***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: A 2-year double-blind r and omized three-treatment controlled parallel-group clinical study compared the anti-caries efficacy of two dentifrices containing 1.5 % arginine , an insoluble calcium compound ( di-calcium phosphate or calcium carbonate ) and 1,450 ppm fluoride ( F ) , as sodium monofluorophosphate , to a control dentifrice containing 1,450 ppm F , as sodium fluoride , in a silica base .  The 6,000 participants were from Bangkok , Thail and and aged 6 - 12 years initially . They were instructed to brush twice daily , in the morning and evening , with their r and omly assigned dentifrice . Three trained and calibrated dentists examined the children at baseline and after 1 and 2 years using the National Institute of Dental Research Diagnostic Procedures and Criteria . The number of decayed , missing and filled teeth ( DMFT ) and surfaces ( DMFS ) for the three study groups were very similar at baseline , with no statistically significant differences among groups . After 1 year , there were no statistically significant differences in caries increments among the three groups . After 2 years , the two groups using the dentifrices containing 1.5 % arginine , an insoluble calcium compound and 1,450 ppm F had statistically significantly ( p < 0.02 ) lower DMFT increments ( 21.0 and 17.7 % reductions , respectively ) and DMFS increments ( 16.5 and 16.5 % ) compared to the control dentifrice . The differences between the two groups using the new dentifrices were not statistically significant . The results of this pivotal clinical study support the conclusion that dentifrices containing 1.5 % arginine , an insoluble calcium compound and 1,450 ppm F provide significantly greater protection against caries lesion cavitation , in a low to moderate caries risk population , than dentifrices containing 1,450 ppm F alone BACKGROUND This study focused on the interaction of arginine and fluoride on the remineralization of artificial enamel carious lesions in vitro . METHODS Human enamel blocks with artificial carious lesions were prepared and r and omly divided into six treatment groups ( n=30 for each group ) : deionized water , arginine solution , NaF solution , arginine/NaF solution , arginine-free fluoride toothpaste slurry and arginine-containing fluoride toothpaste slurry . After a pH-cycling regimen for 10 days , subsets of specimens from each group were subjected to independent analysis , including surface microhardness ( n=8/30 ) , cross-sectional microhardness ( n=8/30 ) , enamel fluoride uptake ( n=8/30 ) and polarized light microscopy ( n=6/30 ) . The sample s tested for surface microhardness were further subjected to simulated plaque acid challenge before surface microhardness was remeasured . RESULTS Arginine solution promoted remineralization compared with deionized water control ( p<0.05 ) . When used in combination with fluoride , arginine significantly increased fluoride uptake compared with fluoride alone ( p<0.05 ) . In addition , lesions treated with arginine-containing toothpaste also showed superior fluoride uptake compared with those treated with conventional fluoride toothpaste ( p<0.05 ) . CONCLUSIONS Arginine promoted enamel fluoride uptake when used in combination with fluoride , thereby contributing to resistance of enamel to carious demineralization UNLABELLED Recent cross-sectional studies suggest that reduced ability to generate alkali via the urease pathway in dental plaque may be an important caries risk factor , but it has not been assessed prospect ively . OBJECTIVE To evaluate the effect of plaque and saliva urease activity on the risk for developing new caries over a three-year period in children . METHODS A panel of 80 children , three to six years of age at recruitment , was followed prospect ively for three years .  Plaque urease activity , saliva urease activity and dental caries  were measured every six months . Survival analysis methodology  was used to evaluate the effect of urease on caries development during the study period adjusted for gender , age , baseline caries levels , sugar consumption , amount of plaque , and mutans streptococci levels . RESULTS The risk for developing new caries increased in a dose-responsive manner with increasing levels of urease activity in saliva ( adjusted HR(Q4 vs. Q1 ) : 4.98 ; 95 % CI : 1.33 , 18.69 ) and with decreasing urease activity in plaque ( adjusted HR(Q4 vs. Q1 ) : 0.29 ; 95 % CI : 0.11 , 0.76 ) . Multiple measurements of urease activity were conducted to overcome the variability of urease activity in this study . Baseline caries and mutans streptococci in saliva were also important predictors of caries risk . CONCLUSIONS Increased urease activity in saliva can be an indicator of increased caries risk in children , whilst increased urease activity in plaque may be associated with reduced caries risk . The reproducibility of urease measurements must be improved before these findings can be further tested and clinical ly applied UNLABELLED The aim of this cross sectional study was to evaluate the ureolytic and arginolytic activities of saliva in children and associate them with their caries status . STUDY DESIGN 65 , 8 year old children , were r and omly selected . The ureolytic and arginolytic activity of non stimulated saliva was studied and associated with DMFT and dmft index . Saliva of children were sample d under fasting conditions ; Children refrained from any oral hygiene procedures during the 12 hours that preceded the sample collection . Caries activity was scored and divided in 3 groups : Group A : Index zero : without lesions ; Group B : Moderate Index : 1 to 3 enamel caries lesions ; and Group C : High Index : more than 4 dentin caries lesions . RESULTS DMFT scores were moderate : 0.4(±0.79 ) and dmft : 2.78(±2.45 ) . Results expressed in μmol/min/mg/protein , for urease activity were statistically significant ( p=0.048 ) : Group A= 0.69 ( ±0.7 ) ; Group B= 0.45 ( ±0.43 ) ; and Group C= 0.39 ( ±0.55 ) . The arginine deiminase activity was not statistically significant ( p=0.16 ) : Group A= 2.53 ( ±1.42 ) , Group B= 2.31 ( ±1.57 ) and Group C= 1.97 ( ±2.0 ) . CONCLUSION Higher levels of ureolytic ( statistically significant ) and arginolytic activity ( trend ) in saliva were associated with lower DMFT/dmft scores in 8 year old children . There was a higher production of ammonia from the arginine deiminase system than the urease enzyme in saliva ( p>0.05 ) 
    Output:
    
Conclusions The results of this review suggest the salivary and plaque ADS activities appear to be promising caries risk indicators for adults , while results remain inconclusive in children .
Clinical relevance Measuring ADS activities ( saliva or plaque ) can be a potential caries risk indicator in adults .