***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: PURPOSE Porous titanium granules ( PTG ) may have potential as an osteoconductive bone graft substitute to treat peri-implant osseous defects . The aim of this study was to analyze clinical and radiographic outcomes of peri-implant osseous defects after treatment with PTG .  MATERIAL S AND METHODS This prospect i ve , r and omized , case-control , clinical 12-month study compared open-flap debridement and surface decontamination with titanium curettes and 24 % ethylenediaminetetraacetic acid gel ( n = 16 )  to the same protocol but with the addition of PTG  ( n = 16 ) . One- , two- , and three-wall infrabony defects were included . Patients were given amoxicillin and metronidazole 3 days before surgery and for 7 days afterwards . Implants were submerged and allowed to heal for 6 months . Probing pocket depths , bleeding on probing , implant stability using resonance frequency analysis , and radiographic evaluation were performed at baseline and at 12 months . The threshold for significance was set at .05 . RESULTS Change in radiographic defect height and percent fill of the peri-implant osseous defect significantly favored patients treated with PTG .  Both treatment modalities demonstrated significant improvements in probing pocket depth , but significant differences between groups were not observed . The PTG-treated implants showed an increase in implant stability quotient ( ISQ ) of 1.6 units , compared with a decrease of 0.7 ISQ for the control group . No adverse effects were associated with PTG treatment . CONCLUSIONS Reconstruction with PTG result ed in significantly better radiographic peri-implant defect fill compared with controls ; however , the results do not necessarily imply reosseointegration or osseointegration of PTG particles . Improvements in clinical parameters were seen in both groups , but no differences between groups were demonstrated Objectives The aim of the present study is to report on preliminary clinical and radiographic results of using porous titanium granules for treatment of peri-implantitis lesions . Methods A retrospective cohort of 18 implants presenting with peri-implantitis in 16 consecutive patients from two private practice s had been evaluated . Treatment included open flap debridement of the lesion , implant surface decontamination using tetracycline , filling of the defect with porous titanium granules and apically positioning of the flaps . Patients ' demographics , site and implant characteristics , as well as clinical and radiographic evaluation as baseline and time of follow-up were recorded . Results Patients ' age ranged from 44 to 79 years with a mean of 61.3 ± 9.5 years . Follow-up time after treating peri-impantitis lesions ranged from 6 to 15 months ( mean 7.5 ± 3.9 ) . Two out of the 18 implants still presented with bleeding and suppuration at follow-up and thus the treatment was considered as a failure . This result ed in an overall success rate of 88 % for the treatment . Mean bone loss prior to treatment was 4.4 ± 2.1 mm and was reduced following treatment to 2.3 ± 2.1 mm . Conclusion The use of porous titanium granules might be a viable treatment option in cases of peri-implantitis lesions . Further large-scale long-term studies are warranted in order to assess the additional benefit from this treatment option compared to other available alternatives . BACKGROUND Limited evidence exists on the efficacy of regenerative treatment of peri-implantitis . MATERIAL AND METHODS Subjects receiving antibiotics and surgical debridement were r and omly assigned to placement of autogenous bone ( AB ) or bovine-derived xenograft ( BDX ) and with placement of a collagen membrane . The primary outcome was evidence of radiographic bone fill and the secondary outcomes included reductions of probing depth ( PD ) bleeding on probing ( BOP ) and suppuration . RESULTS Twenty-two subjects were included in the AB and 23 subjects in the BDX group . Statistical analysis failed to demonstrate differences for 38/39 variables assessed at baseline . At 12 months , significant better results were obtained in the BDX group for bone levels ( p < 0.001 ) , BOP ( p = 0.004 ) , PI ( p = 0.003 ) and suppuration ( p < 0.01 ) . When adjusting for number of implants treated per subject , a successful treatment outcome PD ≤ 5.0 mm , no pus , no bone loss and BOP at 1/4 or less sites the likelihood of defect fill was higher in the BDX group ( LR : 3.2 , 95 % CI : 1.0 - 10.6 , p < 0.05 ) . CONCLUSIONS Bovine xenograft provided more radiographic bone fill than AB . The success for both surgical regenerative procedures was limited . Decreases in PD , BOP , and suppuration were observed OBJECTIVES To evaluate the extent of bone fill over 3 years following the surgical treatment of peri-implantitis with bone grafting with or without a membrane . MATERIAL AND METHODS In a non-submerged wound-healing mode , 15 subjects with 27 implants were treated with a bone substitute ( Algipore ( ® ) ) alone and 17 subjects with 29 implants were treated with the bone substitute and a resorbable membrane ( Osseoquest ( ® ) ) . Implants with radiographic  bone  loss ≥1.8 mm following the first year in function and with bleeding and /or pus on probing were included . Following surgery , subjects were given systemic antibiotics ( 10 days ) and rinsed with chlorhexidine . After initial healing , the subjects were enrolled in a strict maintenance programme . RESULTS Statistical analysis failed to demonstrate changes in bone fill between 1 and 3 years both between and within procedure groups . The mean defect fill at 3 years was 1.3 ± ( SD ) 1.3 mm if treated with the bone substitute alone and 1.6 ± ( SD ) 1.2 mm if treated with an adjunct resorbable membrane , ( p=0.40 ) . The plaque index decreased from approximately 40 - 10 % , remaining stable during the following 2 years . CONCLUSION Defect fill using a bone substitute with or without a membrane technique in the treatment of peri-implantitis can be maintained over 3 years OBJECTIVES The aim of the present case series was to evaluate the 2-year results obtained following treatment of peri-implantitis lesions using either a nanocrystalline hydroxyapatite ( NHA ) or a natural bone mineral in combination with a collagen membrane ( NBM+CM ) . MATERIAL AND METHODS Twenty-two patients suffering from moderate peri-implantitis ( n=22 intra-bony defects ) were r and omly treated with ( i ) access flap surgery ( AFS ) and the application of NHA , or with AFS and the application of NBM+CM . Clinical parameters were recorded at baseline and after 12 , 18 , and 24 months of non-submerged healing . RESULTS Two patients from the NHA group were excluded from the study due to severe pus formation at 12 months . At 24 months , both groups revealed clinical ly important probing depth ( PD ) reductions ( NHA : 1.5+/-0.6 mm ; NBM+CM : 2.4+/-0.8 mm ) and clinical attachment level ( CAL ) gains ( NHA : 1.0+/-0.4 mm ; NBM+CM : 2.0+/-0.8 mm ) . However , these clinical improvements seemed to be better in the NBM+CM group ( difference between groups : PD reduction : 0.9+/-0.2 mm ; CAL gain : 1.0+/-0.3 mm ) . CONCLUSION Both treatment procedures have shown efficacy over a period of 24 months , however , the application of NBM+CM may result in an improved outcome of healing The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . & NA ; Between 1994 and 1999 , 50 patients were treated with either profound parodontopathy ( 30 ) or periimplantitis ( 20 ) . Half of each of the two groups of patients was treated conventionally , and the other half was treated with laser support . Before the operation , microbiological examinations were carried out , in addition to registering the clinical findings and taking x‐rays . These procedures were repeated after the operation , and again after 6 , 12 , 24 , 36 , 48 , and 60 months . The surgical part of therapy for each half of the patient groups included surface decontamination with diode laser light ( 1‐watt output , maximum of 20 seconds ) in addition to conventional procedures . The values of the laser‐supported therapy were lower than those specified in the relevant literature . The relapse rate of the two diseases ( 13 % for the periimplantitis and 23 % for the parodontopathy group ) after 5 years was lower than the comparative values of research ed literature where decontamination was not included in the therapy . We think that integrating diode laser light decontamination in the approved treatment schemes for periimplantitis and parodontitis contributes considerably to the success of this therapy . ( Implant Dent 2000;9:247‐251 AIM The objective of this r and omized , double-blind , placebo-controlled trial was to study the effect of implant surface decontamination with chlorhexidine (CHX)/cetylpyridinium chloride ( CPC ) on microbiological and clinical parameters . MATERIAL & METHODS Thirty patients ( 79 implants ) with peri-implantitis were treated with resective surgical treatment consisting of apically re-positioned flap , bone re-contouring and surface debridement and decontamination . Patients were r and omly allocated to decontamination with 0.12 % CHX + 0.05 % CPC ( test-group ) or a placebo-solution ( without CHX/CPC , placebo-group ) . Microbiological parameters were recorded during surgery ; clinical and radiographical parameters were recorded before ( pre- ) treatment ( baseline ) , and at 3 , 6 and 12 months after treatment . RESULTS Nine implants in two patients in the placebo-group were lost due to severe persisting peri-implantitis . Both decontamination procedures result ed in significant reductions of bacterial load on the implant surface , but the test-group showed a significantly greater reduction than the placebo-group ( log 4.21 ± 1.89 versus log 2.77 ± 2.12 , p = 0.006 ) . Multilevel analysis showed no differences between both groups in the effect of the intervention on bleeding , suppuration , probing pocket depth and radiographical bone loss over time . CONCLUSION Implant surface decontamination with 0.12 % CHX + 0.05 % CPC in resective surgical treatment of peri-implantitis leads to a greater immediate suppression of anaerobic bacteria on the implant surface than a placebo-solution , but does not lead to superior clinical results . The long-term microbiological effect remains unknown OBJECTIVES The study aim ed at investigating the impact of two surface debridement/decontamination ( DD ) methods on the clinical outcomes of combined surgical treatment of peri-implantitis . MATERIAL AND METHODS Thirty-two patients suffering from advanced peri-implantitis ( n=38 combined supra- and intra-bony defects ) were treated with flap surgery , granulation tissue removal , and implantoplasty at buccally and supracrestally exposed implant parts . The intra-bony aspects were r and omly allocated to surface DD using either ( i ) an Er : YAG laser ( ERL ) device , or ( ii ) plastic curets+cotton pellets+sterile saline ( CPS ) . In both groups , the intra-bony component was augmented with a natural bone mineral and covered with a collagen membrane . Clinical and radiographic parameters were recorded at baseline and after 6 months of non-submerged healing . RESULTS Two patients were lost during follow-up . At 6 months , ERL-treated sites failed to reveal higher reductions in mean bleeding on probing ( ERL : 47.8 ± 35.5 versus CPS : 55.0 ± 31.1 % ) and CAL values ( ERL : 1.5 ± 1.4 versus CPS : 2.2 ± 1.4 mm ) when compared with the CPS group . Both groups exhibited a comparable radiographic bone fill at the intra-bony defect component . CONCLUSION The study failed to demonstrate a significant impact of the method of surface DD on the clinical outcome following combined surgical therapy of advanced peri-implantitis lesions OBJECTIVES To investigate the impact of residual defect height ( RDH ) following guided bone regeneration ( GBR ) in dehiscence-type defects on the long-term stability of peri-implant health after a period of 4 years . MATERIAL AND METHODS The RDH values in dehiscence-type defects at titanium implants were clinical ly assessed after 4 months of submerged healing following augmentation using a natural bone mineral ( NBM ) and a r and omized application of either a cross-linked- ( VN ) or a native collagen membrane ( BG )  ( n=12 patients each ) . The RDH values were classified as absent ( 0 mm , control ; n=8 ) , minimal ( 1 mm , test 1 ; n=8 ) , or advanced 
    Output:
    
Within the limitation of this systematic review , the application of grafting material s and barrier membranes result ed in greater PD reduction and RBF , but there is a lack of high- quality comparative studies to support this statement .