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 aim of this study was to evaluate the clinical and microbiological results of treatment with the Er : YAG laser and topical gaseous ozone application as adjuncts to initial periodontal therapy in chronic periodontitis ( CP ) patients . BACKGROUND DATA Although many studies have evaluated the effectiveness of the Er : YAG laser as an adjunct to initial periodontal therapy , few studies have focused on the use of gaseous ozone as an adjunct . MATERIAL S AND METHODS Thirty patients with CP were r and omly divided into three parallel groups , each composed of 10 individuals with at least four teeth having at least one approximal site with a probing depth ( PD ) of ≥5 mm and a sulcus bleeding index ( SBI ) ≥2 in each quadrant . Groups of patients received : ( 1 ) Scaling and root planing (SRP)+Er : YAG laser ; ( 2 ) SRP+topical gaseous ozone ; or ( 3 ) SRP alone . The microbiological and clinical parameters were monitored at day 0 and day 90 . RESULTS At the end of the observation period , statistically significant improvements in clinical parameters were observed within each group . Parallel to the clinical changes , all treatments reduced the number of total bacteria and the proportion of obligately anaerobic microorganisms . Although intergroup comparisons of microbiological parameters showed no significant differences , clinical findings , including attachment gain and PD reduction , were found to be statistically significant in favor of the SRP+Er : YAG laser group . CONCLUSIONS Although statistically nonsignificant , the fact that the obligate anaerobic change was mostly observed in the SRP+Er : YAG laser group , and a similar decrease was noted in the SRP+topical gaseous ozone group , shows that ozone has an antimicrobial effect equivalent to that of the Er : YAG laser Objectives This r and omized split-mouth clinical trial was design ed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction . Material s and methods A total of 36 chronic periodontitis subjects , of both genders , were selected . One pair of contralateral single-rooted teeth with pocket depth > 5 mm was chosen from each subject . All patients received non-surgical periodontal treatment  , after which the experimental teeth were design ated to either test or control groups . Both teeth received scaling , root planing and coronal polishing ( SRP ) and teeth assigned to the test group ( SRP + DL ) were irradiated with the 808 ± 5 nm diode laser , for 20 s , in two isolated appointments , 1 week apart . The laser was used in the continuous mode , with 1.5 W and power density of 1,193.7 W/cm2 . Clinical and microbiological data were collected at baseline , 6 weeks and 6 months after therapy . Results There was a significant improvement of all the clinical parameters— clinical attachment level ( CAL ) , probing depth ( PD ) , plaque index ( PI ) and Bleeding on Probing (BOP)—for both groups ( P < 0.001 ) , with no statistical difference between them at the 6 weeks and the 6 months examinations . As for microbiological analysis , a significant reduction after 6 weeks ( P > 0.05 ) was observed as far as colony forming units ( CFU ) is concerned , for both groups . As for black-pigmented bacteria , a significant reduction was observed in both groups after 6 months . However , the difference between test and control groups was not significant . There was no association between group and presence of Porphyromonas gingivalis , Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study . Conclusions After 6 months of evaluation , the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment . Clinical relevance The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment . More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice This r and omized controlled clinical trial was design ed to evaluate the efficacy of single-session , non-thermal , carbon dioxide ( CO2 ) laser irradiation in relieving the pain of minor recurrent aphthous stomatitis ( miRAS ) as a prototype of painful oral ulcers . Fifteen patients , each with two discrete aphthous ulcers , were included . One of the ulcers was r and omly allocated to be treated with CO2 laser ( 1 W of power in de-focused continuous mode ) and the other one served as a placebo . Before laser irradiation , a layer of transparent , non-anesthetic gel was placed on both the laser lesions and the placebo lesions . The patients were requested to grade their pain on a visual analog scale up to 96 h post-operatively . The reduction in pain scores was significantly greater in the laser group than in the placebo group . The procedure itself was not painful , so anesthesia was not required . Powermetry revealed the CO2 laser power to be 2–5 mW after passing through the gel , which caused no significant temperature rise or any visual effect of damage to the oral mucosa . Our results showed that a low-intensity , non-thermal , single-session of CO2 laser irradiation  reduced pain in miRAS immediately and dramatically , with no visible side effects BACKGROUND The aim of this r and omized clinical study is to evaluate the effect of a 980-nm diode laser as an adjunct to scaling and root planing ( SRP ) treatment . METHODS Thirty-five patients with chronic periodontitis were selected for the split-mouth clinical study . SRP was performed using a sonic device and h and instruments . Quadrants were equally divided between the right and left sides . Teeth were treated with SRP in two control quadrants ( control groups [ CG ] ) , and the diode laser was used adjunctively with SRP in contralateral quadrants ( laser groups [ LG ] ) . Diode laser therapy was applied to periodontal pockets on days 1 , 3 , and 7 after SRP . Baseline data , including approximal plaque index ( API ) , bleeding on probing ( BOP ) , probing depth ( PD ) , and clinical attachment level ( CAL ) , were recorded before the treatment and 6 and 18 weeks after treatment . Changes in PD and CAL were analyzed separately for initially moderate ( 4 to 6 mm ) and deep ( 7 to 10 mm ) pockets . RESULTS The results were similar for both groups in terms of API , BOP , PD in deep pockets , and CAL . The laser group showed only significant PD gain in moderate pockets during the baseline to 18-week ( P < 0.05 ) and 6- to 18- week ( P < 0.05 ) periods , whereas no difference was found between LG and CG in the remaining clinical parameters ( P > 0.05 ) . CONCLUSION The present study indicates that , compared to SRP alone , multiple adjunctive applications of a 980-nm diode laser with SRP showed PD improvements only in moderate periodontal pockets ( 4 to 6 mm ) OBJECTIVE The aim of this split-mouth , double blinded , short-term , controlled clinical trial was to study the effect of low-level laser therapy ( LLLT ) as an adjunct to scaling and root planing ( SRP ) for treatment of chronic periodontitis . BACKGROUND DATA LLLT is reported to improve the outcome of traditional SRP , but the evidence is still weak . MATERIAL S AND METHODS Sixteen patients with a probing pocket depth ( PPD ) of 4 - 6 mm involving at least three teeth in each quadrant were recruited for the study . Afterwards , SRP quadrants were r and omly assigned for 10 sessions of LLLT . RESULTS Results showed that when compared to sites treated with SRP alone , those treated with SRP+LLLT ( 10 sessions , 830 nm , 100 mW , 3 J per point , 3 J/cm(2 ) ) exhibited greater reductions in PPD at 5 weeks and 3 months but not at 6 months . Further , SRP+LLLT-treated sites had a statistically significant increase in mean radiographic bone density when comparing 6- and 12-month data and overall from baseline to 12 months . There was a trend to reduce interleukin (IL)-1β but the difference between control and laser sites was not statistically significant . CONCLUSIONS SRP combined with LLLT  improved radiographic bone density and short-term PPD reduction in patients with chronic periodontitis , but did not significantly affect either the gingival crevicular fluid of IL-1β or the gingival or plaque index BACKGROUND AND OBJECTIVE The aim of this study is to examine the long-term effect of diode laser therapy on periodontal pockets with regard to its bactericidal abilities and the improvement of periodontal condition . STUDY DESIGN / MATERIAL S AND METHODS Fifty patients were r and omly subdivided into two groups ( laser-group  and  control-group ) and microbiologic sample s were collected . There have been six appointments for 6 months following an exact treatment scheme . After evaluating periodontal indices ( bleeding on probing , Quigley-Hein ) including pocket depths and instruction of patients in oral hygiene and scaling therapy of all patients , the deepest pockets of each quadrant of the laser-group 's patients were microbiologically examined . Afterwards , all teeth were treated with the diode laser . The control-group received the same treatment but instead of laser therapy were rinsed with H2O2 . Each appointment also included a hygienic check-up . After 6 months the final values of the periodontal indices and further microbiologic sample s were measured . The total bacterial count as well as specific bacteria , such as Actinobacillus actinomycetemcomitans , Prevotella intermedia , and Porphyromonas gingivalis , were assessed semiquantitatively . RESULTS The bacterial reduction with diode laser therapy was significantly better than in the control group . The index of bleeding on probing improved in 96.9 % in the laser-group , whereas only 66.7 % in the control group . Pocket depths could be more reduced in the laser group than in the control group . CONCLUSION The diode laser reveals a bactericidal effect and helps to reduce inflammation in the periodontal pockets in addition to scaling . The diode laser therapy , in combination with scaling , supports healing of the periodontal pockets through eliminating bacteria AIM This split-mouth , r and omized , clinical trial aim ed to evaluate the efficacy of erbium-doped : yttrium-aluminium-garnet ( Er : YAG ) laser application in non-surgical periodontal treatment . MATERIAL S AND METHODS A total of 27 patients underwent four modalities of non-surgical therapy : supragingival debridement ; scaling and root planing (SRP)+Er : YAG laser ; Er : YAG laser ; and SRP .  Each strategy was r and omly assigned and performed in one of the four quadrants . Clinical outcomes were evaluated at 3 and 6 months . Subjective benefits of patients have been evaluated by means of question naires . RESULTS Six months after therapy , Er : YAG laser showed no statistical difference in clinical attachment gain with respect to supragingival scaling [ 0.15 mm ( 95 % CI -0.16 ; 0.46 ) ] , while SRP showed a greater attachment gain than the supragingival scaling [ 0.37 mm ( 95 % CI 0.05 ; 0.68 ) ] . No difference result ed between Er : YAG laser+SRP and SRP alone [ 0.05 mm ( 95 % CI -0.25 ; 0.36 ) ] . CONCLUSIONS The adjunctive use of Er : YAG laser to conventional SRP did not reveal a more effective result than SRP alone . Furthermore , the sites treated with Er : YAG laser showed similar results of the sites treated with supragingival scaling The aim of this study was to evaluate the clinical , anti-inflammatory , and osteoimmunological benefits of the single ( PT ) and repeated laser phototherapy ( rPT ) as an adjunctive treatment of inflamed periodontal tissue . Twenty-seven patients with chronic periodontitis were r and omly divided into three groups of nine patients each in order to undergo scaling and root planing ( SRP ) , SRP followed by one session of adjunctive PT ( Day 1 ; SRP + PT ) , or SRP followed by adjunctive repeated PT five times in 2 weeks ( Days 1 , 2 , 4 , 7 , and 11 ; SRP + rPT ) . For phototherapy session , a diode laser ( λ = 670 nm , 200 mW , 60 s/tooth ) was applied into the sulcus . Clinical parameters , including full-mouth plaque score , full-mouth bleeding score , probing pocket depth , and clinical attachment level were recorded . Sample s of gingival crevicular fluid ( GCF ) were taken at baseline , 4 , and 8 weeks after treatment . Interleukin 1beta ( IL-1β ) , tumor necrosis factor alpha ( TNF-α ) , receptor activator of nuclear factor κΒ lig and ( RANKL ) , and osteoprotegerin ( OPG ) levels in the collected GCF were measured . PT used in a single or repeated doses , does not produce a significant reduction in the clinical parameters essayed ( p > 0.05 ) . Levels of IL-1β in GCF were significantly reduced in SRP + PT and SRP + rPT groups compared with the SRP group ( p < 0.05 ) . However , the SRP + rPT group showed a significant reduction of pro-inflammatory cytokine TNF-α and RANKL/OPG ratio at 4 weeks post-treatment compared with the SRP + PT and SRP groups ( p < 0. 
    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 aim of this study was to evaluate the clinical and microbiological results of treatment with the Er : YAG laser and topical gaseous ozone application as adjuncts to initial periodontal therapy in chronic periodontitis ( CP ) patients . BACKGROUND DATA Although many studies have evaluated the effectiveness of the Er : YAG laser as an adjunct to initial periodontal therapy , few studies have focused on the use of gaseous ozone as an adjunct . MATERIAL S AND METHODS Thirty patients with CP were r and omly divided into three parallel groups , each composed of 10 individuals with at least four teeth having at least one approximal site with a probing depth ( PD ) of ≥5 mm and a sulcus bleeding index ( SBI ) ≥2 in each quadrant . Groups of patients received : ( 1 ) Scaling and root planing (SRP)+Er : YAG laser ; ( 2 ) SRP+topical gaseous ozone ; or ( 3 ) SRP alone . The microbiological and clinical parameters were monitored at day 0 and day 90 . RESULTS At the end of the observation period , statistically significant improvements in clinical parameters were observed within each group . Parallel to the clinical changes , all treatments reduced the number of total bacteria and the proportion of obligately anaerobic microorganisms . Although intergroup comparisons of microbiological parameters showed no significant differences , clinical findings , including attachment gain and PD reduction , were found to be statistically significant in favor of the SRP+Er : YAG laser group . CONCLUSIONS Although statistically nonsignificant , the fact that the obligate anaerobic change was mostly observed in the SRP+Er : YAG laser group , and a similar decrease was noted in the SRP+topical gaseous ozone group , shows that ozone has an antimicrobial effect equivalent to that of the Er : YAG laser Objectives This r and omized split-mouth clinical trial was design ed to evaluate the efficacy of scaling and root planing associated to the high-intensity diode laser on periodontal therapy by means of clinical parameters and microbial reduction . Material s and methods A total of 36 chronic periodontitis subjects , of both genders , were selected . One pair of contralateral single-rooted teeth with pocket depth > 5 mm was chosen from each subject . All patients received non-surgical periodontal treatment  , after which the experimental teeth were design ated to either test or control groups . Both teeth received scaling , root planing and coronal polishing ( SRP ) and teeth assigned to the test group ( SRP + DL ) were irradiated with the 808 ± 5 nm diode laser , for 20 s , in two isolated appointments , 1 week apart . The laser was used in the continuous mode , with 1.5 W and power density of 1,193.7 W/cm2 . Clinical and microbiological data were collected at baseline , 6 weeks and 6 months after therapy . Results There was a significant improvement of all the clinical parameters— clinical attachment level ( CAL ) , probing depth ( PD ) , plaque index ( PI ) and Bleeding on Probing (BOP)—for both groups ( P < 0.001 ) , with no statistical difference between them at the 6 weeks and the 6 months examinations . As for microbiological analysis , a significant reduction after 6 weeks ( P > 0.05 ) was observed as far as colony forming units ( CFU ) is concerned , for both groups . As for black-pigmented bacteria , a significant reduction was observed in both groups after 6 months . However , the difference between test and control groups was not significant . There was no association between group and presence of Porphyromonas gingivalis , Prevotella intermedia and Aggregatibacter actinomycetemcomitans at any time of the study . Conclusions After 6 months of evaluation , the high-intensity diode laser has not shown any additional benefits to the conventional periodontal treatment . Clinical relevance The high intensity diode laser did not provide additional benefits to non-surgical periodontal treatment . More studies are necessary to prove the actual need of this type of laser in the periodontal clinical practice This r and omized controlled clinical trial was design ed to evaluate the efficacy of single-session , non-thermal , carbon dioxide ( CO2 ) laser irradiation in relieving the pain of minor recurrent aphthous stomatitis ( miRAS ) as a prototype of painful oral ulcers . Fifteen patients , each with two discrete aphthous ulcers , were included . One of the ulcers was r and omly allocated to be treated with CO2 laser ( 1 W of power in de-focused continuous mode ) and the other one served as a placebo . Before laser irradiation , a layer of transparent , non-anesthetic gel was placed on both the laser lesions and the placebo lesions . The patients were requested to grade their pain on a visual analog scale up to 96 h post-operatively . The reduction in pain scores was significantly greater in the laser group than in the placebo group . The procedure itself was not painful , so anesthesia was not required . Powermetry revealed the CO2 laser power to be 2–5 mW after passing through the gel , which caused no significant temperature rise or any visual effect of damage to the oral mucosa . Our results showed that a low-intensity , non-thermal , single-session of CO2 laser irradiation  reduced pain in miRAS immediately and dramatically , with no visible side effects BACKGROUND The aim of this r and omized clinical study is to evaluate the effect of a 980-nm diode laser as an adjunct to scaling and root planing ( SRP ) treatment . METHODS Thirty-five patients with chronic periodontitis were selected for the split-mouth clinical study . SRP was performed using a sonic device and h and instruments . Quadrants were equally divided between the right and left sides . Teeth were treated with SRP in two control quadrants ( control groups [ CG ] ) , and the diode laser was used adjunctively with SRP in contralateral quadrants ( laser groups [ LG ] ) . Diode laser therapy was applied to periodontal pockets on days 1 , 3 , and 7 after SRP . Baseline data , including approximal plaque index ( API ) , bleeding on probing ( BOP ) , probing depth ( PD ) , and clinical attachment level ( CAL ) , were recorded before the treatment and 6 and 18 weeks after treatment . Changes in PD and CAL were analyzed separately for initially moderate ( 4 to 6 mm ) and deep ( 7 to 10 mm ) pockets . RESULTS The results were similar for both groups in terms of API , BOP , PD in deep pockets , and CAL . The laser group showed only significant PD gain in moderate pockets during the baseline to 18-week ( P < 0.05 ) and 6- to 18- week ( P < 0.05 ) periods , whereas no difference was found between LG and CG in the remaining clinical parameters ( P > 0.05 ) . CONCLUSION The present study indicates that , compared to SRP alone , multiple adjunctive applications of a 980-nm diode laser with SRP showed PD improvements only in moderate periodontal pockets ( 4 to 6 mm ) OBJECTIVE The aim of this split-mouth , double blinded , short-term , controlled clinical trial was to study the effect of low-level laser therapy ( LLLT ) as an adjunct to scaling and root planing ( SRP ) for treatment of chronic periodontitis . BACKGROUND DATA LLLT is reported to improve the outcome of traditional SRP , but the evidence is still weak . MATERIAL S AND METHODS Sixteen patients with a probing pocket depth ( PPD ) of 4 - 6 mm involving at least three teeth in each quadrant were recruited for the study . Afterwards , SRP quadrants were r and omly assigned for 10 sessions of LLLT . RESULTS Results showed that when compared to sites treated with SRP alone , those treated with SRP+LLLT ( 10 sessions , 830 nm , 100 mW , 3 J per point , 3 J/cm(2 ) ) exhibited greater reductions in PPD at 5 weeks and 3 months but not at 6 months . Further , SRP+LLLT-treated sites had a statistically significant increase in mean radiographic bone density when comparing 6- and 12-month data and overall from baseline to 12 months . There was a trend to reduce interleukin (IL)-1β but the difference between control and laser sites was not statistically significant . CONCLUSIONS SRP combined with LLLT  improved radiographic bone density and short-term PPD reduction in patients with chronic periodontitis , but did not significantly affect either the gingival crevicular fluid of IL-1β or the gingival or plaque index BACKGROUND AND OBJECTIVE The aim of this study is to examine the long-term effect of diode laser therapy on periodontal pockets with regard to its bactericidal abilities and the improvement of periodontal condition . STUDY DESIGN / MATERIAL S AND METHODS Fifty patients were r and omly subdivided into two groups ( laser-group  and  control-group ) and microbiologic sample s were collected . There have been six appointments for 6 months following an exact treatment scheme . After evaluating periodontal indices ( bleeding on probing , Quigley-Hein ) including pocket depths and instruction of patients in oral hygiene and scaling therapy of all patients , the deepest pockets of each quadrant of the laser-group 's patients were microbiologically examined . Afterwards , all teeth were treated with the diode laser . The control-group received the same treatment but instead of laser therapy were rinsed with H2O2 . Each appointment also included a hygienic check-up . After 6 months the final values of the periodontal indices and further microbiologic sample s were measured . The total bacterial count as well as specific bacteria , such as Actinobacillus actinomycetemcomitans , Prevotella intermedia , and Porphyromonas gingivalis , were assessed semiquantitatively . RESULTS The bacterial reduction with diode laser therapy was significantly better than in the control group . The index of bleeding on probing improved in 96.9 % in the laser-group , whereas only 66.7 % in the control group . Pocket depths could be more reduced in the laser group than in the control group . CONCLUSION The diode laser reveals a bactericidal effect and helps to reduce inflammation in the periodontal pockets in addition to scaling . The diode laser therapy , in combination with scaling , supports healing of the periodontal pockets through eliminating bacteria AIM This split-mouth , r and omized , clinical trial aim ed to evaluate the efficacy of erbium-doped : yttrium-aluminium-garnet ( Er : YAG ) laser application in non-surgical periodontal treatment . MATERIAL S AND METHODS A total of 27 patients underwent four modalities of non-surgical therapy : supragingival debridement ; scaling and root planing (SRP)+Er : YAG laser ; Er : YAG laser ; and SRP .  Each strategy was r and omly assigned and performed in one of the four quadrants . Clinical outcomes were evaluated at 3 and 6 months . Subjective benefits of patients have been evaluated by means of question naires . RESULTS Six months after therapy , Er : YAG laser showed no statistical difference in clinical attachment gain with respect to supragingival scaling [ 0.15 mm ( 95 % CI -0.16 ; 0.46 ) ] , while SRP showed a greater attachment gain than the supragingival scaling [ 0.37 mm ( 95 % CI 0.05 ; 0.68 ) ] . No difference result ed between Er : YAG laser+SRP and SRP alone [ 0.05 mm ( 95 % CI -0.25 ; 0.36 ) ] . CONCLUSIONS The adjunctive use of Er : YAG laser to conventional SRP did not reveal a more effective result than SRP alone . Furthermore , the sites treated with Er : YAG laser showed similar results of the sites treated with supragingival scaling The aim of this study was to evaluate the clinical , anti-inflammatory , and osteoimmunological benefits of the single ( PT ) and repeated laser phototherapy ( rPT ) as an adjunctive treatment of inflamed periodontal tissue . Twenty-seven patients with chronic periodontitis were r and omly divided into three groups of nine patients each in order to undergo scaling and root planing ( SRP ) , SRP followed by one session of adjunctive PT ( Day 1 ; SRP + PT ) , or SRP followed by adjunctive repeated PT five times in 2 weeks ( Days 1 , 2 , 4 , 7 , and 11 ; SRP + rPT ) . For phototherapy session , a diode laser ( λ = 670 nm , 200 mW , 60 s/tooth ) was applied into the sulcus . Clinical parameters , including full-mouth plaque score , full-mouth bleeding score , probing pocket depth , and clinical attachment level were recorded . Sample s of gingival crevicular fluid ( GCF ) were taken at baseline , 4 , and 8 weeks after treatment . Interleukin 1beta ( IL-1β ) , tumor necrosis factor alpha ( TNF-α ) , receptor activator of nuclear factor κΒ lig and ( RANKL ) , and osteoprotegerin ( OPG ) levels in the collected GCF were measured . PT used in a single or repeated doses , does not produce a significant reduction in the clinical parameters essayed ( p > 0.05 ) . Levels of IL-1β in GCF were significantly reduced in SRP + PT and SRP + rPT groups compared with the SRP group ( p < 0.05 ) . However , the SRP + rPT group showed a significant reduction of pro-inflammatory cytokine TNF-α and RANKL/OPG ratio at 4 weeks post-treatment compared with the SRP + PT and SRP groups ( p < 0. 
    Output:
    