***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 AND OBJECTIVE This cross-sectional case-control study was conducted to provide a comparative evaluation of clinical periodontal measurements , together with serum levels of certain bioactive peptides and inflammatory cytokines , in relation to obesity . For this purpose , clinical periodontal measurements and the levels of serum leptin , adiponectin , interleukin-6 ( IL-6 ) , C-reactive protein and soluble intercellular adhesion molecule-1 of obese female individuals and their nonobese counterparts were compared . MATERIAL AND METHODS Sixty obese ( body mass index ( BMI ) > 30 ) and 31 nonobese ( BMI < 30 ) female subjects were recruited for the present study . Before any periodontal intervention , serum sample s were obtained and full-mouth clinical periodontal measurements were recorded at six sites per tooth . ELISA was used for the biochemical analysis . Data were tested statistically . RESULTS Clinical attachment level was significantly higher in the obese group compared with the nonobese control group ( p < 0.05 ) . Serum levels of leptin and IL-6 were significantly higher in the obese group ( p < 0.05 ) . BMI correlated with the serum levels of inflammatory molecules ( p < 0.05 ) , but not with clinical periodontal parameters , in the obese group . CONCLUSION In conclusion , obesity does not seem to have a prominent effect on clinical periodontal parameters but it does have many correlations with circulating inflammatory molecules . As suggested in the literature , increased levels of leptin and IL-6 in the obese group might be one explanation for a possible relationship between obesity and periodontal disease . A prospect i ve study is warranted to clarify , in greater detail , the effects of obesity on periodontal health AIM The purpose of this prospect i ve cohort study was to investigate whether body mass index ( BMI ) and oral health behaviour are related to changes in periodontal status in Japanese university students . MATERIAL S AND METHODS Students ( n = 224 ) who were interested in receiving oral health examinations before entering university and before graduation were included in the analysis . Subjects were investigated regarding the correlations of oral health behaviours and increases in BMI with the percentage of bleeding on probing ( % BOP ) and Community Periodontal Index ( CPI ) scores as indicators of changes in periodontal status . RESULTS The risk of increased % BOP was associated with the non-use of dental floss ( adjusted odds ratio [ OR ] : 3.11 ; 95 % confidence interval [ CI ] : 1.31 - 7.37 ; p < 0.05 ) , whereas the risk of increased CPI score was associated with increases in BMI ( OR : 1.95 ; 95 % CI : 1.05 - 3.65 ; p < 0.05 ) and simplified oral hygiene index score ( OR : 2.28 ; 95 % CI : 1.23 - 4.22 ; p < 0.01 ) . CONCLUSION Increases in BMI were associated with worsening of periodontal status , defined as increased CPI score in Japanese university students , whereas lack of inter-dental cleaning was associated with exacerbated gingival bleeding OBJECTIVE To investigate the effect of conventional periodontal therapy on serum C-reactive protein ( CRP ) level and periodontal status in obese and normal-weight chronic periodontitis patients . METHODS This is a controlled clinical trial conducted at the King Abdulaziz University Faculty of Dentistry , Jeddah , Kingdom of Saudi Arabia between December 2009 and March 2011 . A total of 40 women affected with moderate to severe chronic periodontitis were selected ( 20 obese [ test group ] and 20 normal-weight [ control ] ) . Smokers , pregnant women , and subjects with any systemic disease were excluded . Serum CRP level and periodontal parameters , including clinical attachment level , probing depth , bleeding on probing and plaque scores were assessed at baseline , and 2 months after non-surgical periodontal treatment . RESULTS Periodontal therapy was effective in reducing gingival inflammation , as well as serum CRP level in the total sample and within each group . The pre-treatment mean level of serum CRP was 0.78 ( + /-0.51 ) and post- treatment was 0.55 ( + /-0.41 ) mg/l in the total sample ( p=0.001 ) . A tendency was observed toward a better systemic response to treatment in normal-weight compared to obese women , however , it was not statistically significant ( the mean changes in CRP levels after therapy were 0.28 [ + /-0.43 ] and 0.19 [ + /-0.32 ] mg/l ) . CONCLUSION Periodontal treatment is effective in reducing systemic inflammation as measured by serum CRP level , and obesity does not have a major negative impact on response to periodontal therapy BACKGROUND Earlier studies have shown an association between obesity and periodontitis , which is mediated by cytokine production . The aim of this study is to assess the role of obesity as a modifying factor on periodontal clinical parameters and on circulating proinflammatory cytokine levels in subjects undergoing non-surgical periodontal treatment .  METHODS Twenty-seven obese subjects and 25 normal-weight subjects were enrolled in this study . Subjects in both groups had generalized chronic periodontitis . The periodontal parameters measured before and 3 months after non-surgical periodontal therapy were : visible plaque index , bleeding gingival index , bleeding on probing , probing depth , and clinical attachment level . In addition , subjects underwent anthropometric measurements and serum analyses of fasting glucose , glycated hemoglobin , interleukin-1β , interleukin-6 , tumor necrosis factor-α , and interferon-γ . RESULTS Periodontal therapy significantly decreased visible plaque index , bleeding gingival index , bleeding on probing , probing depth of 4 to 6 mm , probing depth ≥7 mm , clinical attachment level of 4 to 6 mm , and clinical attachment level ≥7 mm in both groups ( P ≤0.05 ) . Circulating proinflammatory cytokines significantly decreased in obese and normal-weight subjects after periodontal treatment ( P ≤0.05 ) . However , interleukin-6 and tumor necrosis factor-α levels remained higher in obese subjects 3 months after treatment ( P ≤0.05 ) . CONCLUSION Obesity does not seem to play a negative role by interfering in the improvement of the periodontal clinical response or decreasing circulating proinflammatory cytokine levels after periodontal treatment 
    Output:
    
Obesity is characterized by a chronic sub clinical inflammation that could exacerbate other chronic inflammatory disorders like as periodontitis .
CONCLUSIONS The association between obesity and periodontitis was consistent with a compelling pattern of increased risk of periodontitis in overweight or obese individuals .
Although the underlying pathophysiological mechanism remains unclear , it has been pointed out that the development of insulin resistance as a consequence of a chronic inflammatory state and oxidative stress could be implicated in the association between obesity and periodontitis .