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 PURPOSE To evaluate the efficacy of hyaluronic acid to improve the healing of surgical incisions in the oral cavity . MATERIAL S AND METHODS Six Italian private practice s participated in this trial , each centre provided 12 patients . After suturing , patients were r and omised to receive either a single application of 0.8 % hyaluronic acid or a placebo ( the carrier ) . Outcome measures were : assessment of wound healing 10 days post-operatively on a Likert scale by the blind operators and by an independent and blinded outcome assessor on the photographs , adverse events and post-operative complications . Reproducibility was assessed by evaluating agreement between operators and the independent outcome assessor using the weighted Kappa statistic . RESULTS Thirty-six patients were evaluated in each group , at ten days none had dropped-out . No post-operative complications or adverse events occurred . There were no statistically significant differences for wound healing , assessed clinical ly by the blinded operators or on photographs evaluated by a blinded and independent outcomes assessor . There was a substantial agreement between operators and the independent outcome assessor in the wound scoring . CONCLUSIONS Hyaluronic acid placed over surgical incisions in the oral cavity does not appear to improve wound healing . Further trials are needed to better underst and the potential role of hyalulonic acid in dental applications The aim of this study was compare the efficacies of two oral sprays in reducing swelling , pain , and trismus after the extraction of impacted m and ibular third molars . This prospect i ve double-blind , r and omized , crossover clinical trial included 34 patients with bilateral symmetrically impacted m and ibular third molars of similar surgical difficulty .  Hyaluronic acid or benzydamine hydrochloride spray was applied ( two pumps ) to the extraction area , three times daily for 7 days . Swelling was evaluated using a tape measure method , pain with a visual analogue scale ( VAS ) , and trismus by measuring the maximum inter-incisal opening . Assessment s were made on the day of surgery and on days 2 and 7 after surgery . Statistically significant differences were detected for the swelling and trismus values between the two treatment groups on the second postoperative day ( P=0.002 and P=0.03 , respectively ) . However , there was no statistically significant difference in VAS scores between the two groups . The administration of hyaluronic acid spray was more effective than benzydamine hydrochloride spray in reducing swelling and trismus . Although no evidence of a reduction in pain levels was detected , hyaluronic acid appears to offer a beneficial effect in the management of swelling and trismus during the immediate postoperative period following impacted third molar surgery Background : The purpose of this study was to assess the efficacy of hyaluronic acid ( HA ) in root coverage procedures as an adjunct to coronally advanced flap ( CAF ) procedure . Material s and Methods : This was a r and omized clinical trial with split mouth design , where 10 patients with 20 sites of Millers Class I recession were treated and followed-up for a period of 6 months . CAF procedure was performed , HA was applied onto the experimental sites before suturing the flap . Recession depth ( RD ) was measured regularly at baseline 1 , 3 , 6 , 12 , and 24 weeks postoperatively . Probing pocket depth ( PPD ) and clinical attachment level ( CAL ) were also measured along with RD at baseline and 12 and 24 weeks . Results : There was a significant change in RD , PPD , CAL , and percentage of root coverage in both groups when compared to the baseline values . There was no statistically significant difference between experimental and control group in terms of RD ( P = 0.917 ) , PPD ( P = 0.917 ) and CAL ( P = 0.761 ) . RD was 3.2 mm ± 0.78 mm in experimental site and control sites 2.9 mm ± 0.73 mm reduced to 1.1 mm ± 0.99 mm in experimental sites and 1.0 mm ± 0.66 mm in control sites . Though , there is no statistically significant difference root coverage in the experimental group appeared to be clinical ly more stable compared with the control group after 24 weeks . Conclusions : This study suggests that use of HA may improve the clinical outcome of root coverage with CAF procedure 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 AIM Hyaluronic acid is a glycosaminoglycan with anti-inflammatory & anti edematous properties . This study is seeking to ascertain whether Hyaluronic acid gel formulation is clinical ly and microscopically effective in treatment of gingivitis . METHODS In longitudinal , r and omized , and placebo-controlled clinical trial , 105 patients with chronic plaque induce gingivitis were r and omly divided into three groups ; negative control group , placebo control group and test group . Patients were instructed to apply gel on inflamed gingiva twice daily in addition with routine oral hygiene maintenance . The clinical parameters Plaque Index ( PI ) , Gingival Index(GI ) and Papilla Bleeding Index ( PBI ) were determined at intervals of 1 week , 2 weeks and 4 weeks from baseline , microbiological parameters were monitored at the interval of 4 weeks from baseline . RESULTS An improvement of all clinical variables was observed ( p<0.05 ) for all treatment modalities . Clinical ly , There is significant difference ( p<0.05 ) for GI & PBI in test group as compared to other groups , but reduction in PI was non-significant . In negative control and placebo control groups , the difference between clinical parameters was non-significant . Statistically significant ( p<0.05 ) reduction in percentage of anaerobic gram negative bacilli and relative increase of gram positive coccoid cells was seen in all treatment groups at 4 weeks as compared to baseline . However , results were not statistically significant ( p>0.05 ) in pair wise comparison in between groups . CONCLUSION Local application of 0.2 % HA gel adjunct to non surgical periodontal treatment provided a significant improvement in clinical parameters than placebo control and negative control groups . Microbiologically experimental group does not showed any spastically significant results 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 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 1 
    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 PURPOSE To evaluate the efficacy of hyaluronic acid to improve the healing of surgical incisions in the oral cavity . MATERIAL S AND METHODS Six Italian private practice s participated in this trial , each centre provided 12 patients . After suturing , patients were r and omised to receive either a single application of 0.8 % hyaluronic acid or a placebo ( the carrier ) . Outcome measures were : assessment of wound healing 10 days post-operatively on a Likert scale by the blind operators and by an independent and blinded outcome assessor on the photographs , adverse events and post-operative complications . Reproducibility was assessed by evaluating agreement between operators and the independent outcome assessor using the weighted Kappa statistic . RESULTS Thirty-six patients were evaluated in each group , at ten days none had dropped-out . No post-operative complications or adverse events occurred . There were no statistically significant differences for wound healing , assessed clinical ly by the blinded operators or on photographs evaluated by a blinded and independent outcomes assessor . There was a substantial agreement between operators and the independent outcome assessor in the wound scoring . CONCLUSIONS Hyaluronic acid placed over surgical incisions in the oral cavity does not appear to improve wound healing . Further trials are needed to better underst and the potential role of hyalulonic acid in dental applications The aim of this study was compare the efficacies of two oral sprays in reducing swelling , pain , and trismus after the extraction of impacted m and ibular third molars . This prospect i ve double-blind , r and omized , crossover clinical trial included 34 patients with bilateral symmetrically impacted m and ibular third molars of similar surgical difficulty .  Hyaluronic acid or benzydamine hydrochloride spray was applied ( two pumps ) to the extraction area , three times daily for 7 days . Swelling was evaluated using a tape measure method , pain with a visual analogue scale ( VAS ) , and trismus by measuring the maximum inter-incisal opening . Assessment s were made on the day of surgery and on days 2 and 7 after surgery . Statistically significant differences were detected for the swelling and trismus values between the two treatment groups on the second postoperative day ( P=0.002 and P=0.03 , respectively ) . However , there was no statistically significant difference in VAS scores between the two groups . The administration of hyaluronic acid spray was more effective than benzydamine hydrochloride spray in reducing swelling and trismus . Although no evidence of a reduction in pain levels was detected , hyaluronic acid appears to offer a beneficial effect in the management of swelling and trismus during the immediate postoperative period following impacted third molar surgery Background : The purpose of this study was to assess the efficacy of hyaluronic acid ( HA ) in root coverage procedures as an adjunct to coronally advanced flap ( CAF ) procedure . Material s and Methods : This was a r and omized clinical trial with split mouth design , where 10 patients with 20 sites of Millers Class I recession were treated and followed-up for a period of 6 months . CAF procedure was performed , HA was applied onto the experimental sites before suturing the flap . Recession depth ( RD ) was measured regularly at baseline 1 , 3 , 6 , 12 , and 24 weeks postoperatively . Probing pocket depth ( PPD ) and clinical attachment level ( CAL ) were also measured along with RD at baseline and 12 and 24 weeks . Results : There was a significant change in RD , PPD , CAL , and percentage of root coverage in both groups when compared to the baseline values . There was no statistically significant difference between experimental and control group in terms of RD ( P = 0.917 ) , PPD ( P = 0.917 ) and CAL ( P = 0.761 ) . RD was 3.2 mm ± 0.78 mm in experimental site and control sites 2.9 mm ± 0.73 mm reduced to 1.1 mm ± 0.99 mm in experimental sites and 1.0 mm ± 0.66 mm in control sites . Though , there is no statistically significant difference root coverage in the experimental group appeared to be clinical ly more stable compared with the control group after 24 weeks . Conclusions : This study suggests that use of HA may improve the clinical outcome of root coverage with CAF procedure 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 AIM Hyaluronic acid is a glycosaminoglycan with anti-inflammatory & anti edematous properties . This study is seeking to ascertain whether Hyaluronic acid gel formulation is clinical ly and microscopically effective in treatment of gingivitis . METHODS In longitudinal , r and omized , and placebo-controlled clinical trial , 105 patients with chronic plaque induce gingivitis were r and omly divided into three groups ; negative control group , placebo control group and test group . Patients were instructed to apply gel on inflamed gingiva twice daily in addition with routine oral hygiene maintenance . The clinical parameters Plaque Index ( PI ) , Gingival Index(GI ) and Papilla Bleeding Index ( PBI ) were determined at intervals of 1 week , 2 weeks and 4 weeks from baseline , microbiological parameters were monitored at the interval of 4 weeks from baseline . RESULTS An improvement of all clinical variables was observed ( p<0.05 ) for all treatment modalities . Clinical ly , There is significant difference ( p<0.05 ) for GI & PBI in test group as compared to other groups , but reduction in PI was non-significant . In negative control and placebo control groups , the difference between clinical parameters was non-significant . Statistically significant ( p<0.05 ) reduction in percentage of anaerobic gram negative bacilli and relative increase of gram positive coccoid cells was seen in all treatment groups at 4 weeks as compared to baseline . However , results were not statistically significant ( p>0.05 ) in pair wise comparison in between groups . CONCLUSION Local application of 0.2 % HA gel adjunct to non surgical periodontal treatment provided a significant improvement in clinical parameters than placebo control and negative control groups . Microbiologically experimental group does not showed any spastically significant results 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 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 1 
    Output:
    