***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 determine the efficacy of chemo-mechanical  caries removal using Carisolv and compare it to the conventional method of caries removal . DESIGN A quasi-experimental study . PLACE AND DURATION OF STUDY The Department of Operative Dentistry , Fatima Jinnah Dental College Hospital , Karachi , from October 2003 to March 2004 . PATIENTS AND METHODS Thirty patients with contralateral cariously involved m and ibular molars participated in the study . Patients were selected using convenience sampling . One side of each patient was r and omly selected for treatment with either Carisolv or the conventional method . In the study group , carious lesion was removed with Carisolv instruments , whereas in control group excavators and round steel burs were used . Single observer assessed all the treated lesions . Time required to remove caries and completeness of caries removal was observed for both techniques . Data was compared using ' Fisher 's exact test ' and ' Independent sample s t-test ' . RESULTS Time taken to remove caries using Carisolv was 12.19 ( SD 3.7 ) minutes , whereas time taken to remove caries by conventional method was 7.4 ( SD 3.21 ) minutes . The difference was statistically significant ( p-value<0.005 ) . Caries could not be removed in 3 teeth in the study group with Carisolv . Complete caries removal was , however , achieved in the control group . The difference was statistically insignificant ( p-value>0.005 ) . CONCLUSION Chemo-mechanical caries removal with Carisolv is as effective as conventional methods in removing dental caries , however , it is significantly more time-consuming OBJECTIVES The purpose of this study was to compare the chemomechanical caries-removal system ( Carisolv ) with high-speed excavation in cavitated occlusal caries of primary molars . Design and setting . The study was a r and omized controlled , clinical trial in which the two techniques were compared in each subject . Participants were chosen from public schools , in Maracaibo County , Zulia State , Venezuela . SAMPLE AND METHODS The sample consisted of 80 primary molars selected from 40 children ( mean age 7.7+/-0.7 years ) . Each patient had at least two contralateral primary molars with cavitated occlusal caries and approximately equal-size access to lesions . The outcome variables were : clinical ly complete caries removal , size of the opening of the cavity , volume of carious tissue removed , pain during caries removal , anaesthesia requested by the patient , caries-removal time , and behaviour and preference of patients . RESULTS All treated molars were clinical ly caries free whichever caries-removal procedure was used . When Carisolv ' was used the final cavity entrance sizes were smaller ( P<0.001 ) and the estimated volume of tissue removed was less ( P<0.001 ) . The time taken for caries removal was three times longer ( 7.51+/-1.83 min , P<0.001 ) . Some pain was reported by seven ( 17.5 % ) participants when Carisolv was used , compared with 16 ( 40 % ) when high-speed excavation was used ( P<0.05 ) . Using the Carisolv method there was a higher proportion of patients with positive behaviour ( P<0.01 ) , and 71.0 % ( P<0.05 ) preferred this treatment . CONCLUSION Carisolv is an effective clinical alternative treatment for the removal of occlusal dentinal caries in cavitated primary molars ; it is more conservative of dental tissue and appeared to be more comfortable for most patients , although the clinical time spent is longer than when using high-speed excavation PURPOSE The purpose of this controlled clinical trial was to compare the working time for caries removal in primary teeth , the need for local anesthesia and patient cooperation , when the chemomechanical Carisolv or the conventional mechanical method were used . METHODS The sample consisted of primary teeth of children who had occlusal or buccal carious lesions into dentin .  High speed and /or low speed were used as the conventional mechanical method of caries removal . The efficiency in caries removal was judged on the basis of clinical criteria . Length of working time , need of local anesthesia , and level of patient cooperation were recorded for both methods . Statistical analysis was performed using the student 's t test and chi-square test . RESULTS Working time with the chemomechanical method was much more prolonged than with the mechanical method ( P < .001 ) , but it did not negatively affect children 's cooperation . Furthermore , the chemomechanical method reduced the need for administration of local anesthesia for Class V cavity preparations . CONCLUSIONS The chemomechanical method , although more prolonged , is effective in caries removal in primary teeth , does not influence children 's cooperation and may reduce the need of local anesthesia in Class V restorations Carisolv is a minimally invasive method for softening and removing dentine caries . A new , modified Carisolv gel has been developed in order to optimise the efficiency if its chemical caries dissolution . The aim of the present study was to compare the caries removal efficiency of the original gel with that of the new gel , which contains almost double the concentration of sodium hypochlorite .  Ten dentists treated 202 cavities in 170 patients ; 104 cavities were r and omised to the new gel and 98 to the original gel . Their mean treatment times for caries removal were 6.7±4.1 min and 7.6±4.2 min , respectively ( P>0.05 ) . In close-to-pulp lesions , constituting 32 % of the cavities , the mean times for caries removal were 9.0±7.0 min and 11.6±4.4 min for the new and original gels , respectively ( P<0.01 ) . Question naires revealed that 81 % of the patients preferred  chemomechanical treatment  to drilling . In conclusion , the improved efficiency of the modified Carisolv gel  did reduce the time for caries removal in deep lesions . However , it still needs more time than conventional drilling The purpose of this study was to evaluate the clinical performance of glass ionomer cement ( GIC ) restorations comparing two minimally invasive methods in permanent teeth after 12 months . Fifty pregnant women ( second trimester of pregnancy ) , mean age 22 ± 5.30 years , were treated by two previously trained operators . The treatment approaches tested were : chemomechanical method ( CarisolvTM ; MediTeam ) and atraumatic restorative treatment ( ART ) . A split-mouth study design was used in which the two treatments were r and omly placed in 50 matched pairs of permanent teeth . The chemomechanical method ( CM ) was the test group and the ART was the control group . The treatments were performed in Public Health Centers . The tested restorative material was a high-strength GIC ( Ketac Molar ; 3M/ESPE ) . The restorations were placed according to the ART guidelines . Two calibrated independent examiners evaluated the restorations in accordance with ART criteria . The interexaminer kappa was 0.97 . Data were analyzed using 95 % confidence interval on the binomial distribution and Fisher 's exact test at 5 % significance level . In a 12-month follow-up , 86 % of the restorations were evaluated . In the test group ( CM ) , 100 % ( CI=93.3 - 100 % ) of the restorations were considered successful . In the control group ( ART ) 97.6 % ( CI=87.4 - 99.9 % ) of the restorations were considered successful and 2.4 % unsuccessful ( marginal defect > 0.5 mm ) . There was no statistically significant difference between the 12-mounth success rate for both groups ( Fisher 's exact test : P=0.49 ) and between the two operators ( Fisher 's exact test : P=1.00 ) . Both minimally invasive methods , chemomechanical method and ART , showed a similar clinical performance after 12 months of follow up UNLABELLED The change in the concepts of cavity preparation and the development of reliable adhesive material s lead to the development of alternative methods of caries removal . Chemo-mechanical caries removal ( CMCR ) involves the chemical softening of carious dentin , followed by its removal with gentle excavation . OBJECTIVE The present study was conducted to evaluate clinical ly the efficiency of caries removal using a new chemo-mechanical agent ( Papacarie ) compared to the conventional drilling method including the need for local anesthesia , the need for drill , duration of the treatment and the pain reaction . STUDY DESIGN This study was split mouth design . The study was performed on thirty seven bilateral open carious lesions . They were divided into two equal groups according to method of caries removal . In Group I , caries was removed using the Papacarie system and in Group II , caries was removed with the conventional drill . RESULTS The results showed that the Papacarie was as efficient as the drill in caries removal from open carious lesions with no significant difference in the operating time . The new CMCR agent also reduced significantly the need for local anesthesia and the use of drill . In addition , Papacarie was also more comfortable than the traditional rotatory instruments . CONCLUSIONS It was concluded that Papacarie could be an effective caries removal method to treat children , particularly those who present with early childhood caries or management problems Objective . The purpose of this study was to make a clinical comparison of the chemomechanical method for caries removal and the conventional rotary instruments technique when used in children and adolescents . Material and Methods . The study comprised 120 patients aged 3–17 years r and omized into two groups : caries were removed chemomechanically in 60 patients and 60 patients received conventional treatment with rotary instruments . The outcome variables were : clinical ly complete caries removal , pain during caries removal , need for local anesthesia , treatment time , preferences of patients , and clinical success of the restorations during the 12-month evaluation period . Results . Complete caries removal was achieved in 92 % of chemomechanically treated teeth and in all teeth treated with rotary instruments ( p>0.05 ) . The chemomechanical method significantly reduced the need for local anesthesia ( p<0.001 ) . Eighty-five percent of patients treated with Carisolv and 47 % treated with rotary instruments were satisfied with the treatment ( p<0.05 ) . The mean time for chemomechanical caries removal was 11.2±3.3 min and 5.2±2.8 min for caries removal with rotary instruments ( p<0.001 ) . At the end of the 12-month evaluation period , there was no observed influence of the caries removal method on the survival of the restorations . Conclusions . The chemomechanical caries removal technique is an adequate alternative to the conventional rotary instruments method and is advantageous in pediatric dentistry Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists Dental fear is often associated with experience of pain , unpleasant sounds and uncomfortable vibrations caused by dental drills . Therefore patients welcome alternative , less painful excavating methods such as lasers , s and blasters and chemomechanical systems . The aim of this study was to compare a chemomechanical caries removal system ( Carisolv ) to traditional drilling with regard to patient acceptance and time consumption as well as the six-month success rate of fillings . Ninety-two primary teeth in 46 children were included in the study . From this study , the following conclusions can be drawn : patient acceptance of Carisolv-treatment compared to drilling is excellent , since 65 % would choose Carisolv and no one drilling when treated next time . The dentists rated patients ' degree of pain significantly lower in Carisolv situations than in drill situations . Time consumption is significantly higher when excavating with Carisolv ( 6.7 min . ) than with drill ( 3.3 min . ) . The durability of fillings six months after treatment is equal in the two groups AIM To test the null hypothesis that Carisolv is no more effective than 1 % sodium hypochlorite in cleaning uninstrumented , immature root canals . METHODOLOGY A total of 240 uniform , immature ovine incisors were decoronated at the CEJ level and r and omly divided into four groups of 60 . After gross pulp extirpation , canals were flooded with normal saline ( negative control ) , 1 % NaOCl , Carisolv or 5 % NaOCl ( positive control ) and incubated for 10 min ( group 1 ) , 20 min ( group 2 ) , 30 min ( group 3 ) or 30 min , refreshing irrigant at 10 and 20 min ( group 4 ) . SEM photomicrographs of canal wall debris in the apical , middle and coronal thirds were scored against a 5-point scale . Internal consistency was assessed by kappa statistics . Debris scores for different irrigant regimes at different canal levels were analysed by non-parametric tests ( P < 0.05 ) . RESULTS Canals were consistently 
    Output:
    
Furthermore , the current scientific evidence shows that the sodium hypochlorite-based ( Carisolv ) chemomechanical caries removal method was more time consuming when compared to the enzyme-based ( Papacarie ) chemomechanical and the conventional caries removal methods .