***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: In each of 14 patients , one bilateral occlusal carious lesion was sealed and the other lesion was left open as a control . The control lesions showed patterns of sudden increases in cavity depth , as well as evidence of being active bacteriologically ; whereas , with one exception , the sealed lesions were inactive bacteriologically . The residual carious material in the sealed lesions suggested a complete cessation of the carious process . No clinical or radiologic signs were seen to suggest that the health of the sealed tooth had been compromised Results of a 3-year clinical trial of Delton fissure sealant resin are reported . 41 % of first molar fissures remained fully sealed after 3 years . Significant differences were found between the levels of resin retention produced by the two operators and retention was significantly better on m and ibular molars than on maxillary molars . In a separate group of 11-year-old children 77 % of fissures were full)’sealed after 3 years The purpose of this study was to evaluate the retention of fissure sealants  , applied with 4 different combinations of isolation and preparation of occlusal surface . In 95 children aged 7 - 8 years , having all four first permanent molars fully erupted and caries free , a chemically initiated tinted fissure sealant was placed with the following 4 different methods in every child . 1 ) Tooth 16 : Cotton rolls isolation and cleaning of occlusal surface using a bristle brush and non-fluori date d paste . 2 ) Tooth 26 : Rubber dam isolation and mechanical preparation of pits and fissures using a round bur No. 0 in a slow h and -piece . 3 ) Tooth 36 : Rubber dam isolation and cleaning of occlusal surface using a bristle brush and non-fluori date d paste . 4 ) Tooth 46 : Isolation with cotton rolls and mechanical preparation of pits and fissures using a round bur No. 0 in a slow h and -piece .  Eighty children were available for re-examination 4 years later ( 320 teeth ) . The 4 methods of application showed the following success rates of full retention : 1 ) 81 % 2 ) 88 % 3 ) 91 % 4 ) 93 % . Although statistical analysis of the results revealed only marginal statistically significant difference among the four different methods of application ( p = 0.091 ) , there was statistical significant difference ( p = 0.031 ) between methods 1 and 4 . No differences were detected among the remaining methods . The present trial revealed best sealant retention using a combination of cotton rolls isolation and mechanical preparation of the occlusal surface . ( ABSTRACT TRUNCATED AT 250 WORDS BACKGROUND While national surveys have found that African-Americans have a higher prevalence and severity of dental caries than white-Americans , there are only a few descriptive studies of the prevalence and severity of dental caries in low-income urban African-Americans . OBJECTIVES This study assessed the prevalence , severity and determinants of dental caries , using the International Caries Detection and Assessment System ( ICDAS ) . METHODS A representative sample of low-income families ( a caregiver and a child aged 0 - 5 years ) was selected from low-income census tracts in the city of Detroit , Michigan . Of the 12,655 r and omly selected housing units , 10,695 were occupied and 9781 were successfully contacted ( 91.5 % ) . There were 1386 families with eligible children in the contacted households ; and of those , 1021 were interviewed and examined at a permanent examination center organized for this study . This represents an overall response rate of 73.7 % . At the center , trained staff interviewed the main caregivers of the selected children , and trained and calibrated dentists examined the caregiver and her/his child . Data used in this study included information gathered from the social , behavioral and parenting question naires , the Block Food Frequency Question naire ( total sugar intake ) , and data collected from community and census data bases . RESULTS Over 90 % of the adults ( ages 14 - 70 years , average 29.3 ) had at least one noncavitated carious lesion and 82.2 % had at least one primary cavitated lesion . Negative binomial regression models found that the age of caregivers and the number of churches in neighborhoods were negatively associated with the number of noncavitated tooth surfaces . Cavitated tooth surfaces were positively associated with age , oral hygiene status , being worried about teeth , a recent visit to a dentist , and the number of grocery stores in the neighborhoods . However , the number of cavitated tooth surfaces was negatively associated with preventive dental visits , positive rating of oral health status and the number of dentists in a community . CONCLUSIONS Dental caries , especially at the noncavitated stage , is highly prevalent in low-income African-American adults in Detroit . A significant increase in the mean number of missing teeth was observed after the age of 34 years . This study found that different individual , social , and community risk indicators were associated with noncavitated versus cavitated tooth surfaces OBJECTIVES This study compared the effectiveness of two different tooth-cleaning techniques on clinical sealant retention . METHODS Seventy-four children in second and third grade s at an elementary school in the rural town of Waverly , Tennessee , had sealants applied to four , noncarious , fully erupted , first permanent molar teeth . The teeth had been cleaned using a brush attached to a rotary instrument with fluori date d prophy paste , versus a toothbrush without paste ( dry brushing ) . A split-mouth design was used , whereby one side ( upper and lower ) of the mouth was subject to one tooth-cleaning technique while the opposite side received the other technique . RESULTS Twelve months after a single application of pit and fissure sealant , 63 children were available for recall . Exactly 252 teeth were examined and overall retention was high , with approximately 98 percent of sealants retained . Although the greatest loss of sealant occurred with the rotary instrument technique , the difference in proportions of missing sealant between techniques was not statistically significant . CONCLUSIONS In this study , the tooth-cleaning technique of dry brushing with a toothbrush as a preparatory step in the sealant procedure yielded high clinical sealant retention at 12 months . This retention was comparable to that observed with rotary instrumentation . This finding suggests that dry brushing by the operator may be an acceptable alternative to using a rotary instrument with brush and paste 
    Output:
    
RESULTS The evidence supports recommendations to seal sound surfaces and noncavitated lesions , to use visual assessment to detect surface cavitation , to use a toothbrush or h and piece prophylaxis to clean tooth surfaces , and to provide sealants to children even if follow-up can not be ensured .
CLINICAL IMPLICATION S These recommendations are consistent with the current state of the science and provide appropriate guidance for sealant use in SBSPs .