***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: A clinical trial was undertaken to evaluate the effectiveness of two new enamel sealing systems in the prevention of enamel decalcification following bracket bonding . Eighty patients undergoing fixed appliance therapy were included . Of these , 40 were treated with a viscous chemically-cured sealant and bonding system ( Maximum Cure ) , while 40 patients were treated using a non-viscous visible light-cured sealant and bonding agent ( Transbond resin ) . Alternate teeth were used as controls where no sealant was used . A total of 289 experimental and 282 control teeth were included in the chemically-cured sealant group , the figures for the light-cured sealant group being 306 and 305 , respectively . Enamel decalcification incidence and distribution were recorded using a modified index by direct clinical observation . The results showed that 75 per cent of patients were affected by some decalcification . The viscous sealant reduced the extent of decalcification of tooth zones by 13 per cent . The non-viscous sealant produced no significant difference . Over 60 per cent of decalcification occurred in the gingival areas . Maxillary lateral incisors and canines , and m and ibular canines and second premolars were the teeth most severely affected , and the most likely to benefit from sealing . Further research is needed to develop a material which provides greater enamel protection The purpose of this study was to compare the effectiveness of a 1100 ppm fluoride toothpaste used alone , or together with a 0.05 % NaF rinse used once daily or a 0.4 % SnF2 gel applied twice daily , in controlling the decalcification that often accompanies orthodontic treatment . Ninety-five consecutively treated adolescent patients were matched for age and sex and assigned to one of these three regimens . Single blind assessment s of decalcification were performed on all labial surfaces of all erupted teeth before appliances were placed and 3 months after appliances were removed . Because the first molars had the highest decalcification scores , data for the whole mouth and for first molars were analyzed separately . When pre-treatment levels of decalcification were subtracted from post-treatment values , significantly lower decalcification scores ( p < 0.05 ) were found for both whole mouth and first molars in the rinse and gel groups as compared with the control group ( toothpaste alone ) . Although the gel group consistently had less decalcification than the rinse group , this difference only approached statistical significance . These results indicate that twice daily use of a 1100 ppm fluoride toothpaste and either a once-daily 0.05 % NaF rinse or a twice-daily 0.4 % SnF2 gel provides additional protection against decalcification beyond that achieved with toothpaste alone OBJECTIVES The aims of this study were to compare the local and systemic uptake of fluoride released from a compomer material ( Dyract Ortho ) and a resin-modified glass ionomer cement ( Vitremer ) with that of a conventional resin adhesive ( Right-On ) and to compare the cariostatic ability of each of the test material s with that of the resin control . METHODS Twenty six patients were r and omly allocated to have a bracket bonded to a premolar on one side of the arch with one of the test material s and on the opposite side with the control material . Premolars destined for extraction as part of an orthodontic treatment plan were selected for bonding . A non-fluoride toothpaste was used by all participants for 4 weeks prior to bracket bonding and throughout the 4 week trial period . Fluoride release was measured in saliva , plaque and urine sample s taken pre-bonding and 4 weeks post-bonding . Enamel demineralisation was assessed by scoring the buccal surface of each extracted tooth using a caries index . RESULTS Neither Vitremer nor  Dyract Ortho altered salivary or urinary fluoride concentration significantly 4 weeks post-bonding but plaque fluoride concentration increased significantly around premolars bonded with Vitremer . The test material s as a combined group were associated with significantly less demineralisation than the control material but there was no significant difference in cariostatic ability detected between either Dyract Ortho or Vitremer when each group was compared separately with the control . CONCLUSIONS Fluoride released from Dyract Ortho or Vitremer is likely to exert a local and not a systemic effect . In a 4-week clinical study , the cariostatic ability of the fluoride-releasing cements , as a combined group , was superior to that of the non-fluoride releasing control but there was no significant difference in cariostatic ability between the two test material s when each test group was compared separately with the control The purpose of this study was to compare the effectiveness of toothbrushing followed by fluoride rinsing , fluoride gel brushing , or fluoride gel dentifrice brushing alone in controlling the demineralization that often follows orthodontic treatment . Seventy-eight consecutive adolescent patients undergoing orthodontic care were divided into 3 groups : group 1 ( control ) used a low-potency , high-frequency fluoride rinse ; group 2 used a high-potency , high-frequency fluoride brush-on gel ; and group 3 used a high-potency , high-frequency fluoride gel dentifrice . When pretreatment levels of demineralization were subtracted from posttreatment values , both gel groups displayed a significant difference ( P < .05 ) in smooth surface demineralization sites when compared to controls . Reversal of white-spot lesions occurred in 15 % of sites that exhibited pathology as a result of the fluoride and preventive regimen . These results indicate that a daily use of a 5000-ppm fluoride gel along with toothbrushing with a fluoride paste or brushing twice daily with a 5000-ppm fluoride dentifrice alone provides greater protection beyond that of tooth-brushing with a fluoride paste ( 1000 ppm ) and rinsing with a 0.05 % sodium fluoride rinse The effect of an anti-adhesive enamel coating on plaque accumulation , gingival health , and enamel demineralization was evaluated in 39 adolescents undergoing treatment with fixed orthodontic appliances using a prospect i ve split-mouth design . Immediately after bracket insertion , the polymer was r and omly applied after enamel etching to the buccal surfaces of the teeth in the left or right upper quadrant , leaving the opposite quadrant as an untreated control ( 218 test and 216 control teeth ) . Reapplications were carried out every 3rd month during the course of the study . The following data were collected at baseline and at design ated follow-ups : visible plaque index , total viable counts and proportion of mutans streptococci in plaque sample s , gingival bleeding index , and amount of gingival crevicular fluid . The incidence of enamel demineralization adjacent to the appliances was scored clinical ly at the termination of the orthodontic treatment . The observation time ranged from 6 - 24 months , during which the participants used fluoride rinses and toothpaste daily . A slightly impaired gingival health and increased levels of mutans streptococci compared with baseline was disclosed during the treatment . Five subjects showed enamel demineralization on a total of 30 teeth at the time of de-bonding . The results indicated no statistically significant differences between the enamel-coated and untreated teeth with regard to the studied variables at any follow-up . In conclusion , the present findings did not support a clinical ly beneficial effect of the polymeric tooth coating in a low-caries group of adolescents treated with fixed orthodontic appliances The aim of this study was to test a particular type of intra-oral fluoride releasing device ( IFRD ) , design ed to release 0.04 mg/day of fluoride over a period of 6 months , using customized holders , in patients receiving orthodontic treatment .  Discomfort , holder detachment , plaque accumulation near the device , and the presence of gingivitis , bleeding , white spot lesions , and /or decay was recorded in 76 orthodontic patients ( 53 experimental and 23 controls ) before and after wearing the device for 12 months . The system proved to be easy and quick to use , and did not cause discomfort . There were no significant differences between the treated and the control groups for plaque index , bleeding , or the presence of gingivitis . In addition , no carious and /or white spot lesions occurred during the duration of this study in the test group The plaque-retentive effects of fixed orthodontic appliances may induce a rapid increase in the amount of plaque . The aim of the present study was to conduct a longitudinal clinical investigation on the antibacterial effect of chlorhexidine-containing Cervitec varnish during orthodontic treatment . Twenty-four subjects ( 9 male , 15 female ) , aged 16.5 + /- 2.5 years , participated in the study . At baseline , the subjects ' DMF-S scores , stimulated salivary flow rates ( ml/min ) and levels of salivary Streptococcus mutans ( SM ) and lactobacilli ( LB ) were determined using Dentocult SM strip and Dentocult LB methods . After placing the orthodontic appliances , the subjects were treated with Cervitec or a placebo varnish around the b and s and brackets . The chlorhexidine varnish was applied r and omly in the first or second quadrant , and placebo varnish in the opposite quadrant , according to the split-mouth technique . The varnish application was repeated every 3 months to the same sites . Follow-up sample s of saliva and plaque from around brackets and b and s were collected at 1 , 3 , 6 , 9 and 12 months . Plaque SM and salivary SM , as well as LB counts were determined as at baseline . The results showed that a significantly higher proportion of plaque sample s belonged to the low-risk category ( SM count10(5 ) CFU/ml ) on the test side than on the placebo side . Distribution of salivary sample s between the low-risk and high-risk categories ( based on SM and LB counts ) did not change significantly until the end of the follow-up period . The number of new carious lesions after debonding the fixed orthodontic appliance was significantly lower ( p < 0.05 ) in the Cervitec-treated quadrant compared to the placebo varnish-treated quadrant . The results show that the chlorhexidine-containing varnish effectively reduced the number of SM in dental plaque around fixed orthodontic appliances The presence of decalcification ( white spots ) after the removal of orthodontic appliances still remains a problem . A method to deliver fluoride to the area beneath and around the bonded attachments , independent of patient compliance , could be very helpful . Therefore special attention is being currently directed to the so-called " fluoride releasing bonding adhesives . " A clinical trial was carried out to compare the effect of a visible light-cured fluoride-releasing ( F-releasing ) material with a chemically cured nonfluoride resin on white spot formation during fixed orthodontic therapy .  Fifty patients entered the trial , and 762 brackets were bonded in a crossover design . Intraoral slides were taken before and after treatment and were evaluated for white spot formation . Statistical data analysis was carried out by means of a chi-square test . The results of this clinical study indicate that there was no significant difference between the decalcification rates for both types of adhesives . When the appearance of white spots was evaluated in an overall manner , there was significantly more upper than lower decalcification Plaque control during the course of orthodontic treatment is not an easy task , and dental caries are not an unlikely complication . We examined the possibility of controlling dental caries with Nd-YAG laser irradiation in orthodontic patients . As a preliminary experiment , we used the Nd-YAG laser to irradiate an extracted tooth and then left it to soak in lactic acid . The decay of the tooth was evaluated with a scanning electron microscope ( SEM ) ; tooth decay was inhibited by the action of the laser . Twenty patients undergoing orthodontic treatment for early decalcification of the teeth ( white spot lesions ) were selected , and photographs were taken of their oral cavities . White spot lesions on the four incisors and two canines of the maxilla were traced on tracing paper , and their areas were calculated by computer . Ten of the patients received laser treatment and acidulated phosphate fluoride solution ( APF ) ; the other ten acted as the control group . Between 11 and 12 months later , we photographed the oral cavity as we had previously ; the white spot lesions were again traced and their areas calculated . The changes in the areas of the white spots of the laser-irradiated and control groups showed the following increases : laser-irradiated group , 1.41 times ; controls , 2.87 times . The difference was statistically significant . These results demonstrate that Nd-YAG laser irradiation with application of APF acts as an effective method of caries control during orthodontic treatment A r and omized prospect i ve clinical study , with 220 patients scheduled for fixed orthodontic therapy , was conducted to test the hypothesis that application of an antimicrobial varnish in combination with a fluoride varnish ( group 1 ) is significantly more efficient in reducing white spot lesions on the labial surfaces than application of the fluoride varnish alone ( group 2 ) . The effects of the antimicrobial varnish on the occurrence of gingivitis and plaque formation were also studied . A third aim was to investigate whether white spot lesion development could be predicted early during treatment . The antimicrobial varnish significantly reduced the number of mutans streptococci in plaque during the first 48 weeks of treatment . This effect did not result in significantly less development of white spot lesions on the labial surfaces compared with the group receiving only the fluoride varnish application . There was however a clear trend that the combination of the antimicrobial and fluoride varnishes more effectively reduced the increments of new lesions on 
    Output:
    
It was impossible to calculate an overall PF for the other preventive measures , but the tendency of their caries-inhibiting effect has been described .
The use of toothpaste and gel with a high fluoride concentration of 1,500–5,000 ppm or of complementary chlorhexidine during orthodontic treatment showed a demineralisation-inhibiting tendency .
The use of a polymeric tooth coating on the tooth surface around the brackets showed almost no demineralisation-inhibiting effect .