***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: OBJECTIVE The aim of this study was to detail the clinical efficacy of low-level laser therapy ( LLLT ) for the management of bisphosphonate-induced osteonecrosis of the jaws ( ONJ-BP ) . BACKGROUND ONJ-BP is the correct term , recently emerged , to describe a significant complication in a subset of patients receiving drugs such as zoledronic acid , pamidronate , and alendronate .  No definitive st and ard of care has been set for ONJ-BP and no definitively agreed guidelines have been provided . There is currently no consensus on the correct approach to the issue . MATERIAL S AND METHODS The investigators studied a prospect i ve cohort of 20 patients affected by ONJ-BP , who received biostimulation with  a pulsed diode laser ( GaAs ) . Patients were exposed to a 904-nm infrared laser ( 50 kHz , 28.4 J/cm(2 ) energy density , 40 % duty cycle , spot size 0.8 cm ) . Outcome variables were the size of lesions , edema , visual analogue score of pain , presence of pus , fistulas , and halitosis . Preoperative results were compared with the postoperative outcome and statistically evaluated . RESULTS Four weeks after LLLT , a statistically significant difference was observed for reported pain ( p = 0.0001 ) , clinical size ( p = 0.0034 ) , edema ( p = 0.0005 ) , and presence of pus and fistulas ( p = 0.0078 and p = 0.03 , respectively ) . CONCLUSION This study suggests that LLLT would appear to be a promising modality of treatment for patients with ONJ-BP , providing that clinical efficacy is safe and well tolerated , especially by those patients who require conservative treatment . Of course , this needs to be addressed further in larger and r and omly controlled studies in different clinical setting Bisphosphonates ( BSPs ) are used for the treatment of multiple myeloma , metastatic breast and lung cancer , Paget 's disease , osteoporosis , hypercalcemia due to malignancy , and many other skeletal diseases . BSPs reduce osteoclastic functions , which result in bone resorption . Bisphosphonates-related osteonecrosis of jaws ( BRONJ ) is a newly developed term that is used to describe the significant complication in patients receiving bisphosphonates .  BSPs are known to exhibit an anti-angiogenetic effect that initiates tissue necrosis of the hard tissue . There is currently no consensus on the correct approach to this issue . The aim of this retrospective study is to compare the effects of laser surgery with biostimulation to conventional surgery in the treatment of BSP-induced avascular bone necrosis on 20 patients who have been treated in our clinic . BRONJ was evaluated in patients with lung , prostate , and breast cancer under intravenous BSP treatment . Twenty patients in this study developed m and ibular or maxillary avascular necrosis after a minor tooth extraction surgery or spontaneously . Bone turnover rates were evaluated by serum terminal C-telopeptide levels ( CTX ) using the electrochemiluminescence immunoassay technique and patients were treated with laser or conventional surgical treatments and medical therapy . Ten patients were treated with laser surgery and biostimulation . An Er : YAG laser ( Fotona Fidelis Plus II ® Combine laser equipment , Slovenia ) very long pulse ( VLP ) mode ( 200 mJ , 20 Hz ) using a fiber tip 1.3 mm in diameter and 12 mm in length was used to remove the necrotic and granulation tissues from the area of avascular necrosis . Biostimulation was applied postoperatively using an Nd : YAG laser . Low-level laser therapy ( LLLT ) was applied to the tissues for 1 min from 4 cm distance using an Nd : YAG laser ( Fotona-Slovenia ) with a R24 950-µm fiber h and piece long-pulse ( LP ) mode , 0.25-W , 10 Hz power/cm2 from the mentioned distance the spot size was 0.4 cm2 , and power output was 2.5 J. Energy density from the mentioned distance was calculated to be 6.25 J/cm2 . The other ten patients were treated with conventional surgery . Treatment outcomes were noted as either complete healing or incomplete healing . There were no statistically significant differences between laser surgery and conventional surgery  ( p > 0.05 ) . CTX values also did not affect the prognosis of the patients . Treatment outcomes were significantly better in patients with stage II osteonecrosis than in patients with stage I osteonecrosis . Our findings suggest that dental evaluation of the patients prior to medication is an important factor in the prevention of BRONJ .  Laser surgery is a beneficial alternative in the treatment of patients with this situation . Further r and omized studies with larger patient numbers may also improve our underst and ing of treatment protocol s for this situation OBJECTIVE The purpose of this study was to investigate gingival healing after gingivectomy  and adjunctive use of low-level laser therapy ( LLLT ) . BACKGROUND DATA LLLT has been used in animal experiments to examine the influence of laser radiation on the wound healing process since the 1960s . However , clinical trials in dentistry are scarce , and most of them refer to treatment after extraction of the third molars , with only a few reports in the area of periodontics . METHODS Twenty patients with periodontal disease were selected , and treatment was planned for gingivectomy to bilateral maxillary and m and ibular premolar teeth . After surgery , one side was su bmi tted to LLLT using a 685-nm wavelength , output power of 50 mW , and energy density of 4 J/cm(2 ) . The other side was used as the control and did not receive laser irradiation .  Healing was evaluated , clinical ly and biometrically , immediately post-surgery and at days 3 , 7 , 14 , 21 , 28 , and 35 . Results were su bmi tted to statistical analysis . RESULTS Biometrical evaluation indicated a significant improvement in healing for the laser group at 21 and 28 days . Clinical evaluation showed better repair for the laser group , mainly after the third day . CONCLUSION LLLT was an effective adjunctive treatment that appeared to promote healing following gingivectomy We investigated the clinical effects of low-power laser therapy ( LPLT ) on prevention and reduction of severity of conditioning-induced oral mucositis ( OM ) for hematopoietic stem cell transplantation ( HSCT ) . We r and omized 38 patients who underwent autologous ( AT ) or allogeneic ( AL ) HSCT .  A diode InGaAlP was used , emitting light at 660 nm , 50 mW , and 4 J/cm2 , measured at the fiberoptic end with 0.196 cm2 of section area . The evaluation of OM was done using the Oral Mucositis Assessment Scale ( OMAS ) and the World Health Organization ( WHO ) scale . In the LPLT group , 94.7 % of patients had an OM grade ( WHO ) lower than or equal to grade 2 , including 63.2 % with grade 0 and 1 , whereas in the controls group , 31.5 % of patients had an OM grade lower than or equal to grade 2 ( P < .001 ) . Remarkably , the hazard ratio ( HR ) for grade s 2 , 3 , and 4 OM was 0.41 ( range , 0.22 - 0.75 ; P = .002 ) and for grade s 3 and 4 it was 0.07 ( range , 0.11 - 0.53 ; P < .001 ) . Using OMAS by the calculation of ulcerous area , 5.3 % of the laser group presented with ulcers of 9.1 cm2 to 18 cm2 , whereas 73.6 % of the control group presented with ulcers from 9.1 cm2 to 18 cm2 ( P = .003 ) . Our results indicate that the use of upfront LPLT in patients who have undergone HSCT is a powerful instrument in reducing the incidence of OM and is now st and ard in our center UNLABELLED Postoperative oedema is common following removal of impacted lower third molars . Several types of drug therapy ( corticosteroids , non-steroidal anti-inflammatory drugs , enzymes ) have been tried . The aim of this study was to compare the effectiveness of low-power laser ( LPL ) and dexamethasone after surgical removal of impacted lower third molars under local anaesthesia ( 2 % lidocaine/epinephrine ) . MATERIAL AND METHODS There were 120 healthy patients divided into four groups of 30 each . Group 1 received LPL irradiation immediately after operation ( energy output 4 J/cm2 with constant power density of 50 mW , wavelength 637 nm ) ; group 2 also received i.m . injection of 4 mg dexamethasone ( Dexason ) into the internal pterygoid muscle ; group 3 received LPL irradiation supplemented by systemic dexamethasone ( Dexason ) , 4 mg i.m . in the deltoid region , followed by 4 mg of dexamethasone intraorally 6h postoperatively ; and the fourth ( control ) group received only the usual postoperative recommendations ( cold packs , soft diet , etc . ) . RESULTS LPL irradiation with local use of dexamethasone ( group 2 ) result ed in a statistically significant reduction of postoperative oedema in comparison to the other groups . No adverse effects of the procedure or medication were observed . CONCLUSION LPL irradiation after lower third molar surgery can be recommended to minimize swelling . The effect is enhanced by simultaneous local intramuscular use of dexamethasone PURPOSE To report a case series of patients with the nonexposed variant of bisphosphonate-associated osteonecrosis of the jaw-a form of jaw osteonecrosis that does not manifest with necrotic bone exposure/mucosal fenestration . METHODS Among 332 individuals referred to 5 clinical centers in Europe because of development of jawbone abnormalities after or during exposure to bisphosphonates , we identified a total of 96 patients who presented with the nonexposed variant of osteonecrosis . Relevant data were obtained via clinical notes ; radiological investigations ; patients ' history , and referral letters . RESULTS The most common clinical feature of nonexposed osteonecrosis was jaw bone pain ( 88/96 ; 91.6 % ) ; followed by sinus tract ( 51 % ) , bone enlargement ( 36.4 % ) ; and gingival swelling ( 17.7 % ) . No radiological abnormalities were identified in 29.1 % ( 28/96 ) of patients . In 53.1 % ( 51/96 ) of the patients ; nonexposed osteonecrosis subsequently evolved into frank bone exposure within 4.6 months ( mean ; 95 % confidence interval ; 3.6 - 5.6 ) . CONCLUSIONS Clinicians should be highly vigilant to identify individuals with nonexposed osteonecrosis , as the impact on epidemiological data and clinical trial design could be potentially significant . Although the present case series represents approximately 30 % of all patients with  bisphosphonates-associated osteonecrosis observed at the study centers , further population -based prospect i ve studies are needed to obtain robust epidemiological figures BACKGROUND AND OBJECTIVES This preliminary report describes a new laser-assisted treatment option for the emerging complication of bisphosphonate related osteonecrosis ( BON ) of the jaw . MATERIAL S AND METHODS In eight tumour patients ( three women , five men ) ten bony lesions in the maxilla and m and ible in the course of intravenous bisphosphonate therapy  were treated with a variable square pulsed ( VSP ) Er : YAG laser . For the treatment , the Er : YAG laser was applied with a pulse energy of 1,000 mJ , a pulse duration of 300 microseconds , and a frequency of 12 Hz ( energy density 157 J/cm(2 ) ) . The spot size was 0.9 mm and the h and piece was kept at a distance of about 10 mm from the bone surface . The diseased bone was ablated exclusively with the Er : YAG laser by subsequently sweeping the bone surface in a well directed scanning mode . RESULTS The surgical procedure and postoperative wound healing were without any complications and a complete soft tissue recovering was achieved within 4 weeks . During follow-up examinations over 12 months soft tissue conditions were stable . The pulsed laser ablation caused a characteristic microstructured and craggy bone surface without a condensation or a smear layer on the laser rims . CONCLUSION The bone ablation technique using a VSP Er : YAG laser yielded promising clinical results without impairment of wound healing . A further analyse of the chemical , physical and pharmacological aspects of laser assisted treatment of BON lesions is necessary to get a safe and reliable treatment protocol for bisphosphonate-related osteonecrosis of the jaw The aim of this controlled , parallel design clinical study was to evaluate the effectiveness of an Er : YAG ( erbium-doped : yttrium , aluminum , and garnet ) laser for nonsurgical treatment of periimplantitis lesions . Twenty patients , each of whom displayed at least one implant with ( a ) moderate and ( b ) advanced periimpl 
    Output:
    
Therefore , laser surgical therapy seems to be a great management strategy for MRONJ treatment from stage II .
LLLT was shown to improve conservative management in earlier MRONJ stages