***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 Several studies have recently demonstrated that a post-treatment communication to explain the importance of an oral hygiene can improve the orthodontic patients ’ compliance over a period of 66 days . The main goal of this study is to evaluate the effects of a structured follow-up communication after orthodontic appliance application on oral hygiene compliance after 30–40 days . Methods Eighty-four orthodontic participants enrolled from patients who were beginning fixed orthodontic treatment at the Orthodontic Department , Gaslini Hospital , Genova , between July and October 2014 were r and omly assigned to one of three trial arms . Before the bonding , all patients underwent a session of oral hygiene aim ed at obtaining an plaque index of “ zero . ” At the following orthodontic appointment , the plaque index was calculated for each patient in order to assess oral hygiene compliance . The first group served as control and did not receive any post-procedure communication , the second group received a structured text message giving reassurance , and the third group received a structured telephone call . Participants were blinded to group assignment and were not made aware that the text message or the telephone call was part of the study . ( The research protocol was approved by the Italian Comitato Etico Regionale della Liguria-sezione 3^ c/o IRCCS-Istituto G. Gaslini 845/2014 , and it is not registered in the trial ’s register . ) Results Thirty patients were r and omly assigned to the control group , 28 participants to the text message group , and 26 to the telephone group . Participants who received a post-treatment communication  reported higher level of oral hygiene compliance than participants in the control group . The plaque index was 0.3 ( interquartile range ( Iqr ) , 0.60 ) and 0.75 ( Iqr , 1.30 ) , respectively , with a significant difference ( P = 0.0205 ) . Conclusions A follow-up procedure after orthodontic treatment may be an effective tool to increase oral hygiene compliance also over a short period OBJECTIVE To evaluate the influence of an app-based approach in a protocol for domestic oral hygiene maintenance in a group of adolescent patients wearing fixed multibracket appliances . MATERIAL S AND METHODS Eighty adolescent patients scheduled to start an orthodontic multibracket treatment were r and omly divided into two groups of 40 .  Plaque index ( PI ) , gingival index ( GI ) , white spots ( WS ) , and caries presence were recorded in all patients , and they were instructed regarding domestic oral hygiene maintenance on the day of braces application ( t0 ) and every 3 months ( t1 , t2 , t3 , t4 ) during the first year of treatment . Study group ( SG ) patients were enrolled in a WhatsApp chat room-based competition and instructed to share monthly with the other participants two self-photographs ( selfies ) showing their oral hygiene status . RESULTS SG patient participation in the chat room was regular and active throughout the observation period . At t2 , t3 , and t4 , SG patients had significantly lower values of both PI and GI and a lower incidence of new WS and caries , compared with the control group . CONCLUSION Integration of new " social " technologies in a st and ard oral hygiene motivation protocol is effective in improving compliance of adolescent patients and in improving their oral health status during orthodontic multibracket treatment OBJECTIVE To determine if text message reminders regarding oral hygiene compliance have an influence on the level of compliance within an orthodontic population . MATERIAL S AND METHODS In this prospect i ve , r and omized , controlled clinical trial , 42 orthodontic patients were assigned to a text message or control group . Parents of patients assigned to the text message group received a reminder text message one weekday each week .  Oral hygiene compliance was measured using bleeding index ( BI ) , modified gingival index ( MGI ) , and plaque index ( PI ) , and visual examination of white spot lesion ( WSL ) development at baseline ( T0 ) , two appointments after baseline ( T1 ) , and four appointments after baseline ( T2 ) . RESULTS BI , MGI , and PI scores were significantly lower in the text message group than in the control group at T2 . CONCLUSION A text message reminder system is effective for improving oral hygiene compliance in orthodontic patients OBJECTIVE To investigate the effects on plaque index ( PI ) scores of manual or electric toothbrush with or without repeated oral hygiene instructions ( OHI ) and motivation on patients wearing fixed orthodontic appliances . MATERIAL S AND METHODS One month after the orthodontic fixed appliance bonding on both arches , 60 patients were r and omly assigned to four groups ; groups E1 ( n = 15 ) and E2 ( n = 15 ) received a powered rotating-oscillating toothbrush , and groups M1 ( n = 15 ) and M2 ( n = 15 ) received a manual toothbrush . Groups E1 and M1 received OHI and motivation at baseline ( T0 ) and after 4 , 8 , 12 , 16 , and 20 weeks ( T4 , T8 , T12 , T16 , and T20 , respectively ) by a Registered Dental Hygienist ; groups E2 and M2 received OHI and motivation only at baseline . At each time point a blinded examiner scored plaque of all teeth using the modified Quigley-Hein PI . RESULTS In all groups the PI score decreased significantly over time , and there were differences among groups at T8 , T12 , T16 , and T20 . At T8 , PI scores of group E1 were lower than those of group E2 , and at T12 , T16 , and T20 , PI scores of groups M1 and E1 were lower compared to those of groups M2 and E2 . A linear mixed model showed that the effect of repeated OHI and motivation during time was statistically significant , independently from the use of manual or electric toothbrush . CONCLUSIONS The present results showed that repeated OHI and motivation are crucial in reducing PI score in orthodontic patients , independent of the type of toothbrush used OBJECTIVE To investigate whether text message reminders regarding oral hygiene have an effect on plaque removal in orthodontic patients . MATERIAL S AND METHODS In this r and omized , controlled clinical trial , 50 orthodontic patients were assigned to either a text message or control group . Patients in the text message group received 12 text messages over the course of 4 weeks and one text message for 8 weeks thereafter . Photos were taken at baseline ( T0 ) , at 4 weeks after baseline ( T1 ) , and at 12 weeks after baseline ( T2 ) . For each subject , photos of eight teeth were taken and then the area of the tooth and amount of plaque were measured using planimetry . RESULTS There was a statistically significant difference in plaque coverage between baseline and both T1 and T2 in the text message group as measured using planimetry . This was demonstrated by comparing the average measurements of the control group and the treatment group . CONCLUSION This study demonstrated that the use of automated text message reminders sent from an orthodontic office was effective in improving oral hygiene compliance in orthodontic patients Objectives This study aims to determine the effectiveness of a messaging app ( WeChat ) in improving patients ’ compliance and reducing the duration of orthodontic treatment ( DOT ) . Material s and methods A r and omized controlled trial was performed in a dental hospital and a clinic from August 2012 to May 2015 . Orthodontic patients were included at the beginning of treatment . Patients with multiphase treatment or braceless technique were excluded . Participants were r and omized to WeChat group ( received regular reminders and educational messages ) or control group ( received conventional management ) and were followed up until the treatment was completed . Primary outcome measure was DOT . Others were late and failed attendance , bracket bond failure , and oral hygiene condition . Results One hundred twelve patients in each group participated and completed the trial . DOT in WeChat group were 7.3 weeks shorter ( P = 0.007 ) . There were less failed attendance ( 3.1 vs. 10.9 % , P < 0.001 ) , late attendance ( 20.1 vs. 29.9 % , P < 0.001 ) , and bracket bond failure ( 11.8 vs. 16.1 % , P < 0.001 ) in WeChat group than control . There was no difference in orthodontic plaque index nor modified gingivitis index between the two groups before and after treatment . Number of failed attendances was identified as an independent factor affecting DOT ( P = 0.004 ; HR = 0.89 , 95 % CI 0.84 to 0.95 ) . Conclusions The intervention with WeChat is effective in reducing the treatment duration and bracket bond failure , and improving the attendance in orthodontic patients . Clinical relevance DOT can be reduced by improving patient ’s compliance . The messaging app is useful for outpatient education and management The gingival and periodontal health of 62 adolescent orthodontic patients was assessed before and again after orthodontic treatment in a controlled clinical study . Before the commencement of orthodontic treatment , the experimental group received an oral hygiene program consisting of 4 weekly sessions of oral health education , instruction on plaque-control techniques and review s in plaque removal performance . The control group did not receive this program . It was found that there was a general trend in the study population for improved gingival health as measured by the bleeding index , gingival index , plaque index and gingival crevicular fluid volume . Furthermore , the oral hygiene program induced in the experimental group significantly lower scores in the measured clinical indices compared to the control group . However , no significant difference was noted in the measured probing depths in all subjects before or after the study period OBJECTIVES To test the null hypotheses that supplementation of verbal information with written information when obtaining consent to orthodontic treatment has no effect on ( 1 ) anxiety , motivation and apprehension related to treatment and ( 2 ) compliance in the early stages of fixed appliance therapy . MATERIAL S AND METHODS Seventy-six adolescents who were due to start fixed appliance therapy were r and omly allocated to receive verbal information only or verbal and written information before orthodontic treatment . Participants ' anxiety , motivation , and apprehension were assessed using a question naire that was completed prior to meeting the orthodontic clinician ( T1 ) , following consent to treatment ( T2 ) , and after 12 weeks of treatment ( T3 ) . Appointment attendance , appliance breakages , and periodontal scores were used as measures of patient compliance . RESULTS Sixty participants completed the study . At T2 there was no change in anxiety scores for either group ( P = .412 ) ; however , increased motivation was detected in the group that had been given both written and verbal information ( P = .049 ) . At T3 both groups demonstrated similar reductions in anxiety ( P = .311 ) and apprehension ( P = .790 ) and similar levels of motivation ( P = .756 ) . A reduction in periodontal scores ( P = .065 ) , better appointment attendance ( P = .732 ) , and fewer breakages ( P = .525 ) were reported in the group that was given additional information , although these changes were not statistically significant . CONCLUSIONS Supplementation of verbal information with written information result ed in improved motivation for orthodontic treatment but had no statistically significant effect on anxiety , apprehension , or patient compliance INTRODUCTION Enamel demineralization and gingival inflammation are the most prevalent consequences of biofilm formation in orthodontics . Our hypothesis was that educating patients about the severe consequences of biofilm accumulation could enhance their oral hygiene while wearing fixed appliances . METHODS This study was design ed as a r and omized controlled 4-arm parallel trial . A total of 148 participants in Chengdu , China , matching the eligibility criteria of 11 to 25 years of age , at least 20 natural teeth , and a treatment plan that included conventional stainless steel brackets , were r and omly assigned to 4 intervention groups based on computer-generated r and om sequencing using simple r and omization without blocking . In group A ( n = 37 ) , the subjects were shown images illustrating the severe consequences of biofilm formation , including enamel demineralization and gingival inflammation ; subjects in group B ( n = 40 ) were given biofilm disclosing tablets ; those in group C ( n = 38 ) received a combination of A and B ; the subjects in group D ( n = 33 ) served as the controls . The investigators were blinded to the allocations , and the research er managing the r and om sequence did not participate in allocation or measurement . All groups received routine oral hygiene instructions . Plaque index and gingival index scores were recorded at each appointment during a 6-month follow-up . RESULTS Eighteen participants were lost during follow-up , result ing in a total of 130 participants after the trial ( group A , 35 ; group B , 32 ; group C , 34 ; group D , 29 ) . No adverse events were recorded . Groups A and C exhibited a significantly lower plaque index scores ( parameter-estimate [ 95 % confidence interval ] = -1.20 [ -1.76 to -0.63 ] for group A , and -1.12 [ -1.69 to -0.56 ] for group C ) and gingival index scores ( -0.13 [ -0.21 to -0.04 ] , and -0.19 [ -0.28 to -0.10 ] ) , respectively , compared with group D ( P < 0.001 for all ) , whereas no significant difference was found between groups B and D , or between groups A and C ( P > 0.05 ) . The adults had significantly lower plaque index ( 0.48 [ 0.13 -  
    Output:
    
Motivational methods had statistically significant advantage regarding PI in the experimental group over control group at 1 , 3 , 6-month , while GI was significantly better controlled in the study group at 3 , 6-month .