for 4 months and included probing depth , clinical attachment level , plaque index , gingival index , and HbA1c level were recorded at baseline ( day zero ) and at the end of 4 months . Results A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG . HbA1c values did not show a statistically significant difference in the treatment group as compared to the CG . Conclusions The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with T2DM in both groups , but no statistical difference was observed with adjunctive systemic doxycycline therapy . A further study with a larger sample size is required Objectives : To evaluate the effects of systemic doxycycline on clinical and microbiological parameters of diabetic subjects with chronic periodontitis . Methods : This 9-month multi-center , r and omized , parallel , single-blinded study was conducted from different hospitals in Riyadh , Saudi Arabia between April 2010 and December 2010 . A total of 76 diabetic subjects with chronic periodontitis were r and omized into 2 groups : control group ( CG ) received only scaling and root planing ( SRP ) , and the treatment group ( TG ) receiving systemic doxycycline during the reevaluation visit 45 days after the completion of SRP .  Probing pocket depth , clinical attachment level , gingival index , plaque index , and bleeding on probing were collected at baseline , 45 days after SRP , and one , 3 , and 6 months after the use of systemic doxycycline . Microbiological analysis comprised the detection of Tannerella forsythia ( Tf ) , Aggregatibacter actinomycetemcomitans ( Aa ) , Porphyromonas gingivalis ( Pg ) , and Prevotella intermedia ( Pi ) by polymerase chain reaction method . Results : Sixty-eight ( 33 CG and 35 TG ) subjects completed the study . Greater reduction in the population of Tf , Pg , and Pi were observed in TG compared with CG in the first month after the administration of systemic doxycycline . The TG showed a significant improvement in gingival index scores compared with the CG ( p<0.05 ) by the end of the first and 6 months after the administration of doxycycline . Conclusion : Adjunct systemic doxycycline can be associated with a reduction of Tf , Pg , and Pi in the first month after the administration of doxycycline with an improvement in the GI BACKGROUND This study assessed the long-term effects of adjunctive antimicrobial therapy on  periodontal disease progression and oral colonization . METHODS Patients with previously untreated chronic periodontitis and subgingival Actinobacillus actinomycetemcomitans and /or Porphyromonas gingivalis were r and omly assigned to subgingival scaling without ( control group ) or with systemic amoxicillin plus metronidazole and CHX irrigation ( test group ) . Relative attachment levels were determined and subgingival and mucosal plaque sample s were taken at baseline , at 10 days ( plaque only ) and at 3 , 6 , 9 , 12 , 18 , and 24 months following initial therapy . During maintenance therapy , patients received supragingival debridement only . RESULTS After 24 months , the 18 test group patients showed at sites with initial probing depths ( PD ) > or = 7 mm a significantly ( P < 0.05 ) higher frequency of 2 mm or more attachment gain ( 37.3 % + /- 4.6 % ) and lower frequency of attachment loss ( 7.2 % + /- 3.1 % ) compared to the 17 controls ( 8.2 % + /- 3.9 % and 19.1 % + /- 13.1 % , respectively ) . Compared to controls , the intraoral prevalence of A. actinomycetemcomitans ( up to 18 months ) and P. gingivalis ( up to 3 months ) decreased and that of Eikenella corrodens ( at 10 days ) increased in test patients ( P < 0.05 ) . In both treatment groups , the detection frequency of Tannerella forsythensis decreased transiently , while an overall increase was recorded for Treponema ssp . CONCLUSIONS Over the 24-month period , a single course of the administered adjunctive antimicrobial therapy led to a relative risk reduction of 62 % for attachment loss at deep sites . However , with the exception of A. actinomycetemcomitans , it failed to induce long-term changes in the prevalence profiles of oral colonization Abstract s on this page have been chosen and edited by Dr Trevor Watts Abstract Periodontal treatment improved periodontal health but did not affect glycaemic control BACKGROUND Periodontitis , a complication of diabetes mellitus ( DM ) , can induce or perpetuate systemic conditions . This double-masked , placebo-controlled study evaluated the effects of periodontal therapy ( scaling and root planing [ SRP ] ) on the serum levels of glycated hemoglobin ( HbA1c ) and on inflammatory biomarkers . METHODS Thirty subjects with type 2 DM and periodontitis were treated with SRP + placebo ( SRP ; N = 15 ) or with SRP + doxycycline ( SRP+Doxy ; N = 15 ) , 100 mg/day , for 14 days . Clinical and laboratory data were recorded at baseline and at 3 months after treatment . RESULTS After 3 months , the reduction in probing depth was 0.8 mm for the SRP group ( P < 0.01 ) and 1.1 mm for the SRP+Doxy group ( P < 0.01 ) followed by a 0.9 % ( SRP ; P = 0.17 ) and 1.5 % ( SRP+Doxy ; P < 0.01 ) reduction in HbA1c levels . A significant reduction in interleukin (IL)-6 ; interferon-inducible protein 10 ; soluble fas lig and ; granulocyte colony-stimulating factor ; RANTES ; and IL-12 p70 serum levels were also verified ( N = 30 ) . To our knowledge , this is the first report on the effects of periodontal therapy on multiple systemic inflammatory markers in DM . CONCLUSIONS Periodontal therapy may influence the systemic conditions of patients with type 2 DM , but no statistical difference was observed with the adjunctive systemic doxycycline therapy . Moreover , it is possible that the observed improvement in glycemic control and in the reduction of inflammatory markers could also be due to diet , which was not controlled in our study . Therefore , a confirmatory study with a larger sample size and controlled diet is necessary AIMS : The purpose of this study is to investigate the effect of improved periodontal health on glycemic control in type 2 diabetes mellitus ( type 2 DM ) patients who have generalized periodontitis . MATERIAL S AND METHODS : A total of 45 type 2 DM patients with generalized periodontitis were selected for the study . The selected patients were r and omly assigned to three groups ( groups A , B , and C ) comprising 15 patients each : • Group A received treatment with scaling and root planing only . • Group B received treatment with scaling and root planing followed by systemic doxycycline . • Group C received no treatment ( control group ) . The periodontal parameters recorded included plaque index , gingival index , probing pocket depth , and clinical attachment level . These parameters were recorded at baseline ( day zero ) , at 1 month , and at the end of 3 months . The following metabolic parameters were recorded : fasting blood glucose ( FBG ) , postpr and ial blood glucose ( PPBG ) , and glycated hemoglobin . These were recorded at baseline ( day zero ) and at the end of 3 months . STATISTICAL ANALYSIS : All the parameters were subjected to repeated- measures ANOVA and Scheffe 's post hoc test . RESULTS : A statistically significant effect could be demonstrated for periodontal parameters for both group A and group B ( treatment groups ) . Glycated hemoglobin values showed statistically significant decrease in treatment groups compared to the control group , with group B showing more significant decrease than group A. CONCLUSIONS : The results of this study showed that nonsurgical periodontal treatment is associated with improved glycemic control in type 2 DM patients BACKGROUND Periodontitis is a major cause of tooth loss among adults . Several studies have shown a possible systemic impact of periodontal infection , including poor glycemic control in patients with diabetes . Recently , photodynamic therapy ( PDT ) was used to successfully treat periodontal infection . PDT provides a broad spectrum antimicrobial efficacy with no local or systemic side effects . The objective of this study was to examine the effect of the adjunctive use of PDT on periodontal status and glycemic control of patients with diabetes and periodontitis . METHODS Forty-five patients with type 2 diabetes and moderate to severe chronic periodontitis were selected and r and omly assigned to one of the following three treatment modalities ( 15 subjects each ) : scaling and root planing ( SRP ) only , SRP plus systemic doxycycline , and SRP plus PDT . The plaque and ble 
    Output:
    
ConclusionS ystemic doxycycline when used in addition to scaling and root planing yields no significant improvement of clinical attachment levels for periodontal status and reduction of HbA1c levels in treatment of diabetic patients with periodontitis when comparing the test group to the control group