***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 / AIM The purpose of the present investigation was to determine the effect of self-performed supragingival plaque removal using either manual ( Crest Complete ) or power ( Braun 3D Plaque Remover ) toothbrushing on supra and subgingival plaque composition . METHODS 47 periodontal maintenance subjects completed this single-blind 6 month longitudinal study . At baseline , sample s of supra and separately subgingival plaque were taken from the mesial aspect of each tooth in each subject using sterile curettes and individually analyzed for their content of 18 bacterial taxa using checkerboard DNA-DNA hybridization . After r and om assignment to groups receiving either a manual ( n=25 ) or power toothbrush ( n=22 ) , subjects received instruction in oral hygiene and used their assigned toothbrush 2x daily for 6 months . Clinical monitoring and microbiological sampling were repeated at 3 and 6 months . Significant differences in microbiological measures over time were sought using the Quade test and between brushing groups at each time point using the Mann-Whitney test . RESULTS Mean total counts were significantly reduced for supra- and subgingival plaque sample s in the manual group and subgingival sample s in the powered brushing group . Actinomyces naeslundii and Actinomyces israelii/gerencseriae were the most numerous organisms detected at baseline and showed the greatest reductions in counts in both brushing groups . Streptococcus constellatus/intermedius was significantly reduced in both groups , while Streptococcus mitis/oralis/sanguis was significantly reduced in the manual toothbrushing group . Mean counts of species were more markedly altered in subgingival plaque . Major reductions occurred in both groups for A. naeslundii , A. israelii/gerencseriae , Peptostreptococcus micros , Veillonella parvula , Prevotella intermedia/nigrescens , S. mitis/oralis/sanguis and S. constellatus/intermedius . All taxa examined were reduced in prevalence ( % of sites colonized ) in the subgingival plaque sample s for both brushing groups . The reductions in prevalence were greater for A. naeslundii , S. constellatus/intermedius , V. parvula , A. israelii/gerencseriae , S. mitis/oralis/sanguis , P. micros , Streptococcus mutans and P. intermedia/nigrescens . Mean prevalence was decreased more for Porphyromonas gingivalis , Campylobacter rectus/showae , Treponema denticola and Bacteroides forsythus in supragingival plaque than subgingival plaque . CONCLUSIONS The major finding was the effect of supragingival plaque removal on the composition of the subgingival microbiota . Counts and prevalence of most taxa examined were markedly decreased in both toothbrushing groups . This reduction should translate to a decreased risk of periodontal disease initiation or recurrence . Further , the decreased prevalence of periodontal pathogens in supragingival plaque lowers potential reservoirs of these species OBJECTIVE To compare the short-term performance of subgingival local delivery of 2 % minocycline gel and conventional subgingival debridement in supportive periodontal therapy ( SPT ) patients . METHODS Forty adult patients having completed active treatment for moderate to advanced chronic periodontitis were included in a r and omized , controlled , single masked maintenance care pilot study . Sites with residual pocket probing depths > or = 5 mm and bleeding on probing were treated with either minocycline gel ( minocycline-group ) or scaling and root planing only ( debridement-group ) at baseline , 3 , 6 , and 9 months . Clinical and microbiological examinations were performed at baseline , 3 , 6 , 9 , and 12 months . RESULTS Full-mouth plaque and bleeding scores remained < 10 % and < 20 % , respectively , for both groups throughout the study . In both groups there was a persistent reduction in number of teeth and sites with probing pocket depths > or = 5 mm ( p<0.05 ) with no significant differences between the groups . The prevalence of Porphyromonas gingivalis , Tannerella forsythia , Treponema denticola , Actinobacillus actinomycetemcomitans , Prevotella intermedia , and Prevotella nigrescens , remained at levels < or = 10(5 ) in the majority of patients and sites in both groups . CONCLUSION This pilot study failed to show a difference between local delivery of 2 % minocycline gel as mono-therapy and traditional subgingival debridement in patients on SPT AIM The objective of this r and omized , controlled clinical trial was to compare the clinical and microbiological effects of pocket debridement using erbium-doped : yttrium , aluminium and garnet ( Er : YAG ) laser with conventional debridement in maintenance patients . MATERIAL & METHODS Fifteen patients , all smokers , having at least four teeth with residual probing depth ( PD ) ≥ 5 mm were recruited . Two pockets in two jaw quadrants were r and omly assigned to subgingival debridement using an Er : YAG laser ( test ) or ultrasonic scaler/curette ( control ) at 3-month intervals . Relative attachment level ( RAL ) , PD , bleeding on probing and dental plaque were recorded at baseline and at 6 and 12 months . Microbiological subgingival sample s were taken at the same time points and analysed using a checkerboard DNA-DNA hybridization technique . RESULTS A significant decrease in PD took place in both treatments from baseline to 12 months ( p < 0.01 ) . In the control , the mean initial PD decreased from 5.4 to 4.0 mm at 12 months . For the test , a similar decrease occurred . No significant between-treatment differences were shown at any time point . The mean RAL showed no overall significant inter- or intra-treatment differences ( p > 0.05 ) . No significant between-treatment differences were observed in subgingival microbiological composition or total pathogens . CONCLUSION The results failed to support that an Er : YAG laser may be superior to conventional debridement in the treatment of smokers with recurring chronic inflammation . This appears to be the first time that repeated Er-YAG laser instrumentation has been compared with mechanical instrumentation of periodontal sites with recurring chronic inflammation over a clinical ly relevant time period Objectives To evaluate repeated subgingival air-polishing in residual pockets with a new erythritol powder containing 0.3 % chlorhexidine . Material and Methods Single-centre , examiner masked , r and omized clinical trial of 12 months with a two-arm , within-subject parallel design . Fifty patients in periodontal maintenance were monitored in 3-month intervals . At months 0 , 3 , 6 and 9 , all sites presenting with a probing depth ( PD ) > 4 mm were subject to subgingival air-polishing ( test side ) or ultrasonic debridement ( control side ) . The primary endpoint was presence/absence of PD > 4 mm after 12 months . Results Totally 6918 sites were monitored at baseline , 457 of them had a PD > 4 mm ( range 5–9 mm ) . The number of pockets > 4 mm per subject , PD and bleeding on probing were significantly lower at month 12 . Differences between test and control were not significant . There was a significant difference in favour of air-polishing for the perception of pain/discomfort . Differences of frequencies at > 1000 and > 100,000 cells/ml of six microorganisms between baseline and month 12 were not significant . At month 12 , test sites were less frequently positive for Aggregatibacter actinomycetemcomitans at > 1000 cells/ml than controls , and counts never exceeded 100,000 cells/ml . Conclusions Repeated subgingival air-polishing reduced the number of pockets > 4 mm similar to ultrasonic debridement . It was safe and induced less pain Recent pre clinical and clinical data have suggested the potential benefit of photodynamic therapy ( PDT ) in the treatment of periodontitis . However , currently , there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis . The aim of the present study was to evaluate the clinical and microbiological effects of the adjunctive use of PDT in non-surgical periodontal treatment in patients receiving supportive periodontal therapy . Twenty-four patients receiving regularly supportive periodontal therapy were r and omly treated with either subgingival scaling and root planing followed by a single episode of PDT ( test ) or subgingival scaling and root planing alone ( control ) . The following parameters were evaluated at baseline and at 3 months and 6 months after therapy : full mouth plaque score ( FMPS ) , full mouth bleeding score ( FMBS ) , bleeding on probing ( BOP ) at experimental sites , probing pocket depth ( PPD ) , gingival recession ( REC ) , and clinical attachment level ( CAL ) . Primary outcome variables were changes in PPD and CAL . Microbiological evaluation of Aggregatibacter actinomycetemcomitans ( A.a . ) , Porphyromonas gingivalis ( P.g . ) , Prevotella intermedia ( P.i . ) , Tannerella forsythensis ( T.f . ) , Treponema denticola ( T.d . ) , Peptostreptococcus micros ( P.m . ) , Fusobacterium nucleatum ( F.n . ) , Campylobacter rectus ( C.r . ) , Eubacterium nodatum ( E.n . ) , Eikenella corrodens ( E.c . ) , and Capnocytophaga species ( C.s . ) was also performed at baseline and at 3 months and 6 months after therapy , using a commercially available polymerase chain reaction test . No differences in any of the investigated parameters were observed at baseline between the two groups . At 3 months and 6 months after treatment , there were no statistically significant differences between the groups in terms of PPD , CAL and FMPS . At 3 months and 6 months , a statistically significantly higher improvement of BOP was found in the test group . At 3 months after therapy , the microbiological analysis showed a statistically significant reduction of F.n . and E.n . in the test group . At 6 months , statistically significantly higher numbers of E.c . and C.s . were detected in the test group . The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PPD reduction and CAL gain , but it result ed in significantly higher reduction of bleeding scores than following scaling and root planing alone BACKGROUND This study assessed the long-term effects of adjunctive antimicrobial therapy on  periodontal disease progression and oral colonization . METHODS Patients with previously untreated chronic periodontitis and subgingival Actinobacillus actinomycetemcomitans and /or Porphyromonas gingivalis were r and omly assigned to subgingival scaling without ( control group ) or with systemic amoxicillin plus metronidazole and CHX irrigation ( test group ) . Relative attachment levels were determined and subgingival and mucosal plaque sample s were taken at baseline , at 10 days ( plaque only ) and at 3 , 6 , 9 , 12 , 18 , and 24 months following initial therapy . During maintenance therapy , patients received supragingival debridement only . RESULTS After 24 months , the 18 test group patients showed at sites with initial probing depths ( PD ) > or = 7 mm a significantly ( P < 0.05 ) higher frequency of 2 mm or more attachment gain ( 37.3 % + /- 4.6 % ) and lower frequency of attachment loss ( 7.2 % + /- 3.1 % ) compared to the 17 controls ( 8.2 % + /- 3.9 % and 19.1 % + /- 13.1 % , respectively ) . Compared to controls , the intraoral prevalence of A. actinomycetemcomitans ( up to 18 months ) and P. gingivalis ( up to 3 months ) decreased and that of Eikenella corrodens ( at 10 days ) increased in test patients ( P < 0.05 ) . In both treatment groups , the detection frequency of Tannerella forsythensis decreased transiently , while an overall increase was recorded for Treponema ssp . CONCLUSIONS Over the 24-month period , a single course of the administered adjunctive antimicrobial therapy led to a relative risk reduction of 62 % for attachment loss at deep sites . However , with the exception of A. actinomycetemcomitans , it failed to induce long-term changes in the prevalence profiles of oral colonization The present study evaluated the long-term effect of ( i ) meticulous self-performed , supragingival plaque control and ( ii ) the use of a triclosan/copolymer containing dentifrice in adult subjects susceptible to destructive periodontitis . 40 individuals were recruited into the trial . 3 - 5 years prior to the baseline examination , they had all been treated by nonsurgical means- for advanced periodontal disease . During the subsequent maintenance phase , all subjects had at different time intervals exhibited sites with recurrent periodontitis . At a baseline examination , 6 surfaces per tooth were examined regarding bleeding on probing , probing pocket depth , and probing attachment level . The deepest pocket site in each quadrant ( i.e. 4 sites per subject ) was selected and sample s of the subgingival bacteria were taken . At baseline , all volunteers received detailed information on proper oral hygiene techniques . This information was repeated on an individual need basis during the course of the subsequent 36-months . No professional subgingival therapy was delivered between the baseline and the 36-month examinations . The subjects were r and 
    Output:
    
The results showed that both SPG and SPG+SBG protocol s of PMP determined stability in the microbiological results along time .