***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: BACKGROUND This pilot study compared data obtained using traditional methods of visual dental screenings in a school setting with data obtained using an intraoral camera and transmitted to a distant location via telehealth technology . METHODS For the study , 137 schoolchildren were screened using traditional methods . Two months later , 32 children were r and omly selected and rescreened in a single day using the intraoral camera and the telehealth system . The measurement indices used were deft/DMFT . RESULTS A comparison revealed no significant difference in the data collected by the two screening methods . The percentage agreement between the methods ranged from 89 % to 100 % . CONCLUSION In under-serviced or remote areas , the telehealth system may allow for accurate identification of oral conditions and act as a means of consultation at a distance between specialists , general dental practitioners , dental hygienists and individual patients A prototype teledentistry service was established that incorporated a PC-based expert system design ed to assist in orthodontic cases . It guided the general dental practitioner ( GDP ) through the assessment of a patient 's malocclusion and helped ensure that all relevant clinical observations were made and details recorded . The result ing data file , containing radiographic images and clinical data , was then transferred via the Internet to a dental specialist . The specialist 's recommendations were returned by the same route or , where appropriate , a realtime videoconference was conducted . During an eight-month trial , six GDPs referred 158 cases through the teledentistry system ; another 24 cases were referred directly to a local consultant . The protocol used during the trial worked satisfactorily . The GDPs found that it was straightforward and covered all aspects of the cases they su bmi tted Distance learning and internet-based delivery of educational content are becoming very popular as an alternative to real face-to-face delivery . Clinical -based discussion s still remain greatly face-to-face despite the advancement of remote communication and internet sharing technology . In this study we have compared three communication modalities between a learner and educator : audio and video using voice over internet protocol ( VoIP ) alone [ AV ] ; audio and video VoIP with the addition of a three dimensional virtual artefact [ AV3D ] and physical face-to-face [ FTF ] . Clinical case discussion s based on fictitious patients were held between a ' learner ' and an ' expert ' using the three communication modalities . The learner presented a clinical scenario to the experts , with the aid of a prop ( partially dentate cast , digitised for AV3D ) , to obtain advice on the management of the clinical case . Each communication modality was tested in timed exercises in a r and om order among one of three experts ( senior clinical restorative staff ) and a learner ( from a cohort of 15 senior clinical undergraduate students ) all from the School of Clinical Dentistry , University of Sheffield . All learners and experts used each communication modality in turn with no prior training . Video recording and structured analysis were used to ascertain learner behaviour and levels of interactivity . Evaluation question naires were completed by experts and learners immediately after the experiment to ascertain effectiveness of information exchange and barriers/facilitators to communication . The video recordings showed that students were more relaxed with AV and AV3D than FTF ( p = 0.01 ) . The evaluation question naires showed that students felt they could provide ( p = 0.03 ) and obtain ( p = 0.003 ) more information using the FTF modality , followed by AV and then AV3D . Experts also ranked FTF better than AV and AV3D for providing ( p = 0.012 ) and obtaining ( p = 0 ) information to/from the expert . Physical face-to-face learning is a more effective communication modality for clinical case-based discussion s between a learner and an expert . Remote , internet-based discussion s enable a more relaxed discussion environment . The effectiveness of 3D supported internet-based communication is dependent upon a robust and simple to use interface , along with some prior training The use of information technology ( IT ) in dentistry is far ranging . In order to produce a working document for the dental educator , this paper focuses on those methods where IT can assist in the education and competence development of dental students and dentists ( e.g. e-learning , distance learning , simulations and computer-based assessment ) . Web pages and other information-gathering devices have become an essential part of our daily life , as they provide extensive information on all aspects of our society . This is mirrored in dental education where there are many different tools available , as listed in this report . IT offers added value to traditional teaching methods and examples are provided . In spite of the continuing debate on the learning effectiveness of e-learning applications , students request such approaches as an adjunct to the traditional delivery of learning material s. Faculty require support to enable them to effectively use the technology to the benefit of their students . This support should be provided by the institution and it is suggested that , where possible , institutions should appoint an e-learning champion with good interpersonal skills to support and encourage faculty change . From a global prospect i ve , all students and faculty should have access to e-learning tools . This report encourages open access to e-learning material , platforms and programs . The quality of such learning material s must have well defined learning objectives and involve peer review to ensure content validity , accuracy , currency , the use of evidence -based data and the use of best practice s. To ensure that the developers ' intellectual rights are protected , the original content needs to be secure from unauthorized changes . Strategies and recommendations on how to improve the quality of e-learning are outlined . In the area of assessment , traditional examination schemes can be enriched by IT , whilst the Internet can provide many innovative approaches . Future trends in IT will evolve around improved uptake and access facilitated by the technology ( hardware and software ) . The use of Web 2.0 shows considerable promise and this may have implication s on a global level . For example , the one-laptop-per-child project is the best example of what Web 2.0 can do : minimal use of hardware to maximize use of the Internet structure . In essence , simple technology can overcome many of the barriers to learning . IT will always remain exciting , as it is always changing and the users , whether dental students , educators or patients are like chameleons adapting to the ever-changing l and scape Background : It has recently been accepted that periodontal disease is a risk factor for not only tooth loss but also systemic diseases . An effective system of public intervention for periodontal health to enable continuous intervention of dental professionals has been sought . We developed a Web-based intervention system regarding periodontal health and evaluated the effects of the system in the workplace . Methods : The system was capable of storage and display of personalized oral health records including video images pertaining to toothbrush manipulation within their own oral cavities based on instructions by dental professionals . The system enabled clients to view movement of their own skill , and repeatedly . Thirteen workers of a company were r and omized to either an experimental or control group . The control group received face-to-face toothbrushing instruction at the company and follow-up via telephone . The experimental group received follow-up through our system in addition to those components employed in the control group . Main results : The workers in the experimental group benefited in terms of improvements of not only plaque removal but also periodontal health over 3 months . Conclusions : These results indicate that implementation of an Web-based approach for periodontal health affords the possibility of remote instruction and produces additional public benefit Objective The primary aim was to evaluate the validity of a teledentistry system for screening new patient orthodontic referrals . The secondary aims were to evaluate whether the teledentistry system affected i ) referral rates ii ) inappropriate referral rates iii ) number of failed appointments . Study design R and omised controlled trial . Sample Fifteen dental practice s in Greater Manchester , UK , were r and omly allocated to either a teledentistry test group ( n = 8) or a control group ( n = 7 ) . They referred 327 patients over a 15 month period . Method Practitioners in the test group referred patients to one of two consultant orthodontists  via a ' store and forward ' teledentistry system consisting of photographs sent as email attachments . The decision to accept or not accept a referral on this basis was compared with the same decision choice when the same patient was subsequently seen on a new patient clinic . This measured the validity of the system with the clinic 's decision used as the gold st and ard . Patients in the control group were referred using the usual letter system . Referral rates , inappropriate referrals and number of failed appointments were then compared between the teledentistry and control groups . Results The sensitivity ( true positive value ) of the teledentistry system was high at 0.80 with a positive predictive value of 0.92 . The specificity ( true negative value ) was slightly lower at 0.73 with a negative predictive value of 0.50 . The inappropriate referral rate for the teledentistry group was 8.2 % and for the controls 26.2 % ( p = 0.037 ) . There was no statistically significant difference in clinic attendance between teledentistry and control groups ( p = 0.36 ) . Conclusions Teledentistry is a valid system for positively identifying appropriate new patient orthodontic referrals . However , there is a risk that a patient is not accepted on the teledentistry system who would benefit from a full clinical examination . Teledentistry could be a significant factor in reducing the inappropriate referral rate . Patient participation in a teledentistry system does not appear to mean they are any more likely to attend their hospital appointment INTRODUCTION The teaching of manual skills and competencies is among the most time-consuming aspects of oral health-care education , especially when large groups of students are involved . Video has been repeatedly used as an educational tool with varying results . PURPOSE The present study aim ed to investigate the effectiveness of a computer-based video support system  during practical training of manual skills and competencies related to periodontal treatment . MATERIAL S AND METHODS Eighty-four students were r and omized into 9 groups : 5 experimental and 4 control groups . The control groups received instruction in the use of scaling and root planing instruments during a 7-hour seminar , and 2 hours of manual practice . The experimental groups received the same instruction , but in addition had access to a computer-based video support system , the Visual Training System ( VTS ) , during practical training . During the 2-hour long practice session , all students practice d 21 different procedures , which were video recorded . The videos were later evaluated by an independent observer . RESULTS On the whole , the students in the experimental group performed significantly better than their colleagues in the control group . Specifically , the groups that utilized the VTS video support performed significantly better in 9 of the 21 procedures tested . CONCLUSION These results suggest that this computer-based video support can be an effective aid in the teaching of manual skills related to oral health care AIM : To assess dental caries prevalence and dental care utilisation in pre-school children enrolled in urban childcare centres that participated in a comparative-effectiveness study . STUDY DESIGN : Cross-sectional study . METHODS : Caries prevalence was determined in a cohort of children 12–60 months of age . Eligible children were r and omised into two groups : group one received a traditional visual/tactile oral examination and group two received a teledentistry examination . Question naires were administered to the children ’s parents/guardians to gather demographics and information about using dental and medical services . RESULTS : Of 234 children examined , approximately 28 % had caries experience . The mean dfs score was 1.56 with a range of 0–34 carious surfaces . The mean dfs score for the children examined by means of teledentistry was 1.75 and for the children examined by means of the traditional visual/tactile method mean dfs was 1.40 ; the means between the two groups were not significantly different . Twenty-six children showed evidence of being treated for dental caries . According to the parents , 31.5 % of the children had never had a dental check-up before , only 3 % of the children were lacking dental insurance and majority of the parents ( 92 % ) did not perceive accessing dental care for the children as a problem . STATISTICS : The Wilcoxon Mann-Whitney test and the Kruskal-Wallis test were used to assess statistical differences among groups of children . CONCLUSIONS : The data showed that 28 % of the children had caries and , of these , 61 % had never been treated for caries , thus indicating that continued efforts are needed to improve oral health care utilisation by inner-city preschool children PURPOSE The incorporation of new technologies into clinical daily practice is nowadays a fact in the field of medicine . Within these new technologies , telemedicine is turning out to be a working tool that is used with increasing frequency in medical centers . The systems of telemedicine have still not reached the same development in oral and maxillofacial surgery that they have reached in other medical specialties . This study describes the preliminary results of a store- and -forward telemedicine system ( SFTMS ) aim ed at the presurgical management of impacted third molar pathology . MATERIAL S AND METHODS A multicenter , longitudinal , descriptive , evaluative pilot study of an SFTMS aim ed at the presurgical management of patients with impacted third molar pathology was conducted at the Oral and Maxillofacial Surgery Unit of Virgen Macarena University Hospital ( Seville , Spain ) and 4 primary care areas located between 15 and 95 km from the hospital . The study was carried out between January and December 2009 . RESULTS Over a period of 12 months , 97 patients were enrolled in the study , from 102 teleconsultations received and evaluated within the same period . Patients managed through telemedicine were included on the surgical wait list on within a mean interval of 3.33 days ( 95 % confidence interval [ CI ] , 2 - 4.65 days ) since the visit to the primary care dentist , with only 1 visit to the hospital that was on the day of surgery . The mean waiting interval of patients managed through the conventional referral system was 28 days ( 95 % CI , 24.51 - 29.6 days ) , with at least 2 visits to the hospital before the final intervention . The on-the-day surgery cancellation rate of the series was 7.8 % ( 95 % CI , 3.8%-10.5 % ) because 8 patients 
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The review indicates that although teledentistry is an area of expansion , there are still some barriers to its increased use