***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 To investigate the parameters that affect primary stability of  dental implants  , to determine how primary stability influences posthealing stability , and to ascertain the effect of primary stability and insertion parameters on marginal bone loss .  MATERIAL S AND METHODS A total of 940 immediately loaded implants were considered . Using resonance frequency analysis , primary stability ( primary implant stability quotient [ pISQ ] ) and stability after 4 months ( tISQ ) were recorded . When the differences between pISQ and tISQ exceeded 5 units , marginal bone loss was measured . The implants were placed into three groups based on their primary stability : high ( pISQ > 72 ) , moderate , and low ( pISQ < 68 ) . Changes in stability after 4 months of loading were evaluated . The relationships between pISQ , insertion parameters , DISQ ( ie , tISQ - pISQ ) , and marginal bone loss were analyzed . The Student t test , one-way analysis of variance , and Spearman nonparametric correlation coefficient were employed for statistical evaluation . RESULTS Of the 940 implants , tISQ  was recorded in 526 implants and marginal bone loss was measured in 76 implants . There was no statistical relationship between pISQ and insertion torque . Primary stability was influenced by implant diameter but not by implant length . There was a significant relationship between implant insertion torque and bone type . The low primary stability group showed a significant increase in stability during healing . However , high primary stability implants demonstrated a significant reduction in their stability . The linear regression analysis demonstrated that at a pISQ of 69.2 , tISQ value would equal pISQ value . Correlations between marginal bone loss and final insertion torque and between marginal bone loss and DISQ values were observed . CONCLUSIONS Stability of immediately loaded implants with high pISQ decreased significantly during the initial 4 months of healing . However , stability of implants with low primary stability increased significantly . DISQ and insertion torque showed correlation with marginal bone loss PURPOSE To compare the outcome of immediately loaded  single implants  inserted with medium ( from 25 to 35 Ncm ) or high insertion torques ( > 80 Ncm ) . MATERIAL S AND METHODS Fifty patients received two single non-adjacent implants  , each r and omly inserted flapless with a torque between 25 to 35 Ncm or > 80 Ncm according to a split-mouth design . Non-occluding temporary crowns were immediately placed on provisional abutments and definitive crowns were delivered after 6 weeks . Patients were followed for 6 months after initial loading . Outcome measures were crown/implant failures , complications , peri-implant marginal bone level changes , postoperative pain and presence of peri-implant apical radiolucency . RESULTS No drop-out occurred . Seven implants inserted with a torque between 25 to 35 Ncm failed versus none of the implants inserted with a torque > 35 Ncm . With the exception of crown/implant failures ( exact McNemar significance P = 0.0156 , difference in proportions : -0.12 ; 95 % CI -0.21 to -0.02 ) there were no statistically significant differences between groups for the other outcome measures . CONCLUSIONS It is preferable to insert single implants with a high insertion torque ( > 80 Ncm ) , to minimise early implant failures , when loading them immediately OBJECTIVES To investigate the impact of two surface decontamination methods on the long-term outcomes following combined surgical resective/regenerative therapy of advanced peri-implantitis lesions . MATERIAL AND METHODS Seventeen patients ( n = 17 combined supra- and intrabony-defects ) completed the 48 months follow-up observation following access flap surgery , granulation tissue removal and implantoplasty at bucally and supracrestally exposed implant parts . The remaining unmodified implant surface areas were r and omly treated using either ( i ) an Er : YAG laser ( ERL ) , or ( ii ) plastic curets + cotton pellets + sterile saline ( CPS ) , and augmented with a natural bone mineral + collagen membrane . RESULTS At 48 months , CPS-treated sites tended to reveal higher reductions in mean BOP ( CPS : 85.2 ± 16.4 % versus ERL : 71.6 ± 24.9 % ) and CAL values ( CPS : 1.5 ± 2.0 mm versus ERL : 1.2 ± 2.0 mm ) when compared with the ERL group . In both groups , clinical outcomes were not directly influenced by the initial defect configuration . CONCLUSION The 4-year clinical outcomes obtained following combined surgical resective/regenerative therapy of advanced peri-implantitis were not influenced by the method of surface decontamination Our objective was to compare survival and peri-implant bone levels of immediately nonocclusally vs early loaded implants in partially edentulous patients up to 12 months after implant placement . Eighty patients ( inclusion criteria : general good health , good oral hygiene , 30 - 65 years old ; exclusion criteria : head and neck irradiation/cancer , pregnancy , uncontrolled diabetes , substance abuse , bruxism , lack of opposing occluding dentition , smokers > 10 cigarettes/day , need for bone augmentation procedures ) were selected in 5 Italian study centers and r and omized into 2 groups : 40 patients in the immediately loaded group ( minimal insertion torque 30 Ncm ) and 40 patients in the early loaded group . Immediately loaded implants were provided with nonoccluding temporary restorations . Final restorations were provided 2 months later . Early loaded implants were provided with a definitive restoration after 2 months . Peri-implant bone resorption was evaluated radiographically with software ( ImageJ 1.42 ) . No dropout occurred . Both groups gradually lost peri-implant bone . After 12 months , patients of both groups lost an average of 0.4 mm of peri-implant bone . There were no statistically significant differences ( evaluated with t test ) between the 2 loading strategies for peri-implant bone level changes at 2 ( P = .6730 ) , 6 ( P = .6613 ) and 12 ( P = .5957 ) months or for survival rates ( 100 % in both groups ) . If adequate primary stability is achieved , immediate loading of dental implants can provide similar success rates , survival rates , and peri-implant bone resorption as compared with early loading , as evaluated in the present study PURPOSE The primary goal of this stratified r and omized controlled trial ( S RCT ) was to compare the stability of  dental implants  placed under three different loading regimens during the first 16 weeks of healing following implant placement . Implants were loaded immediately , early ( 6 weeks ) , or with conventional/delayed timing ( 12 weeks ) . Secondary outcomes were to compare marginal bone adaptation for 3 years after placement . MATERIAL S AND METHODS Single posterior implant sites in the maxilla or m and ible were examined . The insertion torque value was the primary determinant of load assignment . Resonance frequency analysis was performed at follow-up appointments for the first 16 weeks ( with results provided as implant stability quotients [ ISQs ] ) . Marginal bone levels were assessed via radiographs . RESULTS Forty patients each received a single 4.0-mm diameter dental implant between 2004 and 2007 . One implant failure occurred in Lekholm and Zarb type 4 bone with insertion torque value ( ITV ) of < 8.1 Ncm ; the cumulative success rate was 97.5 % . All implants , when classified by bone and loading type , increased in stability over time , with a minor reduction of 1.3 ISQ units seen at 4 weeks in the immediate loading group . The mean marginal bone loss over 3 years was 0.22 mm . The mean ITVs at implant placement for bone types 1 and 2 ( grouped together ) , 3 , and 4 were 32 , 17 , and 10 , respectively , and were significantly different ( P < .05 ) . CONCLUSIONS ITV was a good objective measure of bone type . Using an ITV of 20 Ncm as the determinant for immediate loading and an ITV of 10 Ncm or greater as the determinant for early loading provided long-term success for this implant and led to no negative changes in tissue response . All bone type groups and loading groups showed no reduction in stability during the first 4 months of healing Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials PURPOSE The aim of this prospect i ve clinical study was to evaluate the survival rates at 12 months of transmucosal implants placed in the posterior m and ible and immediately restored with single crowns . MATERIAL S AND METHODS Thirty ITI dental implants with s and blasted , acid-etched surfaces  were placed in 30 patients missing at least 1 m and ibular molar and immediately restored if acceptable primary stability was attained . Primary stability was measured with resonance frequency analysis ( RFA ) using the Osstell device , and only implants with a stability quotient greater than 62 were included in the study . RFA measurement and radiographic assessment were made at baseline and 6 months after implant placement . Plaque Index , Bleeding Index , probing depth , attachment level , and width of keratinized tissue were measured at the 12 month follow-up examination . RESULTS At 12 months , only 1 implant had been lost ; it was removed because of acute infection . Radiographic as well as clinical examination confirmed osseointegration of all implants , with a survival rate of 96.7 % . DISCUSSION Interestingly , implant stability as measured using RFA did not increase significantly from baseline to 12 months ( P > .05 ) . CONCLUSION The present study showed that immediate restoration of transmucosal implants placed in the m and ibular area with good primary stability can be a safe and successful procedure . However , larger , long-term clinical trials are needed to confirm the present results PURPOSE This prospect i ve r and omized controlled trial aim ed to compare single implant-supported m and ibular molar restorations  using either an immediate or a delayed loading protocol . MATERIAL S AND METHODS Thirty subjects requiring single m and ibular molar replacement were consecutively treated . One implant was placed in each patient . Fifteen subjects were assigned to delayed loading protocol and 15 to immediate loading protocol  according to a r and omization table . After insertion , the delayed loaded implants were connected to a healing abutment and restored after 3 to 4 months of healing without loading . The immediately loaded implants were loaded within 24 hours of surgery with a provisional restoration . The interim prosthesis was placed in centric occlusion . All contacts in lateral excursions were eliminated . At implant placement the maximum value of insertion torque was recorded . Radiographic bone level change was measured on periapical radiographs obtained at the time of implant placement and 12 months after loading . Means of the 2 groups were compared by Student t test and analysis of variance ( ANOVA ) . The level of significance was set at .05 . RESULTS No implants were lost in the delayed loading group ( 0/15 ) , whereas 1 implant failed ( 1/15 ) in the immediate loading group . No differences were observed in relation to implant length or insertion torque between the groups . The average radiographic bone level change after 1 year of function was 1.2 + /- 0.55 mm ( range , 0.5 to 2.6 mm ) and 0.77 + /- 0.38 mm ( range , 0.29 to 1.23 mm ) for the delayed loaded and the immediately loaded implants , respectively . The difference in radiographic bone level change between the delayed and immediate loading groups was statistically significant ( P = .022 ; CI = -0.79 to -0.06 ; Student t test ) . CONCLUSIONS Immediate loading 
    Output:
    
There is not strong evidence that insertion torque of 30 Ncm is enough for implant survival in cases of immediate loading