***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: BACKGROUND The aim of this clinical trial was to compare the effects of three oral sprays containing chlorhexidine ( CHX ) , benzydamine hydrochloride ( B-HCl ) , and CHX plus B-HCl ( CHX/B-HCl ) on plaque and gingivitis . METHODS Fifty-one periodontally healthy volunteers , r and omly divided into three spray groups , refrained from all mechanical oral hygiene measures for 7 days and , instead , used one of the r and omly assigned sprays twice daily . The plaque index ( PI ) , gingival index ( GI ) , and gingival bleeding time index ( GBTI ) were assessed at days 0 and 7 . Side effects were also evaluated . RESULTS In all groups , PI , GI , and GBTI showed significant increases from the baseline to day 7 . There were no significant side effects for B-HCl spray and CHX spray at day 7 , but , for CHX/B-HCl , burning sensation significantly increased from the baseline . For all parameters , there were significant differences between B-HCl and CHX/B-HCl and between B-HCl and CHX , but no significant differences were observed between CHX/B-HCl and CHX . In addition , a significant difference was found between CHX/B-HCl and CHX with regard to burning sensation . CONCLUSIONS These results indicate that both CHX and CHX/B-HCl sprays have equal clinical effectiveness , but only B-HCl spray has less anti-plaque and anti-gingivitis effects . Furthermore , CHX/B-HCl spray causes more side effects OBJECTIVE The objective of this independent , double-blind , seven-day clinical study was to assess the efficacy of a commercially available mouthrinse containing 0.05 % CPC for controlling dental plaque relative to that of a control mouthrinse without 0.05 % CPC . METHODS Adult male and female subjects from the San Juan , Puerto Rico area reported to the clinical facility , having refrained from any oral hygiene procedures for 12 hours , and from eating , drinking , and smoking for four hours , for an assessment of the oral soft and hard tissues and a baseline dental plaque evaluation . Qualifying subjects were r and omly assigned into one of the two treatment groups , and were provided with their assigned mouthrinse , an adult soft-bristled toothbrush , and a commercially available fluoride toothpaste for home use . Over the seven-day period of home use , during which there were no restrictions regarding diet or smoking habits , subjects were instructed to brush their teeth for one minute twice daily ( morning and evening ) with the toothbrush and toothpaste supplied , to rinse their mouths with water after brushing , and then to rinse with 15 ml of their assigned mouthrinse for one minute before expectorating . The use of other oral hygiene products or procedures , such as floss or interdental stimulators , was not permitted during the study . After seven days of product use , subjects returned to the clinical facility having followed the same restrictions with respect to oral hygiene procedures , eating , and drinking as prior to the baseline examination , and the oral soft and hard tissue assessment s and dental plaque evaluations were repeated . Comparisons between treatment groups with respect to baseline-adjusted Plaque Index scores at the seven-day examination were performed using Analyses of Covariance , p < or = 0.05 . RESULTS Forty-eight subjects complied with the protocol and completed the study . Results demonstrated that , after seven days of product use and 12 hours after rinsing , both the CPC mouthrinse group and the control mouthrinse group exhibited statistically significant reductions in whole-mouth Plaque Index scores ( 25.3 % and 6.6 % , respectively ) , in Plaque Index scores measured at interproximal sites ( 51.3 % and 32.9 % , respectively ) , and in Plaque Severity Index scores ( 43.5 % and 25.4 % , respectively ) . Relative to the control mouthrinse , the 0.05 % CPC mouthrinse group exhibited statistically significant greater reductions in whole-mouth plaque scores ( 15.9 % ) , in Plaque Index scores measured at interproximal sites ( 23 % ) , and in Plaque Severity Index scores ( 17 % ) . As the measurements were made 12 hours after final product use , the results also demonstrate that the CPC mouthrinse provides 12-hour protection against plaque accumulation in individuals with existing plaque . CONCLUSION The overall results of this double-blind clinical study support the conclusion that after seven days of product use , a mouthrinse containing 0.05 % CPC provides significantly greater efficacy for reducing dental plaque 12 hours after use , than does a control mouthrinse without 0.05 % CPC 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 The present study contains data from a 4-week clinical study where the effect of an experimental toothpaste containing 0.4 % SnF2 on plaque and gingivitis was tested in a group of teenagers . The study was performed according to a double-blind , cross-over design . It was shown that the SnF2 containing toothpaste reduced both plaque and gingivitis significantly compared to a placebo paste which contained no fluoride or stannous ions A long-term prospect i ve , r and omized dietary intervention to prevent exposure of children to the known atherosclerosis risk factors ( the STRIP baby project ) was started when the age of the children was 7 months . The aim of this sub study was to analyze the oral effects of the dietary intervention in the children and their parents when the children had reached the age of 3 years . Every fifth family of the main study was invited to this sub study ( n = 179 ) . Those studied ( n = 148 ) represented well the intervention and the  control  groups and both genders in terms of intake of saturated fatty acids , the dietary polyunsaturated fatty acid to saturated fatty acid ( PUFA/SAFA ) ration and serum cholesterol and HDL cholesterol concentrations . Though no difference was found in sucrose consumption between the intervention and the control groups , the intervention children received relatively ( in E% ) more energy from carbohydrates than the control children ( p < 0.005 ) , used absolutely ( in g ) and relatively ( in E% ) less fat ( p < 0.05 ) and had a higher PUFA/SAFA ratio in their diet ( p < 0.001 ) . Of the 3-year-old children 93 % were caries free , and dental decay was a prevalent in the intervention as in the control children . Control children brushed their teeth unassisted more often than the intervention children ( p < 0.05 ) . The intervention fathers also received more energy ( in E% ) from carbohydrates ( p < 0.01 ) , the intervention mothers used less fat ( p < 0.05 ) and had a higher PUFA/SAFA ratio in the diet ( p < 0.05 ) than the control fathers and mothers , respectively . Dental and periodontal health of the intervention and control parents ( n = 250 , 84 % attending , mean + /- SD age : 34.2 + /- 54.5 years also showed no differences even though the control parents had more commonly last visited a dentist over 3 years before this examination ( p < 0.05 ) . We conclude that a 29-month period of a low-saturated-fat , low-cholesterol but high-carbohydrate diet as advocated in the STRIP baby trial does not seem to have harmful effects on the oral health of the children or their parents . Minor untoward differences had occurred in the dental health behavior of the control children and their parents BACKGROUND Due to the side effects of chlorhexidine digluconate ( CHX ) mouthrinsing , a spray has been proposed as an alternative method of CHX delivery to the oral cavity . The aim of this study was to investigate the plaque inhibitory effects of CHX , cetylpyridinium chloride ( CPC ) , and triclosan ( TRN ) delivered by sprays and mouthrinses . METHODS The study was an observer-masked , r and omized cross-over design balanced for carryover effects , involving 15 healthy volunteers in a 4-day plaque regrowth model . Products being tested ( 0.2 % CHX , 0.12 % CHX , 0.05 % CPC , and 0.03 % TRN ) were used both as sprays and mouthrinses . A saline solution served as a negative control . On day 1 , subjects received professional prophylaxis , suspended oral hygiene measures , and commenced using their allocated products . On day 5 , subjects were scored for disclosed plaque . RESULTS CHX sprays ( P<0.01 ) were the most effective sprays in preventing plaque regrowth , without significant differences between the two concentrations tested ( P>0.05 ) . TRN spray showed a significant inhibition of plaque regrowth in comparison to the negative control ( P<0.05 ) . CPC spray did not differ from saline spray ( P>0.05 ) . A similar trend of efficacy was detected for rinses . Although the effect on plaque regrowth observed with CHX rinses was superior to that of CHX sprays ( P<0.0003 ) , the latter did not cause side effects ( P>0.2 ) . CONCLUSIONS These findings , together with those from clinical trials , suggest that the CHX-containing sprays may represent an effective alternative to CHX rinses when mechanical oral hygiene has to be avoided in restricted areas . On the contrary , the TRN and CPC sprays showed little or no plaque inhibitory effects BACKGROUND / AIMS Chlorhexidine ( CHX ) spray has proven to be an easily applicable method for the chemical control of plaque in elderly and h and icapped patients . A r and omized double-blind cross-over placebo-controlled trial was undertaken to compare the effects of 0.2 % CHX spray applied once or twice daily on the plaque and gingival indexes in 13 institutionalized elderly patients . METHOD The study subjects were r and omly assigned to one of two groups . During the first 30-day period , one group received 0.2 % chlorhexidine spray twice daily and the other received 0.2 % CHX spray once daily plus placebo spray once daily . A washout period of 42 days then followed , after which the groups were interchanged and the process was repeated for another 30-day period . Plaque index and gingival index were determined at the beginning and end of each period . The patients continued with their usual oral hygiene practice s throughout the study . RESULTS A significant reduction in plaque and gingival indexes was produced in both the groups . There were no significant differences in index scores between the groups . CONCLUSIONS The results of the present study suggest that a single-daily application of 0.2 % CHX spray is equally as effective in reducing plaque accumulation and gingival inflammation in institutionalized elderly patients as are two-daily applications of the same spray BACKGROUND This study aims to investigate the effect of various oral hygiene strategies on the symptoms of inflammation in neuromuscularly disabled patients and to define the optimum hygiene method . METHODS Fifty-nine neuromuscularly disabled participants , suffering from cerebral palsy , were r and omly divided into five groups as follows : Group M : manual toothbrush ( n=14 ) , Group E : electrically powered toothbrush ( n=9 ) , Group MC : manual toothbrush and chlorhexidine gluconate ( CHX ) spray ( n=13 ) , Group EC : electrically powered toothbrush and CHX spray ( n=9 ) , and Group C : CHX spray ( n=14 ) . The oral hygiene applications were provided by the parents and staff . At baseline and after 21 days the plaque index ( PI ) , the gingival index ( GI ) , and bleeding on probing ( BOP ) were recorded . R 
    Output:
    
CONCLUSIONS Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents .