***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 Patient discomfort is one reason for poor compliance with  supportive periodontal therapy ( SPT ) . The aim of this study was to compare the levels of discomfort during SPT , using the Vector system and treatment with a conventional ultrasonic scaler . METHODS Forty-six patients with an SPT programme were debrided using both the Vector system and a conventional piezo-electric scaler ( Sirona ) in a split mouth design . A visual analogue scale was used to evaluate of pain scores upon completion of treatment . A verbal response scale(VRS ) was used to assess discomfort , vibration and noise associated with the scaling system , as well as the volume and taste of the coolant used by these systems . RESULTS Patients instrumented with the Vector system experienced approximately half the amount of pain compared with the conventional ultrasonic scaling system . The VRS showed that the Vector system caused less discomfort than the conventional ultrasonic scaling system when assessed for pain , vibration , noise and volume of coolant . These findings were all statistically significant . There was , however , no statistically significant difference between the two systems when assessed for taste . CONCLUSION During SPT the Vector system caused reduced discomforting sensations compared with conventional methods and may be useful in improving compliance with SPT programmes OBJECTIVE A study was conducted to examine the effectiveness of scaling and root planing using a new ultrasonic scaler ( Vector ) . METHODS Eighty extracted teeth affected by periodontal disease were sorted into four groups of 20 , each of which was subjected to one the following procedures : use of the Vector , Vector with polish , Enac and a Gracey scaler . The time spent on cleaning was measured . Half of the sample teeth were examined at r and om for surface roughness , and the surface texture was evaluated by means of the Remaining Calculus Index ( RCI ) and the Roughness and Loss of Tooth Substance Index ( RLTSI ) . The remaining sample s were incubated in dishes with a suspension of fibroblasts . After measuring the number of attached cells , the attachment of fibroblasts was observed by scanning electron microscopy . RESULTS The RLTSI values in the Vector and Vector with polish groups were significantly lower than those in the Enac and Gracey groups , whereas the number of attached cells in the Vector with polish group was larger than in the Enac group . Cell attachment in the Vector and Vector with polish groups proved to be better than in the Enac and Gracey groups . CONCLUSION Since use of the Vector with polish was able to provide scaling and root planing with minimal damage and tight attachment of fibroblasts , it is suggested that this may be a useful instrument for scaling and root planing BACKGROUND A recently introduced piezo-driven ultrasonic device ( Vector ) generates longitudinal oscillations . As a result , the instrument tip moves parallel to the tooth surface . By avoiding vertical oscillations , maintenance treatment with the Vector device should be less painful than treatment with conventional systems . We investigated whether patients perceive treatment with the Vector device as less painful than with a conventional ultrasonic device , and whether the clinical efficacy of the Vector device is comparable with that of the conventional ultrasonic device in maintenance patients . MATERIAL AND METHODS Thirty-eight maintenance patients with moderate to advanced periodontal disease took part in this prospect i ve , r and omized controlled clinical study . Each patients had to have at least two teeth with probing depths of > 4 mm . They were treated either with Dentsply ( n=22 ) at a reduced power setting or with the Vector device ( n=16 ) . The observation period was 6 months . Probing pocket depth , attachment level , and bleeding upon probing were assessed at six sites on each treated tooth by a blinded investigator Patient were asked to report perceived pain during instrumentation with a visual analog scale immediately after treatment , in the evening of the treatment day , and in the evenings 1 and 2 days after treatment . RESULTS Bleeding on probing , probing depth , and attachment level improved in both instrumentation groups from baseline to month 6 ; however , there was no difference between the two instrumentation modalities . The patients perceived treatment with neither instrument as unpleasant , and their perception of pain intensity both during instrumentation and on the following days did not differ . CONCLUSION In maintenance therapy , clinical efficacy of the vector device is comparable with that of conventional ultrasonic device . It makes no difference whether the ultrasonic device at a reduced power setting or the Vector device is used , since patients perceive both instruments as causing very little pain AIM To compare the effectiveness of treatment of peri-implantitis with a novel ultrasonic device , the Vector system , with that of subgingival debridement with carbon fiber curettes . MATERIAL AND METHODS The study , comprising 11 patients with at least two screw type implants with bleeding on probing ( BOP ) , probing pocket depth ( PPD ) > or = 5 mm , and at least 1.5 mm radiographic bone loss and exposed implant threads , was carried out as a single blind r and omized clinical trial . At baseline one r and omly chosen implant in each patient was treated by the Vector system ( test ) while the other implant ( control ) was treated by submucosal debridement with a carbon fiber curette . After 3 months , the same treatments were repeated . Plaque , BOP , and PPD were recorded on all implant surfaces at baseline , and after 3 and 6 months . Bone levels were recorded on radiographs taken prior to the start of the study , and after 6 months . RESULTS Oral hygiene around both test and control implants was improved at 3 and 6 months compared with baseline . At 6 months , four of the Vector-treated sites , and only one site treated with curettes , had stopped to bleed . In neither the test nor the control group , were there any differences between baseline and 6 months regarding PPD and bone levels . CONCLUSION Although there was a greater reduction in the number of sites with BOP following treatment with the Vector system than following instrumentation with carbon fiber curettes , there was no significant difference between the two methods BACKGROUND AND OBJECTIVES The aim of the present study was to investigate the in vivo effects of an Er : YAG laser ( ERL ) , an ultrasonic system and scaling and root planing ( SRP ) on the biocompatibility of periodontally diseased root surfaces in cultures of human periodontal ligament fibroblasts ( PDL ) . STUDY DESIGN / MATERIAL S AND METHODS Forty single rooted teeth , considered for extraction due to severe periodontal destruction , have been r and omly assigned to the following groups : ( 1 )  ERL at 160 mJ/pulse and 10 Hz , or ( 2 ) Vector ultrasonic system ( VUS ) , or ( 3 ) SRP using h and instruments , or ( 4 ) untreated control ( C ) . Immediately after instrumentation , all test and control teeth were extracted and root specimens ( 4 mm2 ) were prepared from all mesial and distal surfaces ( n=80 ) . Following the prescribed treatments , the root specimens were incubated with human PDL fibroblast cultures . Adherent cells were stained with methylene blue and counted using a reflected light microscope and the cell density per mm2 was calculated . Additionally , the cell morphology was investigated using SEM ( n=8 teeth ) . RESULTS Cell counts within each group yielded the following means and st and ard deviations ( cells/mm2 ) : ERL , 111+/-27 ; VUS , 75+/-25 ; SRP , 41+/-17 ; control , 25+/-11 . Analysis of variance ( ANOVA ) revealed significant differences in the number of attached cells between the test and control groups ( P<0.001 , P<0.001 , P<0.01 , respectively ) . ERL and VUS treated specimens showed significantly higher numbers of cells/mm2 than the SRP group ( P<0.001 , respectively ) . The difference between the ERL and VUS group was statistically significant ( P<0.001 ) . CONCLUSIONS The results of the present study indicate that ( i ) ERL , VUS , and SRP promote the attachment of PDL fibroblasts on previously diseased root surfaces , ( ii ) periodontally diseased root surfaces inhibit the adherence of PDL fibroblasts , and ( iii ) the surface structure of ERL and VUS instrumented roots seem to offer better conditions for the adherence of PDL fibroblasts than SRP The aim of this study was to measure subjective intensities of pain during the treatment of periodontal lesions with the Vector-system when compared to pain occurring during the treatment with conventional methods . Twenty patients , each of whom had three teeth with comparable periodontal pocket depths , were treated using three different methods : ( i ) scaling and root planing with h and instruments , ( ii ) cleaning with a conventional ultrasonic instrument ( Siroson S ) and ( iii ) cleaning with the Vector-system . The subjective intensities of pain during the treatment were measured with an intermodal intensity comparison . A visual analog scale was used for the evaluation after the treatment . The results of the intermodal intensity comparison during treatment showed that the use of the Vector-system caused less pain than the cleaning with h and instruments or the conventional ultrasonic system ( P < 0.05 ) . The intermodal intensity comparisons of cleaning with h and instruments and cleaning with the conventional ultrasonic system were not significantly different ( P > 0.05 ) . These results could be confirmed by the visual analog scale . Using the Vector-system for cleaning periodontal lesions it is possible to reduce pain sensations compared to conventional methods . Using cleaning methods that cause less discomfort and pain , it might be possible to increase the patient 's compliance during non-surgical periodontal therapy and recall The goal of this study was to determine whether an ultrasonic scaler with a modified tip is as effective as a curet in providing supportive periodontal treatment for patients , based on clinical parameters of periodontal disease . Nine patients with 10 sites exhibiting probing pocket depth > or = 3 mm were treated at 0 , 90 , and 180 days in a single-blind , split-mouth design for supportive periodontal treatment with either Gracey curets ( GC ) or an ultrasonic scaler with a modified tip ( MU ) . Clinical parameters included plaque index , gingival index , bleeding on probing , darkfield microscopy , and elastase presence . Probing pocket depths and attachment levels were measured using an electronic probe . Measurements of clinical parameters were taken at 0 , 14 , 45 , 90 , 135 , and 180 days . The results showed that treatment with MU was as effective as treatment with GC in all clinical parameters measured . Both treatment modalities were effective in reducing the elastase levels . Instrumentation time was significantly reduced with the MU ( 3.9 minutes vs. 5.9 minutes , P < 0.05 ) . The MU instrument effectively reduced the microbial environment in a significantly shorter time as compared to GC BACKGROUND Surgical periodontal treatment with enamel matrix protein derivative ( EMD ) has been shown to promote periodontal regeneration . However , it is not known whether nonsurgical periodontal therapy with additional subgingival application of EMD may also enhance periodontal regeneration . The purpose of this study was to clinical ly and histologically evaluate healing of human intrabony defects following non-surgical periodontal treatment with and without application of EMD . METHODS Sixteen patients , each of whom displayed one advanced intrabony defect around teeth or roots scheduled for extraction , were included in the study . The defects were treated as follows : 1 ) scaling and root planing with h and instruments and application of EMD ; 2 ) scaling with an ultrasonic instrument and application of EMD ; or 3 ) scaling with an ultrasonic instrument alone .  Healing was uneventful in all cases . Six months after surgery , the teeth or roots were extracted together with some of their surrounding soft and hard tissues and processed for histologic evaluation . RESULTS Clinical examination revealed a probing depth reduction and a gain of clinical attachment after all 3 treatment modalities . The histological evaluation , however , revealed that healing in all 3 procedures was predominantly characterized by formation of a long junctional epithelium along the instrumented root surface and no predictable regeneration of attachment apparatus . CONCLUSION Within its limits , the present study failed to show periodontal regeneration in advanced human intrabony defects following non-surgical treatment with subgingival application of EMD OBJECTIVE The aim of this r and omised , split-mouth , controlled clinical trial was to evaluate the effectiveness of a controlled-release chlorhexidine chip ( CHX chip ) as an adjunctive therapy to scaling and root planing ( SRP ) with a newly developed ultrasonic device in supportive periodontal therapy ( SPT ) . MATERIAL S AND METHODS Twenty patients with moderate-to-severe chronic periodontitis , displaying at least four sites with probing depth ( PD ) > or = 5 mm and persistent bleeding on probing ( BOP ) , were recruited for the study . The target sites were r and omly treated with either a newly developed piezo-driven ultrasonic device Vector -- or ultrasonic system ( VUS ) + CHX chip or VUS alone without adjunctive antimicrobial treatment . The clinical parameters , plaque index ( PI ) , gingival index ( GI ) , BOP , PD and clinical attachment level ( CAL ) were recorded at baseline and after 1 , 3 and 6 months . RESULTS At baseline , there were no significant differences between test and control sites for any of the investigated parameters . The average reduction of PD and improvement in CAL was greater in the VUS + CHX chip sites than in sites treated with the VUS alone at 1 , 3 and 6 months ( P < 0.05 ) . The mean reductions on PD and CAL were 0.7 and 0.6 mm for the control sites and 2.2 and 1.9 mm for the test sites , respectively . Also , the mean reduction in BOP scores were higher in the VUS + CHX chip sites compared to VUS alone at 1 , 3 and 6 months ( P < 0.05 ) . PI scores were not significantly different between VUS + CHX chip sites and VUS alone sites at any visit . CONCLUSION These data suggest that CHX chip application following SRP with the tested ultrasonic 
    Output:
    
The Vector ultrasonic scaler provided comparable clinical and microbiological periodontal healing results as scaling and root planing and conventional ultrasonic system in moderately deep pockets .
The Vector ultrasonic scaler may be used as a gentle root debridement device for supportive periodontal therapy , as an alternative to other conventional ultrasonic system .