***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: Introduction : The bonding of orthodontic brackets and their failure rates by both direct and in-direct procedures are well-documented in orthodontic literature . Over the years different adhesive material s and various indirect bonding transfer procedures have been compared and evaluated for bond failure rates . The aim of our study is to highlight the use of a simple , inexpensive and ease of manipulation of a single thermo-plastic transfer tray and the use the of a single light cure adhesive to evaluate the bond failure rates in clinical situations . Material s and Methods : A total of 30 patients were r and omly divided into two groups ( Group A and Group B ) . A split-mouth study design was used , for , both the groups so that they were distributed equally with-out bias . After initial prophylaxis , both the procedures were done as per manufactures instructions . All patients were initially motivated and review ed for bond failures rates for 6 months . Results : Bond failure rates were assessed for over-all direct and indirect procedures , anterior and posterior arches , and for individual tooth . Z-test was used for statistically analyzing , the normal distribution of the sample in a spilt mouth study . The results of the two groups were compared and P value was calculated using Z-proportion test to assess the significance of the bond failure . Conclusion : Over-all bond failure was more for direct bonding . Anterior bracket failure was more in-direct bonding than indirect procedure , which showed more posterior bracket failures . In individual tooth bond failure , m and ibular incisor , and premolar brackets showed more failure , followed by maxillary premolars and canines INTRODUCTION Previous in-vitro investigations reported no significant differences in the bond strength of brackets cured with conventional halogen lamps and those cured with light-emitting diodes ( LED ) , even though LED curing times are much shorter . However , it is not known how LED curing performs in the oral cavity . The purpose of this r and omized clinical trial was to evaluate the clinical performance of brackets cured with 2 light-curing units : a conventional halogen unit and an LED . METHODS Thirty patients treated with fixed appliances were included in this study . The bonding followed a contralateral quadrant pattern : in each patient , 2 quadrants were cured with the conventional halogen unit , and the other 2 quadrants were cured with the LED unit . The study had a single blind controlled design with a within-patient comparison of the 2 curing techniques , and the patients were allocated r and omly . A total of 544 stainless steel brackets were examined for bracket failure . Location ( tooth ) , cause , and date of failure were recorded over 15 months . Statistical analyses were performed with the Kaplan-Meier survival estimates and the log rank test . RESULTS No statistically significant differences were found in total bond failure rate or in mean survival time between brackets cured with the halogen light and those cured with the LED . Neither were significant differences found between the 2 lights when the clinical performances of the maxillary and m and ibular arches were compared , or when the posterior and anterior segments were compared . CONCLUSIONS These results show that curing with an LED does not result in more bond failures or shorter time to failure when compared with conventional halogen light curing . Curing with an LED is an acceptable alternative to conventional halogen light curing Background The purpose of this clinical longitudinal study was to investigate the effectiveness of indirect bonding technique evaluating the number of bond failures which occurred during treatment . Methods Fifty-two patients were selected and divided into two groups : group A ( 33 patients ) bonded with the direct technique and group B ( 19 patients ) bonded with the indirect technique . The number and date of bracket failure were recorded for over 15 months . Moreover , also the effect of crowding level on bracket failures was calculated . Statistical analysis was performed by means of t-test , Kaplan-Meier survival estimates and chi-squared test . Results No statistically significant differences were found in the total bond failure rate between direct and indirect techniques , also when comparing the upper and lower arches . The only significant difference was found comparing the posterior segment of the lower arches , in which a higher percentage of detachments were recorded in group B , bonded with the indirect technique . Moreover , no significant differences between direct and indirect bonding were found when evaluating crowding level . Conclusions Orthodontic practitioners can safely use the indirect bonding technique , even in patients with severe crowding , because it does not influence the adhesive quality and the bracket survival rate OBJECTIVE To comparatively assess clinical failure rate of brackets cured with two different photopolymerization sources after nine months of orthodontic treatment . MATERIAL S AND METHODS The sample of this study comprised 30 patients who received comprehensive orthodontic treatment by means of fixed appliances . Using the same adhesive , 600 stainless steel brackets were directly bonded and light cured for 10 seconds with the light-emitting diode ( LED ) lamp or for 20 seconds with the conventional halogen lamp . A split-mouth design r and omly alternated from patient to patient was applied . Failure rates were recorded for nine months and analyzed with Pearson chi2 test , and log-rank test at alpha = .05 level of significance . RESULTS The overall failure rate recorded with the halogen unit ( 3.33 % ) was not significantly different from the failure rate for the LED lamp ( 5.00 % ) . Significantly more failures were found in boys compared with girls , in the m and ibular dental arch compared with the maxillary arch , and in posterior segments compared with anterior segments . However , no significant difference was found between the right and left segments . CONCLUSION Both light-curing units showed sufficiently low bond failure rates .  LED curing units are an advantageous alternative to conventional halogen sources in orthodontics because they enable a reduced chair-time bonding procedure without significantly affecting bond failure rate A trial was carried out to evaluate the clinical performance of a visible light-cured adhesive when used with a foil mesh base in an indirect bonding technique . Thirty-seven patients entered the trial , and a total of 407 brackets were placed . The incidence and site of bond failure were recorded . The overall failure rate was 6.5 % . There were no significant differences detected between the failure rates for either the upper or the lower arches or for the anterior and the posterior segments of the arches ( p less than 0.01 ) The purpose of this prospect i ve longitudinal r and omized study was to compare the clinical performance of recycled brackets with that of new stainless steel brackets ( Orthos ) .  Twenty patients treated with fixed appliances were included in the investigation . Using a ' split-mouth ' design , the dentition of each patient was divided into four quadrants . In 11 r and omly selected patients , the maxillary left and m and ibular right quadrants were bonded with recycled brackets , and the remaining quadrants with new stainless steel brackets . In the other nine patients the quadrants were inverted . Three hundred and ten stainless steel brackets were examined : 156 were recycled and the remaining 154 were new . All the brackets were bonded with a self-cured resin-modified glass ionomer ( GC Fuji Ortho ) . The number , cause , and date of bracket failures were recorded over 12 months . Statistical analysis was performed by means of a paired t-test , Kaplan-Meier survival estimates , and the log-rank test . No statistically significant differences were found between : ( a ) the total bond failure rate of recycled and new stainless steel brackets ; ( b ) the upper and lower arches ; ( c ) the anterior and posterior segments . These findings demonstrate that recycling metallic orthodontic brackets can be of benefit to the profession , both economically and ecologically , as long as the orthodontist is aware of the various aspects of the recycling methods , and that patients are informed about the type of bracket that will be used for their treatment Blinding embodies a rich history spanning over two centuries . Most research ers worldwide underst and blinding terminology , but confusion lurks beyond a general comprehension . Terms such as single blind , double blind , and triple blind mean different things to different people . Moreover , many medical research ers confuse blinding with allocation concealment . Such confusion indicates misunderst and ings of both . The term blinding refers to keeping trial participants , investigators ( usually health-care providers ) , or assessors ( those collecting outcome data ) unaware of the assigned intervention , so that they will not be influenced by that knowledge . Blinding usually reduces differential assessment of outcomes ( information bias ) , but can also improve compliance and retention of trial participants while reducing biased supplemental care or treatment ( sometimes called co-intervention ) . Many investigators and readers naïvely consider a r and omised trial as high quality simply because it is double blind , as if double-blinding is the sine qua non of a r and omised controlled trial . Although double blinding ( blinding investigators , participants , and outcome assessors ) indicates a strong design , trials that are not double blinded should not automatically be deemed inferior . Rather than solely relying on terminology like double blinding , research ers should explicitly state who was blinded , and how . We recommend placing greater credence in results when investigators at least blind outcome assessment s , except with objective outcomes , such as death , which leave little room for bias . If investigators properly report their blinding efforts , readers can judge them . Unfortunately , many articles do not contain proper reporting . If an article cl aims blinding without any accompanying clarification , readers should remain sceptical about its effect on bias reduction The aim of this study was to compare the clinical performance of a self-etching primer ( SEP ) with a conventional two-step etch and primer [ conventional method ( CM ) ] . The chair time required for bonding was also evaluated . Thirty-seven patients ( 14 males and 23 females ) with a mean age of 16 years 5 months were included in the study . Six hundred and seventy-two brackets were bonded by one operator using a split-mouth design , with either SEP ( Transbond Plus ) or CM ( Transbond XT ) . Bracket failure rates were estimated with respect to bonding procedure , dental arch , type of tooth ( incisor , canine , and premolar ) , and gender . The results were evaluated using the chi-square test . The survival rate of the brackets was estimated with Kaplan-Meier analysis . Bracket survival distributions with respect to bonding procedure , dental arch , type of tooth , and patient gender were compared with a log-rank test . Bond failure interface was determined with the adhesive remnant index ( ARI ) . The failure rates were 0.6 per cent for both bonding procedures . The failure and survival rates did not show significant differences between the bonding procedures , upper and lower dental arches , or gender . However , premolar brackets displayed a higher bond failure rate and a lower survival rate than incisor and canine brackets ( P < 0.05 ) . The mean bracket bonding time per tooth with SEP was significantly shorter than with CM ( P < 0.001 ) . No significant difference was observed for the ARI scores ( P > 0.05 ) . The results of this in vivo , r and omized , cross-mouth clinical trial demonstrated a high survival rate with Transbond Plus . This finding indicates that  SEP  can be effectively used for bonding of orthodontic brackets Objective To investigate the use of  fixed appliances in the UK . Design Prospect i ve postal question naire . Setting UK . Participants All members of the General Dental Council Specialist List in Orthodontics still in active practice and not in training posts . Method A preemptive letter of explanation was sent inviting orthodontists to participate in the survey . The question naire was subsequently posted to 935 specialists . Data analysis investigated differences in clinical practice related to varying provider groups , level of operator experience and geographical region . Results The response rate achieved was 66·3 % . A majority of orthodontists routinely used the 0·022 inch pre‐adjusted edgewise system , st and ard size Siamese pattern stainless steel brackets , conventionally ligated and bonded using st and ard etch and light cured composite . Nickel titanium and stainless steel were the most popular archwire material s. Anchorage was supported routinely by palatal and lingual arches in up to 25 % and by headgear in over a third of respondents . Newer innovations showed variable popularity . Self‐etching primer  was used routinely by one‐third of respondents with 11 % use of self‐ligating brackets . B and ing of first molars was preferred by over 60 % of clinicians . Bone screw implants were used by only 0·2 % of respondents . Clinicians with less than 10 years experience used more headgear , light curing , MBT prescription and molar bonding . Operators with over 20 years experience used more chemically cured bonding , Roth prescription , b and ed first molars , 0·018 inch slot size and Tip‐EdgeTM , with less use of headgear . Fixed appliance use differed from that reported in the US with lower use in the UK of st and ard edgewise and Roth systems , aesthetic , miniaturised and 0·018 inch slot brackets and rapid maxillary expansion . Conclusion Most UK orthodontic specialists routinely used the 0·022 inch pre‐adjusted edgewise system with st and ard size Siamese steel brackets bonded using st and ard etch and light cured composite with conventional ligation . Variations were seen between different provider groups , types of treatment funding , levels of operator seniority and geographical regions . Differences were noted particularly in the use of bracket prescription and design , types of molar attachment and anchorage control The purpose of this r and omized clinical trial was to evaluate the clinical performance of brackets cured with 2 different light-curing units ( conventional halogen light and plasma arc light ) ;  83 patients treated with fixed appliances were included in the study . With the " split-mouth " design , each patient 's mouth was divided into 4 quadrants . In 42 r and omly selected patients , the maxillary left and m and ibular right quadrants were cured with the halogen light , and the remaining quadrants were cured with the plasma arc light . In the other 41 patients , the quadrants were inverted . A total of 1434 stainless steel brackets were examined : 717 were cured with a conventional halogen light for 20 seconds ; the remaining 717 were cured with the plasma arc light for 5 seconds . The number , cause , and date of bracket failures were recorded for each light-curing unit over 12 months . Statistical analysis was performed with the Fisher exact test 
    Output:
    
Conclusions : The incidence of brackets detachment during orthodontic treatment is high