***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: The purpose of this study was to determine the effects of professional mechanical toothcleansing on plaque , gingivitis , and dental caries in young children with a high caries experience . Seventy-eight children , 7 years of age , were stratified according to presence or absence of smooth surface lesions on the permanent teeth and subsequently r and omly assigned to an experimental group and a control group . The experimental group was given a thorough mechanical toothcleansing every 2 weeks . After 12 months a statistically significant difference in plaque accumulation and a minor difference in level of gingival inflammation could be demonstrated between the two groups . The incidence of dental caries in permanent teeth present at both examinations was 70 % lower in the experimental group . The effect on permanent teeth erupting during the study and on primary teeth present at both examinations was not statistically significant Background Practice -based general dental practitioners routinely provide " scale and polish " or " oral prophylaxis " to patients attending their practice s. Despite its routine provision , there is no evidence to support the clinical effectiveness of single-visit scale and polish , nor the frequency at which it should be provided . A recent systematic review recommended that future trials investigating scale and polish should involve dental practice patients . Methods A practice -based parallel r and omised controlled trial with 24-month follow-up was conducted . Healthy adults ( Basic Periodontal Examination [ BPE ] codes <3 ) were r and omly assigned to 3 groups ( 6-month , 12-month , or 24-month interval between scale and polish ) . The primary outcome was gingival bleeding with the hypothesis that 6-monthly scale and polish would result in lower prevalence than 12-month or 24-month frequency . Follow-up measurements were recorded by examiners blinded to the allocation . 125 , 122 and 122 participants were r and omised to the 6-month , 12-month and 24-month groups respectively . Complete data set analyses were conducted for 307 participants : 107 , 100 , and 100 in the 6-month , 12-month and 24-month groups respectively . Chi-square test and ANOVA were used to compare treatment groups at follow-up . Logistic regression and ANCOVA were used to estimate the relationship between outcome and treatment group , adjusted for baseline values . Multiple imputation analyses were also carried out for participants with incomplete data sets . Results Prevalence of gingival bleeding at follow-up was 78.5 % ( 6-month ) , 78 % ( 12-month ) and 82 % ( 24-month ) ( p = 0.746 ) . There were no statistically significant differences between groups with respect to follow-up prevalence of plaque and calculus . Statistically significant differences detected in the amount ( millimetres ) of calculus were too small to be clinical ly significant . Seventeen ( 4.6 % ) participants were withdrawn from the trial to receive additional treatment . Conclusions This trial could not identify any differences in outcomes for single-visit scale and polish provided at 6 , 12 and 24 month frequencies for healthy patients ( with no significant periodontal disease ) . However , this is the first trial of scale and polish which has been conducted in a general practice setting and the results are not conclusive . Larger trials with more comprehensive measurement and long-term follow up need to be undertaken to provide a firm evidence base for this intervention . This trial informs the design of future practice -based trials on this subject A clinical trial was conducted to compare the effect of different caries  –  preventive strategies  on  caries progression in lower – income , ethnically diverse persons 60 years of age and older . Two hundred and ninety – seven subjects were r and omized into one of five experimental groups . Group 1 received usual care from a public health department or a private practitioner . Group 2 received an educational program of 2 h duration implemented twice a year . Group 3 received the educational program plus a 0.12 % chlorhexidine rinse weekly . Group 4 received the education and chlorhexidine interventions and a fluoride varnish application twice a year . Group 5 received all the above interventions as well as scaling and root planing every 6 months throughout the 3–year study . A carious event was defined as the onset of a carious lesion , a filling , or an extraction on a surface which was sound at baseline . Two hundred and one subjects remained in the study for the 3–year period . Groups that received usual intraoral procedures ( groups 3 , 4 , and 5 ) had a 27 % reduction for coronal caries events ( p = 0.09 ) and 23 % for root caries events ( p = 0.15 ) , when compared to the groups that received no intraoral procedures ( groups 1 and 2 ) . Routine preventive treatments may have had only a small – to – moderate effect upon caries development Eighty-two periodontally involved patients were treated in a split mouth design such that one quadrant received coronal scaling ( CS ) , root planing ( RP ) , modified Widman surgery ( MW ) , and flap with osseous resection surgery ( FO ) . The therapy was performed in three phases : Phase I : the teeth previously design ated to receive RP , MW , and FO were thoroughly root planed and the teeth design ated to receive CS were scaled with no subgingival instrumentation , plaque control was initiated and reinforced for the entire mouth ; Phase II : the design ated teeth received MW or FO surgery ; and Phase III : maintenance therapy every three months . The CS teeth received coronal scaling and polishing during maintenance appointments , while RP , MW , and FO teeth received supragingival instrumentation , subgingival instrumentation and polishing .  Clinical measurements were taken initially , four weeks post-Phase I , 10 weeks post-Phase II , and after each of two years of maintenance care . All therapy modalities result ed in a decrease of mean probing depth with the FO producing the greatest decrease followed by MW , RP , and CS . The deeper the initial probing depth , the greater was the mean reduction of probing depth . FO created a loss of mean probing attachment in the 1 to 4 mm category . RP and MW produced the greatest gain of mean probing attachment in the 5 to 6 mm category . RP , MW , and FO produced similar gains in the greater than or equal to 7 mm category . FO created the most gingival recession followed by MW , RP , and CS This paper addresses the long-term effect of two dental delivery systems established during the Rural Dental Health Program ( RDHP ) in 1975 . At that time 725 children in grade s K-2 were assigned r and omly to an enriched dental health education program or regular health education program and to a SCHOOL- or COMMUNITY-based dental delivery system . Seven years after funding for RDHP ended , children originally assigned to the COMMUNITY group utilized more professional services and showed a higher level of dental knowledge than children assigned to the SCHOOL group . In addition , COMMUNITY-based children had , on average , twice as many sealed teeth . While the follow-up study did not reveal any statistically significant difference in the clinical oral health indices ( DMFS , gingival index , calculus index , plaque index , periodontal probing depth , and orthodontic treatment priority index ) the COMMUNITY-based children 's higher level of professional dental service utilization , greater number of sealed teeth , and increased dental knowledge should lead to a higher level of oral health in the long run BACKGROUND One hypothesis to explain the association between periodontal disease ( PD ) preterm/low birth weight ( PT/LBW ) is that PT/LBW may be indirectly mediated through translocation of bacteria or bacterial products in the systemic circulation . Transient bacteremias occur in subjects with marginal periodontitis or with gingivitis , and it is possible that bacteria and their products may reach the placental membranes hematogenously and provide the inflammatory effect to induce preterm labor . The effect of gingivitis as a potential risk factor for PT/LBW has still not been studied . A r and omized controlled trial was undertaken to determine the effect of routine plaque control and scaling on the pregnancy outcomes in women with gingivitis . METHODS Eight hundred seventy ( 870 ) pregnant women with gingivitis , aged 18 to 42 , were enrolled while receiving prenatal care in Santiago , Chile . Women were r and omly assigned in a two-to-one fashion to either a treatment group ( N = 580 ) , receiving periodontal treatment before 28 weeks of gestation or to a control group ( N = 290 ) , receiving periodontal treatment after delivery . Periodontal therapy consisted of plaque control , scaling , and daily rinsing with 0.12 % clorhexidine . Maintenance therapy was provided every 2 to 3 weeks until delivery , and consisted of oral hygiene instruction and supragingival plaque removal by instrumentation , as needed . The primary outcomes assessed were delivery at less than 37 weeks of gestation or an infant weighing less than 2,500 g. RESULTS Of the 870 women enrolled , 36 women ( 27 in the treatment group and nine in the control group ) were excluded from the analyses for different reasons . The incidence of PT/LBW in the treatment group was 2.14 % ( 12/560 ) and in the control group , 6.71 % ( 19/283 ) ( odds ratio [ OR ] 3.26 ; 95 % confidence interval [ CI ] 1.56 to 6.83 ; P = 0.0009 ) . Multivariate logistic regression analysis showed that , after adjusting for several known risk factors for PT/LBW , women with gingivitis were at a higher risk of PT/LBW than women who received periodontal treatment ( OR 2.76 ; 95%CI 1.29 to 5.88 ; P = 0.008 ) . CONCLUSIONS Periodontal treatment significantly reduced the PT/LBW rate in this population of women with pregnancy-associated gingivitis . Within the limitions of this study , we conclude that gingivitis appears to be an independent risk factor for PT/LBW for this population AIM The objective was to determine clinical and microbiological effects and perceived treatment discomfort of root debridement by subgingival air polishing compared with ultrasonic instrumentation during supportive periodontal therapy ( SPT ) . MATERIAL AND METHODS The trial was conducted as a split-mouth design ed study of 2-month duration including 20 recall patients previously treated for chronic periodontitis . Sites with probing pocket depth ( PPD ) of 5 - 8 mm and bleeding on probing ( BoP+ ) in two quadrants were r and omly assigned to subgingival debridement by ( i ) glycine powder/air polishing applied with a specially design ed nozzle or ( ii ) ultrasonic instrumentation . Clinical variables were recorded at baseline , 14 and 60 days post-treatment . Primary clinical efficacy variable was PPD reduction . Microbiological analysis of subgingival sample s was performed immediately before and after debridement , 2 and 14 days post-treatment . RESULTS Both treatment procedures result ed in significant reductions of periodontitis-associated bacterial species immediately and 2 days after treatment , and in significant reduction in BoP , PPD and relative attachment level at 2 months . There were no statistically significant differences between the treatment procedures at any of the examinations intervals . Perceived treatment discomfort was lower for air polishing than ultrasonic debridement . CONCLUSION This short-term study revealed no pertinent differences in clinical or microbiological outcomes between subgingival air polishing and ultrasonic debridement of moderate deep pockets in SPT patients BACKGROUND The interpretation of the results of r and omized controlled trials ( RCTs ) has traditionally emphasized statistical significance rather than clinical importance . Our aim was to assess the quality of reporting of factors related to clinical importance in a sample of published RCTs . METHODS A r and om sample of 27 ( of a total of 266 ) RCTs published in 5 major medical journals over a 1-year period were review ed by 4 independent review ers for factors considered important in the interpretation of the clinical importance of study results : identification of a clearly defined primary outcome , reporting of the expected difference between groups used in the calculation of sample size ( the delta value ) and whether it was based on the minimal clinical ly important difference of the intervention , the statistical significance of the results , presentation of pertinent confidence intervals , and the authors ' interpretation of the clinical importance of the results . RESULTS Twenty-two of 27 ( 81 % ) articles explicitly reported a single primary outcome . Of the 20 articles that included a sample size calculation , 18 ( 90 % ) reported a delta value . Two of the 18 ( 11 % ) articles explicitly stated that the delta value was chosen to reflect the minimal clinical ly important difference of the intervention . For the primary outcomes , confidence intervals surrounding the point estimates of the efficacy of the interventions were reported in 11 of 27 ( 41 % ) studies . The study results were interpreted from the perspective of clinical importance in 20 of 27 ( 74 % ) of the articles . Of these 20 reports , 5 ( 25 % ) provided justification for their clinical interpretation of the results . INTERPRETATION Authors of RCTs published in major general medical and internal medicine journals do not consistently provide their own interpretation of the clinical importance of their results , and they often do not provide sufficient information to allow readers to make their own interpretation Background To investigate , within general dental practice , patients ' and vocational dental practitioners ' ( VDP ) attitudes towards the benefits and costs of a simple scale and polish and to compare the experience of using manual versus ultrasonic instruments to scale teeth . Methods 28 VDPs and 420 patients participated . Patients were r and omly allocated to either group . Patients ' and VDPs ' attitudes towards , and experience of , the scale and polish were elicited by means of self-administered question naires . Results The majority of patients ( 99 % ) believed a scale and polish was beneficial . VDPs considered  ultrasonic treatment to be 
    Output:
    
This study showed no evidence to cl aim or refute benefit for scale and polish treatments for the outcomes of gingivitis , calculus and plaque .
There was some evidence of a reduction in calculus .
The body of evidence was once again assessed as of low quality .- Objective 4 : Scale and  polish  provided by a dentist compared with a dental care professionalNo studies were found which compared the effects of routine scaling and polishing provided by a dentist or dental care professional ( dental therapist or dental hygienist ) on periodontal health .
There is insufficient evidence to determine the effects of routine scale and polish treatments .