***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: Guided bone regeneration ( GBR ) is frequently used in oral implantology . It is unclear to what extent GBR affects the periodontium of adjacent teeth . Therefore , the present study quantifies changes in the proximal gingiva and bone levels at these teeth in 30 patients . Staged surgery involved a st and ard GBR treatment , r and omly using resorbable membranes with a bone substitute or non-resorbable membranes with or without a bone substitute , followed by fixture installation at 6 months and abutment connection a further 6 months later . The data were sample d at each surgery and analysed using MANOVA . Twelve months after GBR , there was on average a small but statistically significant amount of proximal gingival recession ( 0.75 mm ) and bone resorption ( 0.34 mm ) observed , of which 50 % was the result of GBR surgery . No significant differences were found between the different GBR treatment modalities . It is concluded that GBR treatment may have a small negative effect on the levels of the free gingival margin and alveolar bone at adjacent teeth , which is in most patients not clinical ly relevant PURPOSE The aim of this study was to report on the rehabilitation of partial edentulism with immediate function implants placed in predominantly soft bone with flap and flapless surgical techniques . MATERIAL S AND METHODS The prospect i ve clinical study comprises 72 implants ( 50 in the maxilla and 22 in the m and ible ) placed in 41 consecutively included patients rehabilitated from partial edentulism , followed for 1 year . An implant specially design ed for immediate function was used . The evaluation included clinical examinations and radiographic assessment of the marginal bone level at 6 months and 1 year . The outcome measure was the implant success , evaluated using the following implant success criteria : clinical stability ( fixed dental prostheses removed and implants individually checked ) ; fulfilled purported function without any discomfort to the patient ; no suppuration or infection present ; no radiolucent areas around the implants at time of evaluation ; and no aesthetic complaints from the patient . RESULTS No dropouts were registered during the follow-up of the study . The overall cumulative survival rate at 1 year was 98.6 % ( 1 implant lost ) , with 100 % for the implants placed with the flap surgical technique , and 96.9 % for the implants placed with the flapless surgical technique . The overall average marginal bone resorption was 1.6 mm ( SD=1.1 mm ) at 1-year follow-up , with 1.4 mm ( SD=0.8 mm ) and 2.0 mm ( SD = 1.4 mm ) for the flap and flapless surgical technique study groups , respectively . The complications registered were : peri-implant pathology ( 3 implants in 3 patients ) ; fracture of the provisional crown/prosthesis ( 2 patients ) ; crown loosening ( 1 patient ) and prosthetic screw loosening ( 1 patient ) . CONCLUSIONS The placement of the specially design ed implant for immediate function in predominantly soft bone is viable , as given by the overall 98.6 % cumulative survival rate , and the rehabilitation using flapless surgery is safe and predictable . However , the flapless technique revealed more marginal bone resorption compared with the flap technique . Extra care should be taken in the flapless approach with respect to the inclusion criteria and difficulty of the surgery Background The association between periodontal conditions , oral yeast colonisation and salivary proteins in subjects with type 2 diabetes ( T2D ) is not yet documented . The present study aim ed to assess the relationship between these variables in type 2 diabetic subjects with reference to gender . Methods Fifty-eight type 2 diabetic subjects ( 23 males and 35 females ) with r and om blood glucose level ≥ 11.1 mmol/L were investigated . Periodontal conditions ( plaque index [ PI ] , bleeding on probing [ BOP ] , probing pocket depth [ PD ] ( 4 to 6 mm and ≥ 6 mm ) , oral yeasts , salivary immunoglobulin ( Ig ) A , IgG and total protein concentrations , and number of present teeth were determined . Results Periodontal conditions ( PI [ p < 0.00001 ] , BOP [ p < 0.01 ] and PD of 4 to 6 mm [ p < 0.001 ] , salivary IgG (μg)/mg protein ( p < 0.001 ) and salivary total protein concentrations ( p < 0.05 ) were higher in type 2 diabetic females with C and ida albicans ( C. albicans ) colonisation compared to males in the same group . Type 2 diabetic females with C. albicans colonisation had more teeth compared to males in the same group ( p < 0.0001 ) . Conclusion Clinical and salivary parameters of periodontal inflammation ( BOP and IgG (μg)/mg protein ) were higher in type 2 diabetic females with oral C. albicans colonisation compared to males in the same group . Further studies are warranted to evaluate the association of gender with these variables in subjects with T2D BACKGROUND The association among periodontal conditions , socioeconomic status ( SES ) , and diabetes has been reported . However , there is a lack of published data comparing periodontal conditions among individuals with poorly controlled type 2 diabetes mellitus ( T2D ) . The aim of the present study was to compare the periodontal conditions and SES between subjects with T2D and non-diabetic controls . METHODS A total of 75 ( 31 males and 44 females ) individuals with T2D ( 62 poorly controlled and 13 well-controlled ) and 99 non-diabetic patients ( healthy controls ; 51 males and 48 females ) participated in the study .  Plaque index ( PI ) , bleeding on probing ( BOP ) , and probing depth ( PD ) were investigated . R and om blood glucose level was recorded . Premolar and molar marginal bone loss ( MBL ) was measured digitally on scanned orthopantomograms . RESULTS Individuals with poorly controlled T2D had increased MBL in molars and maxillary premolars ( P<0.05 ) compared to individuals with well-controlled T2D . PI , BOP , and PD of 4 to < 6 mm were increased in individuals with poorly controlled T2D compared to those with well-controlled T2D ( P<0.001 ) . There was no difference between the diabetic groups when PD was > or=6 mm . Individuals with poorly controlled T2D had a lower SES compared to patients with well-controlled T2D ( P<0.05 ) . Illiteracy and the number of missing teeth were not different between the groups . CONCLUSIONS Radiologic and clinical indicators of periodontal destruction were increased in individuals with poorly controlled T2D . Low SES aggravated the periodontal condition in individuals with T2D The purpose of this r and omized controlled clinical study was to compare the survival of a one-piece anodically oxidized surface implant when placed with a flapless or flap protocol . Bone loss measurements on radiographs and changes in clinical probing depths 1 year post-definitive restoration placement were recorded and compared . Fifty-two of 60 patients ( implants ) remained in the study at the 1-year follow-up . At the time of final evaluation , no implant was lost in either group . At the time of placement of the definitive restoration , there was a mean mesial and distal bone gain in both groups compared to bone levels present at the time of implant insertion . There were no significant changes in bone levels between placement of the definitive restoration and those recorded 12 months later , and no significant differences in bone levels between the flap or flapless group at 6 or 12 months were noted . No significant differences were seen either in pocket depth or change in pocket depth at 6 and 12 months in the flapless and flap groups . It was therefore concluded that one-piece anodically oxidized surface implants , 1 year post-definitive restoration insertion , had high survival rates ( 100 % ) and stable marginal bone and probing depth levels whether a flapless or flap protocol was used for implant insertion OBJECTIVES To evaluate and compare the outcome of  dental implants  placed using a flapless protocol and immediate loading with a conventional protocol and loading after 6 weeks . MATERIAL S AND METHODS Fourteen patients with bilateral maxillary edentulous areas were treated using Straumann SLA-implants .  Using a r and omized split-mouth design , implants were placed in one side of the maxilla using a stereolithographic surgical guide for flapless surgery and immediately loaded on temporary abutments with a bridge ( test ) . Implants in the other side were placed using the conventional protocol and loaded after 6 weeks of healing ( control ) . Clinical and radiographic evaluation of peri-implant tissues was performed at time of implant surgery , and after 1 week , 6 weeks , 3 , 6 , 12 and 18 months . RESULTS A total of 70 implants were placed ( 36 test and 34 control ) . One implant ( test ) was lost after 3 months , result ing in a survival rate of 97.3 % for the test implants and 100 % for the control implants . Marginal bone levels were not statistically significantly different between the test and control implants but at baseline the marginal bone level was significantly lower compared to the other evaluation periods ( P < 0.05 ) . The mean bone level for test and control implants was 1.95 mm ± 0.70 and 1.93 mm ± 0.42 after 18 months , respectively . There was a significant change in height of the attached mucosa at implants placed with a conventional flap between post-operative and 1 week and between 1 week and 6 weeks . Statistically significant differences were found between the test side and the control side for opinion about speech , function , aesthetics , self-confidence and overall appreciation the first 6 weeks . CONCLUSION Implants can successfully integrate in the posterior maxilla using a flapless approach with immediate loading similar to a conventional protocol . The mucosal tissues around implants placed with a conventional flap changed significantly compared with flapless placed implants PURPOSE To evaluate and compare the changes in crestal bone height around  implants placed with flapless surgery and with-flap surgery . MATERIAL S AND METHODS Ten implants were placed in six patients --five using flapless and five using with-flap techniques .  Single-piece root-form implants and a one-stage approach with immediate nonfunctional loading protocol were used . The change in heights of crestal bone was measured on st and ardized digital periapical radiographs taken at 0 , 1 , and 3 months . RESULTS On mesial side , the mean change from months 0 - 1 , months 1 - 3 , and months 0 - 3 for flapless method was significantly lower than with-flap method [ 0.01 - 0.06 mm for flapless and 0.13 - 0.40 mm for with-flap ( P = 0.01 ) ] . On the distal side , the mean change from months 0 - 1 , months 1 - 3 , and months 0 - 3 for flapless method was significantly lower than with-flap method [ 0.02 - 0.05 mm for flapless and 0.09 - 0.30 mm for with-flap ( P = 0.01 ) ] . CONCLUSIONS During the three-month period , reduction of crestal bone height around the implants placed with flapless surgery ( 0.06 mm ) was not statistically significant , while the reduction of crestal bone height around the implants placed using with-flap surgery ( 0.4 mm ) was statistically significant . Comparitively , flapless approach showed lesser crestal bone height reduction , which was statistically significant OBJECTIVE To evaluate how bone-level implants  maintain crestal bone stability after thickening of thin mucosal tissues with allogenic membrane . MATERIAL S AND METHODS Ninety-seven bone-level implants of 4.1 mm diameter ( Institute Straumann AG , Switzerl and ) were evaluated in 97 patients ( 28 men and 69 women , mean age 47.3 ± 1.2 years ) . According to vertical gingival thickness , patients were assigned into test T1 ( thin , 2 mm or less , n = 33 ) , test T2 ( thin thickened with allogenic membrane , n = 32 ) and control C groups ( thick , more than 2 mm , n = 32 ) . Implants were placed in posterior m and ible in one-stage approach and after integration were restored with single screw-retained metal-ceramic restorations . Radiographic examination was performed after implant placement , 2 months after healing , after prosthetic restoration and after 1-year follow-up . Crestal bone loss was calculated mesially and distally . Mann-Whitney U-test was applied and significance was set to 0.05 . RESULTS After 2 months , implants in group T1 had 0.75 ± 0.11 mm bone loss mesially and 0.73 ± 0.10 mm distally . Implants in group T2 had 0.16 ± 0.06 mm mesially and 0.20 ± 0.06 mm distally . C group implants lost 0.17 ± 0.05 mm mesially and 0.18 ± 0.03 mm distally . Differences between T1/T2 , and T1/C were statistically significant ( P = 0.000 ) both mesially and distally , while between T2 and C was not significant mesially ( P = 0.861 ) and distally ( P = 0.827 ) . 
    Output:
    
CBL around dental implants placed in healed sites using flapped and flapless techniques is comparable