***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 To compare the effectiveness of annual topical application of silver diamine fluoride ( SDF ) solution , semi-annual topical application of SDF solution , and annual application of a flowable high fluoride-releasing glass ionomer in arresting active dentine caries in primary teeth . METHODS A total of 212 children , aged 3 - 4 years , were r and omly allocated to one of three groups for treatment of carious dentine cavities in their primary teeth :  Gp1-annual application of SDF , Gp2-semi-annual application of SDF , and Gp3-annual application of glass ionomer . Follow-up examinations were carried out every six months to assess whether the treated caries lesions had become arrested . RESULTS After 24 months , 181 ( 85 % ) children remained in the study . The caries arrest rates were 79 % , 91 % and 82 % for Gp1 , Gp2 and Gp3 , respectively ( p=0.007 ) . In the logistic regression model using GEE to adjust for clustering effect , higher caries arrest rates were found in lesions treated in Gp2 ( OR=2.98 , p=0.007 ) , those in anterior teeth ( OR=5.55 , p<0.001 ) , and those in buccal/lingual smooth surfaces ( OR=15.6 , p=0.004 ) . CONCLUSION Annual application of either SDF solution or high fluoride-releasing glass ionomer can arrest active dentine caries . Increasing the frequency of application to every 6 months can increase the caries arrest rate of SDF application . CLINICAL SIGNIFICANCE Arrest of active dentine caries in primary teeth by topical application of SDF solution can be enhanced by increasing the frequency of application from annually to every 6 months , whereas annual paint-on of a flowable glass ionomer can also arrest active dentine caries and may provide a more aesthetic outcome Root caries is common in institutionalized elders , and effective prevention methods are needed . This clinical trial compared the effectiveness of four methods in preventing new root caries .  From 21 residential homes , 306 generally healthy elders having at least 5 teeth with exposed sound root surfaces were r and omly allocated into one of four groups : ( 1 ) individualized oral hygiene instruction ( OHI ) ; ( 2 ) OHI and applications of 1 % chlorhexidine varnish every 3 months ; ( 3 ) OHI and applications of 5 % sodium fluoride varnish every 3 months ; and ( 4 ) OHI and annual applications of 38 % silver diamine fluoride ( SDF ) solution . Two-thirds ( 203/306 ) of the elders were followed for 3 years . Mean numbers of new root caries surfaces in the four groups were 2.5 , 1.1 , 0.9 , and 0.7 , respectively ( ANOVA , p < 0.001 ) .  SDF solution , sodium fluoride varnish , and chlorhexidine varnish  were more effective in preventing new root caries than giving OHI alone Background Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to caries . The objective of the study was to assess and compare the effect of a single application of 38 % SDF with ART sealants and no treatment in preventing dentinal ( D3 ) caries lesions on occlusal surfaces of permanent first molars of school children who participated in a daily school-based toothbrushing program with fluoride toothpaste . Methods The prospect i ve community clinical trial in the Philippines was conducted over a period of 18 months and included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based fluoride toothpaste brushing program . Children were r and omly assigned for SDF application or ART sealant treatment . Children from two of the eight schools did not receive SDF or ART sealant treatment and served as controls . SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars . Surfaces that were originally defined as sound at baseline but which changed to dentinal ( D3 ) caries lesions were defined as surfaces with new caries ( caries increment ) . Non-compliance to the daily toothbrushing program in three schools offered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste brushing and in non-toothbrushing children . Results In the brushing group , caries increment in the SDF treatment group was comparable with the non-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a statistically significant lower hazard ratio of 0.12 ( 0.02 - 0.61 ) . In the non-brushing group , caries increment in the SDF treatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only statistically significant for the sealant group ( HR 0.33 ; 0.20 - 0.54 ) . Caries increment was lower in toothbrushing children than in non-toothbrushing children . Hazard ratios reached statistical significance for the non-treated children ( HR 0.43 ; 0.21 - 0.87 ) and the sealant-treated children ( HR 0.15 ; 0.03 - 0.072 ) . Conclusions A one-time application of 38 % SDF on the occlusal surfaces of permanent first molars of six- to eight-year-old children is not an effective method to prevent dentinal ( D3 ) caries lesions . ART sealants significantly reduced the onset of caries over a period of 18 months . Trial registration numberGerman Clinical Trial Register Background / Aims : Root caries among elderly communities is of growing public health concern globally . This controlled clinical trial investigated the effectiveness of silver diamine fluoride and oral health education in preventing and arresting root caries . Methods : Two hundred sixty-six elderly subjects who had at least 5 teeth with exposed root surfaces and did not have serious life-threatening medical diseases were allocated to 3 groups according to a computer-generated r and om list : group 1 ( the control group ) received oral hygiene instructions ( OHI ) annually ; group 2 received OHI and silver diamine fluoride ( SDF ) application annually , and group 3 was given OHI and SDF application annually , plus an oral health education ( OHE ) programme every 6 months . Results : Two hundred twenty-seven elderly subjects were followed for 24 months . The mean numbers of new root caries surfaces in groups 1 , 2 and 3 were 1.33 , 1.00 and 0.70 , respectively ( ANOVA , p < 0.05 ) . Group 3 had fewer root surfaces with new caries than group 1 ( Scheffé multiple-comparison test , p < 0.05 ) . The mean numbers of arrested root caries surfaces in groups 1 , 2 and 3 were 0.04 , 0.28 and 0.33 , respectively ( ANOVA , p < 0.01 ) . Group 3 and group 2 had a greater number of active root caries surfaces which became arrested than group 1 ( Scheffé multiple-comparison test , p < 0.05 ) . Conclusion : Annual application of SDF together with biannual OHE was effective in preventing new root caries and arresting root caries among community-dwelling elderly subjects Aim : To evaluate in vivo the remineralizing efficacy of silver diamine fluoride ( SDF ) , glass ionomer Type VII ( GC VII ) and calcium hydroxide ( Dycal ) . Material s and Methods : 60 subjects in the age group of 18 - 35 years , matching the inclusion criteria and having deep carious lesions in the permanent first and second molars were selected . The teeth were aseptically opened under rubber dam and after gross caries removal , approximately 0.4 mg of soft discolored dentin was removed with a sharp spoon excavator from the mesial or distal aspect of the cavity . The test material was r and omly selected and applied in a thickness of 1.5 - 2 mm and the cavity sealed with cavit . The patients were followed up at regular intervals with radiographic evaluation at 12 weeks . At 3 months the temporary restoration was removed and dentin sample s were collected from the other half of the cavity which was left in the first appointment . Atomic absorption spectrophotometry , Colorimetric test using UV-vis spectrometer and potentiometric titration were used for determining calcium , phosphorous and fluoride respectively . Results : Almost equivalent rise in the percentage of calcium level was seen in GC VII and Ca(OH)2 groups , followed by SDF group . Highest percentage rise in phosphate ions was seen in GC VII group followed by SDF group and Ca(OH)2 group . Highest percentage of fluoride rise was seen in GC VII group followed by SDF group and Ca(OH)2 group . Conclusions : The results indicated that both GC VII and SDF can be potential indirect pulp capping material Arresting Caries Treatment ( ACT ) has been proposed to manage untreated dental caries in children . This prospect i ve r and omized clinical trial investigated the caries-arresting effectiveness of a single spot application of : ( 1 ) 38 % silver diamine fluoride ( SDF ) with tannic acid as a reducing agent ; ( 2 ) 38 % SDF alone ; ( 3 ) 12 % SDF alone ; and ( 4 ) no SDF application in primary teeth of 976 Nepalese schoolchildren . The a priori null hypothesis was that the different treatments have no effect in arresting active cavitated caries . Only the single application of 38 % SDF with or without tannic acid was effective in arresting caries after 6 months ( 4.5 and 4.2 mean number of arrested surfaces ; p < 0.001 ) , after 1 year ( 4.1 and 3.4 ; p < 0.001 ) , and after 2 years ( 2.2 and 2.1 ; p < 0.01 ) . Tannic acid conferred no additional benefit . ACT with 38 % SDF provides an alternative when restorative treatment for primary teeth is not an option To investigate the effectiveness of topical fluorides in preventing fissure caries , we conducted a r and omized controlled trial with parallel groups . In total , 501 children ( 1,539 molars , 3,078 sites ) , mean age 9.1 years , who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited . They were r and omly allocated among four groups : ( 1 ) resin sealant , single placement ; ( 2 ) 5 % NaF varnish , semi-annual application ; ( 3 ) 38 % silver diamine fluoride ( SDF ) solution , annual application ; and ( 4 ) placebo control . Follow-up examinations were conducted every 6 months by a masked examiner . After 24 months , 485 children ( 97 % ) were examined . Proportions of pit/fissure sites with dentin caries in the sealant , NaF , SDF , and control groups were 1.6 % , 2.4 % , 2.2 % , and 4.6 % , respectively . A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls ( p < 0.05 ) . We concluded that placement of resin sealant , semi-annual application of NaF varnish , and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars ( Clinical Trials.gov number CT01446107 ) Background There is growing interest in the use of diammine silver fluoride ( DSF ) as a topical agent to treat dentin hypersensitivity and dental caries as gauged by increasing published research from many parts of the world . While DSF has been available in various formulations for many years , most of its pharmacokinetic aspects within the therapeutic concentration range have never been fully characterized . Methods This preliminary study determined the applied doses ( 3 teeth treated ) , maximum serum concentrations , and time to maximum serum concentration for fluoride and silver in 6 adults over 4 h.  Fluoride was determined using the indirect diffusion method with a fluoride selective electrode , and silver was determined using inductively coupled plasma-mass spectrometry . The mean amount of DSF solution applied to the 3 teeth was 7.57 mg ( 6.04 μL ) . Results Over the 4 hour observation period , the mean maximum serum concentrations were 1.86 μmol/L for fluoride and 206 nmol/L for silver . These maximums were reached 3.0 h and 2.5 h for fluoride and silver , respectively . Conclusions Fluoride exposure was below the U.S. Environmental Protection Agency ( EPA ) oral reference dose . Silver exposure exceeded the EPA oral reference dose for cumulative daily exposure over a lifetime , but for occasional use was well below concentrations associated with toxicity . This preliminary study suggests that serum concentrations of fluoride and silver after topical application of DSF should pose little toxicity risk when used in adults . Clinical trials registration NCT01664871 Systematic review s have become very popular . A recent estimate suggests that 22 new systematic review s are published daily [ 1 ] . One reason for this interest is that they serve many purpose s. For example , the influential Institute of Medicine has indicated that a systematic review is an essential component when developing clinical practice guidelines within the USA [ 2 ] . Some granting agencies are now advocating for the use of systematic review s as an evidence -based rationale for the conduct of a proposed r and omized trial [ 3 ] . And journals are now dem and ing the use of systematic review s to provide readers with context of the results of a clinical trial [ 4 ] . For systematic review s to be useful , they need to be reported in 
    Output:
    
This systematic review evaluates the use of SDF for both root caries prevention and arrest in older adults .
Existing reports of SDF trials support effectiveness in root caries prevention and arrest , remineralization of deep occlusal lesions and treatment of hypersensitive dentin