human
***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: OBJECTIVE The efficacy of a topical application of hyaluronic acid ( HA ) was tested for treating gingivitis . METHOD AND MATERIAL S Sixty nonsmoking out patients in good general condition , with clinical signs of gingivitis , were included in the study . Forty patients ( HA group , 20 men , 20 women ; age : 32.8 + /- 11.3 years ) used a spray containing HA 5 times daily over a period of 1 week . The control group consisted of 20 patients ( 10 men , 10 women ; age : 31.3 + /- 9.3 years ) . The clinical parameters DMF-T ( decayed , missed , filled teeth ) index , approximal plaque index , sulcus bleeding index , papilla bleeding index , and gingival crevicular fluid were measured at baseline ( T1 ) , after 3 days ( T2 ) , and after 7 days ( T3 ) . RESULTS A reduction in the sulcus bleeding index of the HA group ( T1 : 72.9 + /- 19.5 % ) to 50.3 + /- 21.1 % was noted at T2 , and at T3 the sulcus bleeding index was 40.7 + /- 23.0 % . The papilla bleeding index values of the HA group were 1.6 at T1 , 1.0 at T2 , and 0.7 at T3 . The gingival crevicular fluid showed significant reductions in the HA group . At T1 the recorded mean value was 16.3 , at T2 it was 11.8 , and at T3 it was 7.9 . Only insignificant changes were observed in the respective indices of the control group . There were no significant alterations in the plaque values of either group throughout the study period . CONCLUSION The results obtained by this study demonstrate that the topical application of an HA-containing preparation represents a potentially useful adjunct in the therapy of gingivitis , although its use does not diminish the need for plaque reduction as a primary therapeutic measure To determine the safety and efficacy of viscosupplementation with hylan G-F 20 , a cross-linked hyaluronan preparation , used either alone or in combination with continuous non-steroidal anti-inflammatory drug ( NSAID ) therapy , a r and omized , controlled , multicenter clinical trial , assessed by a blinded assessor , was conducted in 102 patients with osteoarthritis ( OA ) of the knee . All patients were on continuous NSAID therapy for at least 30 days prior to entering the study . Patients were r and omized into three parallel groups : ( 1 ) NSAID continuation plus three control arthrocenteses at weekly intervals ; ( 2 ) NSAID discontinuation but with three weekly intra-articular injections of hylan G-F 20 ; and ( 3 ) NSAID continuation plus three injections , one every week , intra-articular injections of hylan G-F 20 . Outcome measures of pain and joint function were evaluated by both the patients and an evaluator at baseline and weeks 1 , 2 , 3 , 7 and 12 , with a follow-up telephone evaluation at 26 weeks . At 12 weeks all groups showed statistically significant improvements from baseline , but did not differ from each other . A statistical test for the equivalence , the q-statistic , demonstrated that viscosupplementation with hylan G-F 20 was at least as good or better than continuous NSAID therapy for all outcome measurements except activity restriction . At 26 weeks both groups receiving hylan G-F 20 were significantly better than the group receiving NSAIDs alone . A transient local reaction was observed in three patients after hylan G-F 20 injection ; only one patient withdrew from the study as a result and all recovered without any sequela . Hylan G-F 20 is a safe and effective treatment for OA of the knee and can be used either as a replacement for or an adjunct to NSAID therapy BACKGROUND The study is design ed to determine the effect on clinical variables , subgingival bacteria , and local immune response brought about by application of hyaluronan-containing gels in early wound healing after scaling and root planing ( SRP ) . METHODS In this r and omized clinical study , data from 34 individuals with chronic periodontitis were evaluated after full-mouth SRP . In the test group ( n = 17 ) , hyaluronan gels in two molecular weights were additionally applied during the first 2 weeks after SRP . The control group ( n = 17 ) was treated with SRP only . Probing depth ( PD ) and clinical attachment level ( CAL ) were recorded at baseline and after 3 and 6 months , and subgingival plaque and sulcus fluid sample s were taken for microbiologic and biochemical analysis . RESULTS In both groups , PD and CAL were significantly reduced ( P < 0.001 ) . The changes in PD and the reduction of the number of pockets with PD ≥5 mm were significantly higher in the test group after 3 ( P = 0.014 and 0.021 ) and 6 ( P = 0.046 and 0.045 ) months . Six months after SRP , the counts of Treponema denticola were significantly reduced in both groups ( both P = 0.043 ) , as were those of Campylobacter rectus in the test group only ( P = 0.028 ) . Prevotella intermedia and Porphyromonas gingivalis increased in the control group . CONCLUSION The adjunctive application of hyaluronan may have positive effects on PD reduction and may prevent recolonization by periodontopathogens AIMS The aim of this clinical trial was to compare clinical and biochemical healing outcomes following ultrasonic mechanical instrumentation versus ultrasonic mechanical instrumentation associated with topical subgingival application of amino acids and sodium hyaluronate gel . METHODS Eleven systemically healthy subjects with moderate-severe chronic periodontitis , who had four sites with pocket probing depth and clinical attachment level greater than or equal to 5 mm were r and omly assigned to two different types of treatment : two pockets were treated with ultrasonic debridement ( Control Group ) and two pockets with ultrasonic mechanical instrumentation associated with 0,5 ml of amino acids and sodium hyaluronate gel ( Test Group ) . Probing depth , clinical attachment level , plaque index and bleeding on probing were recorded at baseline , 45 and 90 days . Levels of calprotectin and myeloperoxidase activity in gingival crevicular fluid were assessed at baseline and on day 7 and 45 . RESULTS Statistical significance was found between baseline and day 45 in relation to probing depth reduction and bleeding on probing between groups for both of the tested treatments . Significant reductions in μg/ sample of calprotectin and myeloperoxidase were found after 1-week and an increase at 45 days in both groups . There were no statistically significant differences between other variables evaluated in this study . CONCLUSIONS These data suggest that subgingival application of hyaluronic acid following ultrasonic mechanical instrumentation is beneficial for improving periodontal parameters OBJECTIVES To evaluate the effects of a 1 % hyaluronic acid ( HA ) gel in combination with an absorbable collagen sponge ( ACS ) in the healing of critical-size calvaria defects in rats . MATERIAL AND METHODS Thirty-two adult Wistar rats were used . Two 5-mm-diameter critical-size defects were created and the treatments were r and omly distributed as follows : ( 1 ) 1 % HA ; ( 2 ) 1 % HA gel-soaked ACS ; ( 3 ) control ( blood clot ) ; and ( 4 ) ACS . The animals were sacrificed 60 days post-surgery , when biopsies were collected and processed for histology and histometric analysis . Bone fill was measured as the difference between the initial and the final defect sizes . Non-parametric tests were used to analyze differences between treatments ( α=1 % ) and a t-test for body weight gain in each treatment group ( α=5 % ) . RESULTS Histological analysis showed bone formation on the edges of the defects , although very limited , and a thin layer of connective tissue occupying the midportion of the defects in the control and the ACS groups . Defects filled with a 1 % HA gel and 1 % HA gel+ACS had a thicker layer of connective tissue and more new bone formed in the margins of the defects . Linear histometric measures showed no significant differences in the initial defect sizes between the groups ( P>0.05 ) . The association 1 % HA gel+ACS ( 0.96 ± 0.14 mm ) had significantly greater bone fill than the control ( 0.5 ± 0.02 mm ) and ACS ( 0.56 ± 0.05 mm)-treated groups ( P=0.0043 and 0.0173 , respectively ) . Treatment with a 1 % HA gel ( 0.7 ± 0.14 mm ) showed no significant differences when compared with the other treatments . CONCLUSION Within the limits of this study , a 1 % HA gel associated with a collagen scaffold can improve new bone formation in critical-size defects . However , this treatment never result ed in complete closure of the defects and healing in the major portion of the defects was characterized by fibrous tissue BACKGROUND The aims of this study were to investigate the anti-inflammatory effect and the effect on bone regeneration of hyaluronan in surgical and non-surgical groups . METHODS In each of 15 individuals , 2 teeth with defects of similar character and magnitude in the upper or lower jaw were chosen . There were at least 2 teeth between the test and the control sites . In the surgical group , a bioabsorbable membrane was used for both test and control sites , and hyaluronan was placed in the intrabony pocket of the test site . In the non-surgical group , the periodontal pockets were scaled and hyaluronan was administered 3 times with an interval of 1 week in the test pockets . Alveolar bone height and bone healing patterns were analyzed using digital intraoral radiographs . Measurements of bone height were performed in the original digital black- and -white radiographs to obtain quantitative data on bone gain or loss . Bone healing patterns were studied with color-coded radiographs , using specially design ed software in a personal computer with subsequent combinations of radiographs . Gingival crevicular fluid immunoglobulin (Ig)G , C3 , and prostagl and in E2 ( PGE2 ) responses ; periodontal probing depth ; bleeding on probing ; and the presence of plaque were studied to evaluate the anti-inflammatory effect . Data were obtained at baseline before treatment , and at 2 weeks , and 1 , 3 , 6 , and 12 months after treatment . RESULTS For the surgical treatments , bone height was increased in the test group treated with hyaluronan ( mean value 2.2 % , corresponding to an average increase of approximately 0.5 mm ) and reduced in the control group ( mean value -1.8 % , corresponding to an average decrease of approximately - 0.4 mm ) ( P<0.05 ) after 12 months . For the non-surgical treatments , bone height was reduced by a mean value of -1.1 % ( corresponding to an average decrease of approximately -0.25 mm ) in the test group treated with hyaluronan and -3.3 % ( corresponding to an average decrease of approximately -0.75 mm ) in the control group after 12 months ( N.S. ) . According to the digital color-coded radiographs , the test sites in the surgical and non-surgical groups showed apposition of bone minerals . Immune responses showed no differences during the 12 months studied for the surgical and non-surgical sites . Mean periodontal probing depths were reduced between 2.5 mm and 4.1 mm in the surgical and non-surgical groups . CONCLUSIONS The observed difference in bone height between test and control sites in the surgical group after 12 months was less than 1 mm , which was only detectable on radiographs . No statistical difference was found on radiographs in the non-surgical group , where a decrease in bone height was found for both groups after scaling . Probing depth reduction after the surgical treatment , as well as after scaling and root planing , was as expected . Hyaluronan in contact with bone and soft tissues had no influence on the immune system in this study . Further studies are needed to determine the extent to which hyaluronan can lead to clinical ly significant healing of periodontal lesions Aim : The aim of this study was to evaluate the effects of hyaluronan ( HA ) and chlorhexidine ( CHX ) gels as adjunct to scaling and root planing ( SRP ) in the treatment of chronic periodontitis . Material s and Methods : Sixty patients within the age group of 30 - 65 years recruited to participate in the study were r and omly equally divided into three groups . Complete SRP and subgingival debridement were performed within 6 h in all the patients . For control ( Group I ) patients , SRP was the only treatment modality given ; for Group II and III patients , at least 8 teeth with 4 - 8 mm probing pocket depth ( PPD ) were selected for subgingival application of HA gel and CHX gel , respectively . Clinical periodontal parameters such as gingival index , PPD , and clinical attachment level ( CAL ) were recorded at baseline and 3 months , whereas plaque index was recorded at baseline , 1 month , and 3 months . For measuring systemic/hematological parameters , blood sample s for laboratory tests for total leucocyte count ( TLC ) , differential leucocyte count ( DLC ) , and C-reactive protein ( CRP ) were obtained using st and ard 2-mL syringe from each subject in all the three groups at baseline , 24 h , and on the 1 month and 3 months post-baseline . Results : In all 
    Output:
    
agent
***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: OBJECTIVE The efficacy of a topical application of hyaluronic acid ( HA ) was tested for treating gingivitis . METHOD AND MATERIAL S Sixty nonsmoking out patients in good general condition , with clinical signs of gingivitis , were included in the study . Forty patients ( HA group , 20 men , 20 women ; age : 32.8 + /- 11.3 years ) used a spray containing HA 5 times daily over a period of 1 week . The control group consisted of 20 patients ( 10 men , 10 women ; age : 31.3 + /- 9.3 years ) . The clinical parameters DMF-T ( decayed , missed , filled teeth ) index , approximal plaque index , sulcus bleeding index , papilla bleeding index , and gingival crevicular fluid were measured at baseline ( T1 ) , after 3 days ( T2 ) , and after 7 days ( T3 ) . RESULTS A reduction in the sulcus bleeding index of the HA group ( T1 : 72.9 + /- 19.5 % ) to 50.3 + /- 21.1 % was noted at T2 , and at T3 the sulcus bleeding index was 40.7 + /- 23.0 % . The papilla bleeding index values of the HA group were 1.6 at T1 , 1.0 at T2 , and 0.7 at T3 . The gingival crevicular fluid showed significant reductions in the HA group . At T1 the recorded mean value was 16.3 , at T2 it was 11.8 , and at T3 it was 7.9 . Only insignificant changes were observed in the respective indices of the control group . There were no significant alterations in the plaque values of either group throughout the study period . CONCLUSION The results obtained by this study demonstrate that the topical application of an HA-containing preparation represents a potentially useful adjunct in the therapy of gingivitis , although its use does not diminish the need for plaque reduction as a primary therapeutic measure To determine the safety and efficacy of viscosupplementation with hylan G-F 20 , a cross-linked hyaluronan preparation , used either alone or in combination with continuous non-steroidal anti-inflammatory drug ( NSAID ) therapy , a r and omized , controlled , multicenter clinical trial , assessed by a blinded assessor , was conducted in 102 patients with osteoarthritis ( OA ) of the knee . All patients were on continuous NSAID therapy for at least 30 days prior to entering the study . Patients were r and omized into three parallel groups : ( 1 ) NSAID continuation plus three control arthrocenteses at weekly intervals ; ( 2 ) NSAID discontinuation but with three weekly intra-articular injections of hylan G-F 20 ; and ( 3 ) NSAID continuation plus three injections , one every week , intra-articular injections of hylan G-F 20 . Outcome measures of pain and joint function were evaluated by both the patients and an evaluator at baseline and weeks 1 , 2 , 3 , 7 and 12 , with a follow-up telephone evaluation at 26 weeks . At 12 weeks all groups showed statistically significant improvements from baseline , but did not differ from each other . A statistical test for the equivalence , the q-statistic , demonstrated that viscosupplementation with hylan G-F 20 was at least as good or better than continuous NSAID therapy for all outcome measurements except activity restriction . At 26 weeks both groups receiving hylan G-F 20 were significantly better than the group receiving NSAIDs alone . A transient local reaction was observed in three patients after hylan G-F 20 injection ; only one patient withdrew from the study as a result and all recovered without any sequela . Hylan G-F 20 is a safe and effective treatment for OA of the knee and can be used either as a replacement for or an adjunct to NSAID therapy BACKGROUND The study is design ed to determine the effect on clinical variables , subgingival bacteria , and local immune response brought about by application of hyaluronan-containing gels in early wound healing after scaling and root planing ( SRP ) . METHODS In this r and omized clinical study , data from 34 individuals with chronic periodontitis were evaluated after full-mouth SRP . In the test group ( n = 17 ) , hyaluronan gels in two molecular weights were additionally applied during the first 2 weeks after SRP . The control group ( n = 17 ) was treated with SRP only . Probing depth ( PD ) and clinical attachment level ( CAL ) were recorded at baseline and after 3 and 6 months , and subgingival plaque and sulcus fluid sample s were taken for microbiologic and biochemical analysis . RESULTS In both groups , PD and CAL were significantly reduced ( P < 0.001 ) . The changes in PD and the reduction of the number of pockets with PD ≥5 mm were significantly higher in the test group after 3 ( P = 0.014 and 0.021 ) and 6 ( P = 0.046 and 0.045 ) months . Six months after SRP , the counts of Treponema denticola were significantly reduced in both groups ( both P = 0.043 ) , as were those of Campylobacter rectus in the test group only ( P = 0.028 ) . Prevotella intermedia and Porphyromonas gingivalis increased in the control group . CONCLUSION The adjunctive application of hyaluronan may have positive effects on PD reduction and may prevent recolonization by periodontopathogens AIMS The aim of this clinical trial was to compare clinical and biochemical healing outcomes following ultrasonic mechanical instrumentation versus ultrasonic mechanical instrumentation associated with topical subgingival application of amino acids and sodium hyaluronate gel . METHODS Eleven systemically healthy subjects with moderate-severe chronic periodontitis , who had four sites with pocket probing depth and clinical attachment level greater than or equal to 5 mm were r and omly assigned to two different types of treatment : two pockets were treated with ultrasonic debridement ( Control Group ) and two pockets with ultrasonic mechanical instrumentation associated with 0,5 ml of amino acids and sodium hyaluronate gel ( Test Group ) . Probing depth , clinical attachment level , plaque index and bleeding on probing were recorded at baseline , 45 and 90 days . Levels of calprotectin and myeloperoxidase activity in gingival crevicular fluid were assessed at baseline and on day 7 and 45 . RESULTS Statistical significance was found between baseline and day 45 in relation to probing depth reduction and bleeding on probing between groups for both of the tested treatments . Significant reductions in μg/ sample of calprotectin and myeloperoxidase were found after 1-week and an increase at 45 days in both groups . There were no statistically significant differences between other variables evaluated in this study . CONCLUSIONS These data suggest that subgingival application of hyaluronic acid following ultrasonic mechanical instrumentation is beneficial for improving periodontal parameters OBJECTIVES To evaluate the effects of a 1 % hyaluronic acid ( HA ) gel in combination with an absorbable collagen sponge ( ACS ) in the healing of critical-size calvaria defects in rats . MATERIAL AND METHODS Thirty-two adult Wistar rats were used . Two 5-mm-diameter critical-size defects were created and the treatments were r and omly distributed as follows : ( 1 ) 1 % HA ; ( 2 ) 1 % HA gel-soaked ACS ; ( 3 ) control ( blood clot ) ; and ( 4 ) ACS . The animals were sacrificed 60 days post-surgery , when biopsies were collected and processed for histology and histometric analysis . Bone fill was measured as the difference between the initial and the final defect sizes . Non-parametric tests were used to analyze differences between treatments ( α=1 % ) and a t-test for body weight gain in each treatment group ( α=5 % ) . RESULTS Histological analysis showed bone formation on the edges of the defects , although very limited , and a thin layer of connective tissue occupying the midportion of the defects in the control and the ACS groups . Defects filled with a 1 % HA gel and 1 % HA gel+ACS had a thicker layer of connective tissue and more new bone formed in the margins of the defects . Linear histometric measures showed no significant differences in the initial defect sizes between the groups ( P>0.05 ) . The association 1 % HA gel+ACS ( 0.96 ± 0.14 mm ) had significantly greater bone fill than the control ( 0.5 ± 0.02 mm ) and ACS ( 0.56 ± 0.05 mm)-treated groups ( P=0.0043 and 0.0173 , respectively ) . Treatment with a 1 % HA gel ( 0.7 ± 0.14 mm ) showed no significant differences when compared with the other treatments . CONCLUSION Within the limits of this study , a 1 % HA gel associated with a collagen scaffold can improve new bone formation in critical-size defects . However , this treatment never result ed in complete closure of the defects and healing in the major portion of the defects was characterized by fibrous tissue BACKGROUND The aims of this study were to investigate the anti-inflammatory effect and the effect on bone regeneration of hyaluronan in surgical and non-surgical groups . METHODS In each of 15 individuals , 2 teeth with defects of similar character and magnitude in the upper or lower jaw were chosen . There were at least 2 teeth between the test and the control sites . In the surgical group , a bioabsorbable membrane was used for both test and control sites , and hyaluronan was placed in the intrabony pocket of the test site . In the non-surgical group , the periodontal pockets were scaled and hyaluronan was administered 3 times with an interval of 1 week in the test pockets . Alveolar bone height and bone healing patterns were analyzed using digital intraoral radiographs . Measurements of bone height were performed in the original digital black- and -white radiographs to obtain quantitative data on bone gain or loss . Bone healing patterns were studied with color-coded radiographs , using specially design ed software in a personal computer with subsequent combinations of radiographs . Gingival crevicular fluid immunoglobulin (Ig)G , C3 , and prostagl and in E2 ( PGE2 ) responses ; periodontal probing depth ; bleeding on probing ; and the presence of plaque were studied to evaluate the anti-inflammatory effect . Data were obtained at baseline before treatment , and at 2 weeks , and 1 , 3 , 6 , and 12 months after treatment . RESULTS For the surgical treatments , bone height was increased in the test group treated with hyaluronan ( mean value 2.2 % , corresponding to an average increase of approximately 0.5 mm ) and reduced in the control group ( mean value -1.8 % , corresponding to an average decrease of approximately - 0.4 mm ) ( P<0.05 ) after 12 months . For the non-surgical treatments , bone height was reduced by a mean value of -1.1 % ( corresponding to an average decrease of approximately -0.25 mm ) in the test group treated with hyaluronan and -3.3 % ( corresponding to an average decrease of approximately -0.75 mm ) in the control group after 12 months ( N.S. ) . According to the digital color-coded radiographs , the test sites in the surgical and non-surgical groups showed apposition of bone minerals . Immune responses showed no differences during the 12 months studied for the surgical and non-surgical sites . Mean periodontal probing depths were reduced between 2.5 mm and 4.1 mm in the surgical and non-surgical groups . CONCLUSIONS The observed difference in bone height between test and control sites in the surgical group after 12 months was less than 1 mm , which was only detectable on radiographs . No statistical difference was found on radiographs in the non-surgical group , where a decrease in bone height was found for both groups after scaling . Probing depth reduction after the surgical treatment , as well as after scaling and root planing , was as expected . Hyaluronan in contact with bone and soft tissues had no influence on the immune system in this study . Further studies are needed to determine the extent to which hyaluronan can lead to clinical ly significant healing of periodontal lesions Aim : The aim of this study was to evaluate the effects of hyaluronan ( HA ) and chlorhexidine ( CHX ) gels as adjunct to scaling and root planing ( SRP ) in the treatment of chronic periodontitis . Material s and Methods : Sixty patients within the age group of 30 - 65 years recruited to participate in the study were r and omly equally divided into three groups . Complete SRP and subgingival debridement were performed within 6 h in all the patients . For control ( Group I ) patients , SRP was the only treatment modality given ; for Group II and III patients , at least 8 teeth with 4 - 8 mm probing pocket depth ( PPD ) were selected for subgingival application of HA gel and CHX gel , respectively . Clinical periodontal parameters such as gingival index , PPD , and clinical attachment level ( CAL ) were recorded at baseline and 3 months , whereas plaque index was recorded at baseline , 1 month , and 3 months . For measuring systemic/hematological parameters , blood sample s for laboratory tests for total leucocyte count ( TLC ) , differential leucocyte count ( DLC ) , and C-reactive protein ( CRP ) were obtained using st and ard 2-mL syringe from each subject in all the three groups at baseline , 24 h , and on the 1 month and 3 months post-baseline . Results : In all 
    Output:
    