***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: To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results The aim of this work was to investigate the long-term effects of a single application of a water-cooled pulsed neodymium yttrium aluminium garnet ( Nd : YAG ) laser , in combination with scaling and root planing ( SRP ) for the treatment of periodontal inflammation . Twenty-two patients were included in this split-mouth single blind r and omized controlled clinical trial . The parameters of the air and water-cooled Nd : YAG laser were : 4 W , 80 mJ/pulse , 50 Hz and a pulse width of 350 μs . The “ test side ” was treated with a single application of Nd : YAG laser and SRP ; while the “ control side ” was treated with SRP alone . At baseline , and after a median follow-up time of 20 months ( range 12–39 ) , periodontal inflammatory parameters ( plaque index [ PI ] , gingival index [ GI ] , probing pocket depth [ PPD ] ) , and marginal bone loss ( on digital bite-wing radiographs ) were measured . Gingival crevicular fluid ( GCF ) was collected from the teeth 35 , 36 , 45 , and 46 at baseline and at follow-up . Pl ( p < 0.01 ) , GI ( p < 0.01 ) , and PPD ( p < 0.001 ) were significantly lower on the test side compared to the control side at follow-up . Radiological results showed significantly less bone loss on the test side compared to the control side ( p < 0.05 ) . GCF volume was lower on the test side compared to the control side ( p < 0.01 ) . In conclusion , a single application of Nd : YAG laser in combination with SRP had a positive long-term effect on periodontal health compared to treatment by SRP alone Eighty-two periodontal patients were treated in a split mouth design with coronal scaling ( CS ) , root planing ( RP ) , modified Widman surgery ( MW ) , and flap with osseous resection surgery ( FO ) which were r and omly assigned to various quadrants in the dentition . Therapy was performed in 3 phases : non-surgical , surgical , and supportive periodontal treatment ( SPT ) < or = 7 years . Clinical data consisted of probing depth ( PD ) , clinical attachment level ( CAL ) , gingival recession ( REC ) , bleeding on probing ( BOP ) , suppuration ( SUP ) , and supragingival plaque ( PL ) . Because of the necessity to exit many CS treated sites due to breakdown , data for CS were reported only up to 2 years . All therapies produced mean PD reduction with FO > MW > RP > CS following the surgical phase for all probing depth severities . By the end of year 2 there were no differences between the therapies in the 1 to 4 mm sites . There were no differences in PD reduction between MW and RP treated sites by the end of year 3 in the 5 to 6 mm sites and by the end of year 5 in the > or = 7 mm sites . FO produced greater PD reduction in > or = 5 mm sites through year 7 of SPT . Following the surgical phase , FO produced a mean CAL loss and CS and RP produced a slight gain in 1 - 4 mm sites . RP and MW produced a greater gain of CAL than CS and FO following the surgical phase in 5 to 6 mm sites , but the magnitude of difference decreased during SPT . Similar CAL gains were produced by RP , MW , and FO in sites > or = 7 mm . These gains were greater than that produced by CS and were sustained during SPT . Recession was produced with FO > MW > RP > CS . This relationship was maintained throughout SPT . The prevalences of BOP , SUP , and PL were greatly reduced throughout the study and were comparable between sites treated by RP , MW , and FO while the CS sites had more BOP and SUP 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 BACKGROUND Several studies have documented the clinical efficacy of guided tissue regeneration ( GTR ) with non-resorbable exp and ed polytetrafluoroethylene ( ePTFE ) membranes and enamel matrix proteins ( EMP ) in the treatment of infrabony defects . The objective of this controlled clinical study was to compare the clinical outcomes of 3 surgical modalities in the treatment of deep interproximal infrabony defects . METHODS Ninety ( 90 ) defects in 90 healthy subjects affected by chronic periodontitis were assigned to 1 of 3 treatment groups by blocking to prognostic variables . The test group was treated with the application of EMP and the simplified papilla preservation ( SPP ) technique ; the second group was treated with titanium-reinforced ePFTE membranes and the SPP technique ; and the third group was treated with the SPP technique used as access flap control procedure . No differences were observed in terms of baseline oral hygiene and defect characteristics among the 3 groups , indicating that the blocking approach was effective . A stringent infection control program was adopted for 1 year . RESULTS The 1-year results indicated that : 1 ) all treatment modalities result ed in clinical ly significant improvements in clinical attachment levels ( CAL ) and reduction in probing depth ( PD ) ; 2 ) a statistically significant treatment effect was demonstrated comparing the EMP test , the membrane control , and the flap control groups in terms of CAL gains ; 3 ) both the EMP test and the membrane control groups showed significant CAL gains compared to the flap control group ; 4 ) a statistically significantly greater amount of CAL gain was demonstrated in GTR-treated compared to EMP-treated patients ; 5 ) deeper residual probing depths but smaller increases in gingival recession were demonstrated following EMP therapy ; and 6 ) smoking habits reduced the clinical outcomes of both regenerative procedures . CONCLUSIONS The use of a regenerative procedure is indicated in the treatment of deep vertical bony defects since both the regenerative techniques ( GTR and EMD ) in the present study result ed in clinical ly and statistically significant improvements in clinical parameters compared to the access flap procedure . The use of EMP can be helpful in esthetically-sensitive sites and in reducing patient morbidity BACKGROUND Periodontitis is an inflammatory condition of tooth-supporting tissues that is usually treated by mechanical removal of plaque and microorganisms that adhere to teeth . This treatment , known as scaling and root planing , is not optimally effective . Adjunctive therapy with locally delivered antimicrobials has result ed in improved clinical outcomes such as probing depth reduction . This article reports on the efficacy and safety of locally administered microencapsulated minocycline . METHODS Seven hundred forty-eight ( 748 ) patients with moderate to advanced periodontitis were enrolled in a multi-center trial and r and omized to 1 of 3 treatment arms : 1 ) scaling and root planing ( SRP ) alone ; 2 ) SRP plus vehicle ; or 3 ) SRP plus minocycline microspheres . The primary outcome measure was probing depth reduction at 9 months . Clinical assessment s were performed at baseline and 1 , 3 , 6 , and 9 months . RESULTS Minocycline microspheres plus scaling and root planing provided substantially more probing depth reduction than either SRP alone or SRP plus vehicle . The difference reached statistical significance after the first month and was maintained throughout the trial . The improved outcome was observed to be independent of patients ' smoking status , age , gender , or baseline disease level . There was no difference in the incidence of adverse effects among treatment groups . CONCLUSIONS Scaling and root planing plus minocycline microspheres is more effective than scaling and root planing alone in reducing probing depths in periodontitis patients BACKGROUND The purpose of the present parallel design , controlled clinical trial was to evaluate the treatment outcome following flap debridement surgery ( FDS ) in cigarette smokers compared to non-smokers . METHODS After initial therapy , 57 systemically healthy subjects with moderate to advanced periodontitis who presented with one area ( at least 3 teeth ) where surgery was required were selected . Twenty-eight patients ( mean age : 39.6 years , 20 males ) were smokers ( > or = 10 cigarettes/day ) ; 29 patients ( mean age : 43.9 years , 7 males ) were non-smokers .  Full-mouth plaque ( FMP ) and bleeding on probing ( BOP ) scores , probing depth ( PD ) , clinical attachment level ( CAL ) , and recession depth ( RD ) were assessed immediately before and 6 months following surgery . Only sites with presurgery PD > or = 4 mm were used for statistical analysis . RESULTS Presurgery FMP and BOP were similar in smokers and non-smokers and significantly decreased postsurgery in both groups . Overall , PD reduction and CAL gain were greater , although not significantly , in non-smokers ( 2.4 + /- 0.9 mm and 1.6 + /- 0.7 mm , respectively ) than in smokers ( 1.9 + /- 0.7 mm and 1.2 + /- 0.7 mm , respectively ) . For moderate sites ( PD 4 to 6 mm ) , no significant differences in PD and CAL changes were found between groups . For deep sites ( PD > or = 7 mm ) , PD reduction was 3.0 + /- 1.0 mm in smokers and 4.0 + /- 0.8 mm in non-smokers , and CAL gain amounted to 1.8 + /- 1.1 mm in smokers and 2.8 + /- 1.0 mm in non-smokers ( P = 0.0477 ) . In smokers , 16 % of deep sites healed to postsurgery PD values < or = 3 mm as compared to 47 % in non-smokers ( P = 0.0000 ) ; 58 % of deep sites in smokers showed a CAL gain > or = 2 mm , as compared to 82 % in non-smokers ( P = 0.0000 ) . CONCLUSIONS Results of the study indicated that : 1 ) FDS determined a statistically significant PD reduction and CAL gain in patients with moderate to advanced periodontitis ; 2 ) smokers exhibited a trend towards less favorable healing response following FDS compared to non-smokers , both in terms of PD reduction and CAL gain ; and 3 ) this trend reached clinical and statistical significance at sites with initial deep PD AIM This prospect i ve multicentre r and omized controlled clinical trial was design ed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of enamel matrix proteins ( EMD ) . MATERIAL AND METHODS 172 patients with advanced chronic periodontitis were recruited in 12 centers in 7 countries . All patients had at least one intrabony defect of > or = 3 mm . Heavy smokers ( > or 
    Output:
    
Qualitative assessment of the articles consistently showed an improved treatment effect among non-smokers versus smokers .
Considering the relatively homogenous information available , the authors conclude that active smokers could be c and i date s for periodontal flap surgical procedures .
However , the magnitude of the therapeutic effect is compromised in smokers compared with non-smokers .