***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: Resin modified glass ionomer ( RMGI ) restorative material s have gained popularity in recent years . Their use is most often indicated in Class III and Class V cavities in adults and in numerous applications in children . This popularity in use has taken place in the absence of scientific knowledge of the RMGI material s. Lacking are adequate clinical trials to vali date the proposed indications . The purpose of this study was to examine a representative  RMGI in cervical abrasions and root caries in adults . Patients were recalled up to three years to evaluate st and ard clinical criteria . Results found the RMGI to be inferior to conventional  composite resin in similar applications . The most noted deficiencies were in color stability and anatomic form , or wear of the RMGI  . The results of this prospect i ve clinical trial would suggest a limited longevity for RMGI compared to traditional restorative material s. This study also reinforces the need for evidence of clinical performance prior to making decisions regarding material selection The aim of this study was to assess the prevalence and distribution of root caries in the adult population of Pomerania , Germany . The study sample comprised 6,267 r and omly selected subjects who were scheduled for examination from 1997 to 2001 ( population -based cross-sectional study , response rate : 69 % , age range 20–79 years ) . 499 edentulous persons were excluded from the dental examination ( 12 % ) performed according to WHO guidelines ( 1997 ) . In the statistical analysis , frequency distributions , means and median values were calculated and subdivided for different age groups . The percentage of exposed and affected root surfaces increased with age ( root caries index 4.6–10.6 % ) . The mean number of carious/filled root surfaces ( RDFS ) rose from 0.4 per person ( 25–34 years ) to 2.3 ( 55–64 years ) and dropped for seniors due to the low number of retained teeth . Fillings comprised the largest proportion of the RDFS ( 69.5 % ) . Most caries/fillings were found on buccal surfaces , the highest rate in m and ibular premolars . With about half of over-45-year-olds having at least one carious/filled root surface and increasing number of retained teeth in seniors , root caries is a relevant and probably growing disease in Pomerania and East Germany Successful use of atraumatic restorative treatment ( ART ) in children has been reported , but little information is available regarding its use in older adults . The hypothesis of this study was that survival rates of root restorations placed by both ART and the conventional technique were similar . Root-surface caries lesions in 103 institutionalized elders in Hong Kong were treated r and omly by either : ( 1 ) the conventional approach — caries removed by dental burs , and the cavity filled with light-cured resin-modified glass ionomer ; or ( 2 ) the ART approach — caries removed by h and instruments , and the cavity filled with chemically cured high-strength glass ionomer . In total , 84 conventional and 78 ART restorations were placed . After 12 months , 63 conventional and 59 ART restorations were review ed , and the respective 12-month survival rates were 91.7 % and 87.0 % ( p > 0.05 ) . It is concluded that the survival rates of both types of root restorations were high and similar The aim of this study was to evaluate the clinical performance of adhesive filling material s in class V cavities in xerostomic head- and neck-irradiated cancer patients , in terms of marginal adaptation , anatomical form and recurrent caries . We selected 35 high-caries-risk , post-radiation , xerostomic adults with ≥3 cervical carious lesions in the same arch . Every patient received a KetacFil ( KF ) , PhotacFil ( PF ) and Herculite XRV ( HX ) restoration . Patients were instructed to use a neutral 1 % sodium fluoride gel in custom trays , on a daily basis . After 6 , 12 , 18 and 24 months , the restorations were examined for material loss , marginal integrity and recurrent caries . Fluoride compliance was determined at each recall appointment and recorded as the percentage of recommended use during that interval [ compliance of ≤50 % = NFUs , > 50 % = FUs ] . Only 30 patients were available for recall at 6 months , with 28 patients at 12 and 18 months , and 27 patients at 24 months . In the NFU group , differences in recurrent caries were found between KF and HX at all observation times ( p < 0.05 ) . Differences ( p < 0.05 ) in adaptation and /or anatomical form were found between KF and PF in NFUs after 18 and 24 months . In FUs , significant differences were observed between KF and PF , and KF and HX after 6 and 12 months , between KF and HX , PF and HX after 18 and 24 months . In summary , glass ionomers ( especially the conventionally setting formulation ) provide clinical caries inhibition but erode easily , while composite resin provides greater structural integrity Root surface caries is of growing importance because its prevalence increases with age , and the population of the United States is growing older while edentulism and tooth loss rates have declined . Few clinical studies have evaluated material s used for the restoration of active root caries lesions . This study evaluated a Type II glass ionomer cement and a microfilled composite resin , both placed in preparations without mechanical retention or acid etching of enamel , in the restoration of root caries . Fifty adult volunteers with active root caries received one or both material s with the material chosen r and omly . Patients were recalled after 24 months to evaluate restorations for retention , additional caries , marginal integrity , and overall clinical acceptability .  Seventy-seven restorations were available for reevaluation . Forty-five percent of the glass ionomer and 73 % of the composite restorations were clinical ly acceptable after 24 months . Of the glass ionomers , 39 % were fully retained compared with 73 % of composite restorations . Among those partially or fully retained , 25 % of the glass ionomer restorations had minimal loss of marginal integrity and 30 % had extensive loss while 53 % and 9 % of composite restorations had minimal and extensive loss , respectively . Most restorations were clinical ly unacceptable because of restorative material loss . Substantial numbers of  glass ionomer cement and  composite resin restorations were lost . This may be the result of difficulties in maintaining isolation and obtaining a proper gingival seal . Thus , routine use of mechanical retention is still highly recommended to reduce the loss of restorative material Controversy exists as to whether there is less secondary caries at the margins of glass ionomer restorations compared with other material s that do not release fluoride . This study examined the incidence of secondary caries for three types of restorative material s in Class V restorations in xerostomic patients . The study group consisted of 45 high caries-risk adult patients who had undergone head and neck irradiation for the treatment of cancer . All were substantially xerostomic and in need of at least three restorations in the same arch . Every patient received a restoration with each of the test material s , a conventional glass ionomer ( GI ) , a resin modified glass ionomer ( RMGI ) and a resin composite ( C ) . Patients were instructed in the daily use of a neutral pH sodium fluoride gel in custom trays . Recall appointments were made at 6 , 12 , 18 and 24 months , and the restorations were examined for material loss , marginal integrity and recurrent caries at the restoration margin . Fluoride compliance was determined at each recall period and recorded as the percentage of recommended use during that interval . Patients were categorized at the end of the study as fluoride non-users if their average compliance was 50 % or less . Those with greater than 50 % compliance were categorized as fluoride users . In the latter group , no recurrent caries was found for any of the restorations , whereas a material -dependent incidence of recurrent caries was found in the fluoride non-user group . None of the GI , one RMGI and eight C restorations failed due to recurrent caries . For the fluoride non-user patients , Fishers exact test ( p=0.05 ) showed no statistical difference between GI and RMGI but statistical differences were found among those material s and resin composite at each recall period . Recurrent caries reductions for GI and RMGI relative to C were greater than 80 % in xerostomic patients not using topical fluoride supplementation Fifty-four pairs of  restorations ( one glass ionomer and the other amalgam ) were placed in the mouths of 36 xerostomic head and neck cancer patients . Patients were either fluoride users or fluoride nonusers . In patients who used a daily application of a mildly acidic ( pH 5.8 ) sodium fluoride gel , glass-ionomer cements failed and amalgam restorations did not ( P < 0.0001 ) . In patients who neglected to use their topical fluoride as directed , glass-ionomer cement restorations  did not fail , but amalgam restorations did ( P < 0.001 ) . The mean time to restoration loss for both restorative material s was 8.5 months . In severely xerostomic patients these findings were exaggerated The CONSORT statement is used worldwide to improve the reporting of r and omised controlled trials . Kenneth Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . To encourage dissemination of the CONSORT 2010 Statement , this article is freely accessible on bmj.com and will also be published in the Lancet , Obstetrics and Gynecology , PLoS Medicine , Annals of Internal Medicine , Open Medicine , Journal of Clinical Epidemiology , BMC Medicine , and Trials 
    Output:
    
There is a need for more research in this area as many of the studies identified in this systematic review treated post-radiation , xerostomic patients which are not typical of the general population .