***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: Various studies have shown biostimulation effects of laser irradiation by producing metabolic changes within the cells . Little is known about the biological effect of laser irradiation on the oral tissues . Among the many physiological effects , it is important to recognize that low-level laser therapy ( LLLT ) may affect release of growth factors from fibroblasts . Therefore , the aim of the present study was to determine whether the laser irradiation can enhance the release of basic fibroblast growth factor ( bFGF ) , insulin-like growth factor-1 ( IGF-1 ) , and receptor of IGF-1 ( IGFBP3 ) from human gingival fibroblasts ( HGF ) . The number of all sample s in the study were 30 , and the sample s were r and omly divided into three equal groups ; In the first group ( single dose group ) , HGF were irradiated with laser energy of 685 nm , for 140 s , 2 J/cm2 for one time , and in the second group , energy at the same dose was applied for two consecutive days ( double dose group ) . The third group served as nonirradiated control group . Proliferation , viability , and bFGF , IGF-1 , IGFBP3 analysis of control and irradiated cultures were compared with each other . Both of the irradiated groups revealed higher proliferation and viability in comparison to the control group . Comparison of the single-dose group with the control group revealed statistically significant increases in bFGF ( p < 0.01 ) and IGF-1 ( p < 0.01 ) , but IGFBP3 increased insignificantly ( p > 0.05 ) . When the double dose group was compared with the control group , significant increases were determined in all of the parameters ( p < 0.01 ) . In the comparison of the differences between the two irradiated groups ( one dose and two doses ) , none of the parameters displayed any statistically significant difference ( p > 0.05 ) . In both of the laser groups , LLLT increased the cell proliferation and cell viability . The results of this study showed that LLLT increased the proliferation of HGF cells and release of bFGF , IGF-1 , and IGFBP3 from these cells . LLLT may play an important role in periodontal wound healing and regeneration by enhancing the production of the growth factors AIMS The aim of present r and omized controlled clinical study was to evaluate the effects of the use of diode laser for graft harvesting and palatal wound irradiation on post-operative morbidity and root coverage outcomes after a coronally advanced flap ( CAF ) with de-epithelialized gingival grafts ( DGG ) . METHODS Fifty-two patients with isolated recessions were treated . The CTG result ed from the de-epithelialization of a free gingival graft ( FGG ) with blade ( control group : DGG-B ) or diode laser ( DL ) ( test group : DGG-L ) . The DL was used to de-epithelialize the outer part of the FGG and photo-biostimulate the palatal wound area . Post-operative morbidity was evaluated by using Oral Health-related Quality of Life ( OHQoL ) and Visual Analogue Scale-discomfort ( VAS ) . Root coverage outcomes were also evaluated 6 months after operation . RESULTS Statistically significant differences were found for OHQoL ( p = 0.0001 ) and VAS ( p = 0.0001 ) at the 7th day post-operatively favouring test sites . Root coverage results did not show a statistically significant difference . CONCLUSIONS While both techniques were effective with regard to root coverage at 6 months , the DGG-L technique decreased post-operative morbidity associated with palatal donor-site surgery OBJECTIVE The aim of this study was to determine the effects of low-level laser therapy ( LLLT ) on wound healing at free gingival graft ( FGG ) donor sites . MATERIAL S AND METHODS Forty patients requiring FGG were selected for this r and omized , controlled , and double-blinded prospect i ve clinical trial . The FGG donor sites were treated with LLLT and compared with an untreated control group . The Wound-Healing Index ( WHI ) , tissue consistency , color match , and H2O2 bubbling test for the evaluation of complete wound epithelialization were recorded on the 3rd , 7th , 14th and 21st days . The pain-burning level , number of analgesics , and bleeding were recorded for 7 days . Donor area soft tissue thickness ( TT ) was measured at baseline and at the first month . RESULTS The prevalence of Complete Wound Epithelization was higher in the LLLT group than in the control group on the 14th day ( p < 0.001 ) . The bleeding was lower in the test group than in the control group during the first 2 days ( p ≤ 0.001 ) . Higher WHI Scores were observed in the test group relative to the control group at all visits ( p ≤ 0.001 ) . Color match scores were higher in the test group than in the control group at the first 3 visits ( p < 0.05 ) . The TT changed from 4.62 ± 0.79 to 4.71 ± 0.82 mm in the LLLT group and from 4.23 ± 0.62 to 4.01 ± 0.68 mm in the control group . CONCLUSIONS It can be concluded that LLLT enhances FGG donor site wound healing and preserves TT at palatinal donor sites Connective tissue graft ( CTG ) , which is considered to be among the best techniques for treating gingival recession , has presented stable long-term results . However , this technique causes morbidity and discomfort in the palatine region due to graft removal at that site . A previous study reports that photobiomodulation ( PBM ) using a dosage of 15 J/cm2 may improve wound healing and the patient ’s postoperative comfort . However , no other studies in the literature provide the best application dosage or comparisons between protocol s for this purpose . The aim of this study is to compare two power densities of PBM on the wound-healing process of the donor palatine area after CTG removal . In this study , 51 patients presenting buccal gingival recession were r and omized into one of the following groups : group 1 : CTG procedure for root coverage and PBM application at the donor site using a 60 J/cm2 dose ; group 2 : CTG and PBM application using a 30 J/cm2 dose ; or group 3 : CTG and sham application . The evaluated parameters were the wound remaining area ( WRA ) , scar and tissue colorimetry ( TC ) , tissue thickness ( TT ) , and postoperative discomfort ( D ) , evaluated at baseline and 7 , 14 , 45 , 60 , and 90 days after surgery . Group 1 presented statistically significant smaller wounds at day 7 ( p > 0.05 ) . None of the patients presented scars at the operated area , and all of the patients reported mild discomfort , with low consumption of analgesic pills . We concluded that the protocol of 60 J/cm2 provided faster wound healing 7 days after removing the connective tissue graft for root coverage . Trial registration : Clinical Trial.org ( NCT02580357 ) https:// clinical trials.gov/ct2/show/NCT02580357 OBJECTIVES The aim of this split-mouth , double-blind controlled clinical trial was to study the effects of irradiation with low-level lasers as an adjunctive treatment of inflamed gingival tissue . MATERIAL S AND METHODS Seventeen patients with moderate periodontitis were included . After clinical examination , all teeth were scaled and root planed ( SRP ) . One week after SRP , we took sample s of gingival crevicular fluid ( GCF ) and subgingival plaque . The laser therapy was started 1 week later and continued once a week for 6 weeks . One side of the upper jaw was treated with active laser and the other with a placebo . The test side was treated with two low-level lasers having wavelengths of 635 and 830 nm . The patients then underwent another clinical examination with sampling of GCF and plaque . The GCF sample s were analysed for elastase activity , interleukin-1beta ( IL-1beta ) and metalloproteinase-8 ( MMP-8 ) . We examined the subgingival plaque for 12 bacteria using DNA probes . RESULTS The clinical variables i.e. probing pocket depth , plaque and gingival indices were reduced more on the laser side than on the placebo one ( p<0.01 ) . The decrease in GCF volume was also greater on the laser side , 0 , 12 microl , than on the placebo side , 0.05 microl ( p=0.01 ) . The total amount of MMP-8 increased on the placebo side but was slightly lower on the laser side ( p=0.052 ) . Elastase activity , IL-1beta concentration and the microbiological analyses showed no significant differences between the laser and placebo sides . CONCLUSION Additional treatment with low-level lasers reduced periodontal gingival inflammation The aim of this study was to determine whether the Nd : YAG laser energies of 50 and 80 mJ at 10 pulses per second ( pps ) were capable of improving the clinical parameters associated with periodontal disease . These energy setting s were chosen as previous work indicated that higher values would damage root surfaces and that 80 mJ had an in-vitro bactericidal effect . Eighty periodontally affected sites in teeth scheduled for extraction from 11 patients with adult periodontitis were r and omly placed in one of the following four treatment groups : 1 . laser treatment at 50 mJ , 10 pps for 3 minutes ; 2 . laser treatment at 80 mJ , 10 pps for 3 minutes ; 3 . scaling and 4 . untreated control .  Probing depth , bleeding on probing ( BOP ) , plaque index , gingival index and gingival crevicular fluid ( GCF ) volume were measured at baseline and week 6 . Baseline subgingival microbiological sample s were collected , then repeated immediately after treatment and at week 6 to assess the total anaerobic colony forming units ( CFU ) . Only the scaling group showed a significant reduction in pocket depth and BOP ( P < 0.001 ) . The microbial sample s taken immediately after scaling and laser at 80 mJ and 10 pps treatments showed a significant reduction in total CFU compared with the baseline ( P < 0.01 ) , which was sustained only in the scaling group until week 6 . Electron microscopy did not reveal any heat damage on the root surfaces . This study demonstrated that application of Nd : YAG laser pulses of 50 mJ and 80 mJ failed to improve the clinical and microbiological parameters of periodontal AIM Primary aim of this study was to evaluate if patient morbidity was improved by diminishing graft thickness and height ; secondary objective was to evaluate if such graft modifications influence root coverage and aesthetic outcomes . METHODS 60 Miller class I and II gingival recessions ( GR ) ( ≥ 3 mm in depth ) were treated with the coronally advanced flap plus extraoral de-epithelialized free gingival graft ( FGG ) . In 30 r and omly selected control GRs ( " big graft group " ) , the FGG thickness was ≥ 2 mm and the height was equal to bone dehiscence ( BD ) ; in the other 30 test defects ( " small graft group " ) , the thickness of the FGG was < 2 mm and the height was 4 mm . The post-operative patient morbidity was assessed 1 week after the surgery . The clinical and aesthetic evaluations were performed 1 year after the surgery . RESULTS Lower analgesic assumption , better post-operative course evaluations , better patient colour match scores and better periodontist aesthetic assessment s were reported in the " small graft " group . No statistically significant differences were demonstrated between the two groups in terms of recession reduction , CRC and increase in KTH . Greater GT increase was obtained in the control-treated sites . CONCLUSIONS Coronally advanced flap plus CTG of reduced thickness and height was associated with less patient morbidity , better aesthetic evaluations with no difference in RC outcomes Among the available techniques to treat gingival recession , connective tissue graft ( CTG ) presents more foreseeability and better results in the long term . However , this technique causes morbidity and discomfort in the palatine region due to graft removal at that site . The aim of this clinical trial was to evaluate the influence of low-level laser therapy ( LLLT ) on the healing of the donor palatine area after CTG .  Thirty-two patients presenting buccal gingival recession were selected and r and omly assigned to receive LLLT irradiation ( test group ) or LLLT sham ( control group ) in the palatine area after connective graft removal . A diode laser ( AsGaAl , 660 nm ) was applied to test the sites immediately after surgery and every other day for 7 days . The evaluated parameters were wound remaining area ( WRA ) , scar and tissue colorimetry ( TC ) , tissue thickness ( TT ) , and postoperative discomfort ( D ) . These parameters were evaluated at baseline and 7 , 14 , 45 , 60 , and 90 days after surgery . Two-way repeated measures ANOVA was used for analysis . The test group presented statistically significant smaller wounds at days 14 and 45 . None of the patients presented a scar at the operated area , and colorimetry analysis revealed that there was no statistically significant difference between groups ( p > 0.05 ) . Patients reported mild to moderate discom 
    Output:
    
Due to the low number of included clinical studies , it remains debatable whether LILT  improves clinical and patient-centered outcomes of PCTG procedures .