***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 
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    Input: Purpose : To investigate the perceived clinical outcome and parents ’ satisfaction after dental rehabilitation under general anesthesia over a follow-up period of 2 years . Material s and Methods : A prospect i ve study of question naire data obtained from 352 pediatric patients before and after treatment of early childhood caries with full dental rehabilitation under general anesthesia .  Question naires focused on oral symptoms , functional limitations , and emotional and social well-being before and after dental treatment . Cases were followed up for 2 years postoperatively . Results : A dramatic disappearance of symptoms was reported from parents ’ perspective . There was a high satisfaction rate ( 99.14 % ) also among parents of the children included in the study . Conclusion : Children with early childhood caries do not necessarily express it verbally as pain . The disease has a lot of other expressions affecting children 's behavior and habits , including the ability to sleep , thrive , and socialize . This study contributes to the existing literature that full dental rehabilitation under general anesthesia [ dental general anesthesia ( DGA ) ] has an immediate positive impact on the physical and social quality of life of children suffering from early childhood caries as well as on their families . Postoperative preventive care , early diagnosis , and treatment of recurrent caries are key factors to maintain postoperative outcome of DGA OBJECTIVE To compare subjective pain experience and oral health-related quality of life ( OH-QoL ) in treated and untreated subjects over the first 3 months of fixed appliance therapy .  SETTING AND SAMPLE POPULATION The Department of Orthodontics , School of Medicine and Dentistry . One hundred and twenty-four subjects aged between 11 and 14 years either commencing or awaiting fixed appliance treatment .  MATERIAL & METHODS A prospect i ve controlled longitudinal study design was applied to subjects , over a 3-month observation period , following the placement of fixed appliances .  Socio-economic status , OH-QoL , pain experience and analgesic consumption were recorded on question naires at baseline ( T0 ) , 6 weeks ( T1 ) and 3 months ( T2 ) . RESULTS Oral symptoms and functional limitation domains of OH-QoL were found to worsen , during the follow-up period , in the test group ( p = 0.001 and p = 0.002 , respectively ) . In the treated group , pain intensity declined significantly on days 3 and 2 at T1 and T2 , respectively ( p < 0.001 ) . Analgesia was required during both periods in a total of 13 participants ( 24.5 % ) undergoing orthodontic treatment . CONCLUSION Based on this prospect i ve controlled study , the initial stages of fixed appliance treatment results in subjective pain experience , with subsequent reduction , and a significant impact on oral symptoms and functional limitation domains of Non-r and omised studies of the effects of interventions are critical to many areas of healthcare evaluation , but their results may be biased . It is therefore important to underst and and appraise their strengths and weaknesses . We developed ROBINS-I ( “ Risk Of Bias In Non-r and omised Studies - of Interventions ” ) , a new tool for evaluating risk of bias in estimates of the comparative effectiveness ( harm or benefit ) of interventions from studies that did not use r and omisation  to allocate units ( individuals or clusters of individuals ) to comparison groups . The tool will be particularly useful to those undertaking systematic review s that include non-r and omised studies Abstract Our goal was to evaluate how dental treatments under general anesthesia ( GA )  affect the quality of life by a prospect i ve pair-matched design . Pediatric patients , who had received dental treatments under GA , were enrolled and were asked to complete the Early Childhood Oral Health Impact Scale ( ECOHIS ) before the treatment and 1 month after the treatment . To shield the observed impacts , a pair-matched control group was performed . Patients in the control group were also required to complete the ECOHIS at these different points in time . In both groups , the items of troubled sleep and oral/dental pain scored highest , whereas avoiding smiling or laughing and avoiding talking scored lowest before the treatment . The total mean score in the 2 groups was 13.1 and 13.7 , respectively , and there was no significant statistical difference ( P > 0.05 ) . However , the total mean score was 1.9 in the experimental group after the treatment and smaller compared with the control group ( 1.9 vs. 4.7 , P < 0.001 ) . The majority of the items in both groups had an apparent effect size and the total mean effect in the experimental group was greater than that in the control group ( 85.5 % vs. 65.7 % , P < 0.001 ) . Therefore , dental treatment under GA could provide better quality of life restoration compared with treatment over multiple visits We present data from two studies which clarify the relationship between the responsiveness and validity of instruments design ed to measure health status in clinical trials . In a controlled trial of  long vs short duration adjuvant chemotherapy for women with Stage II breast cancer , the Breast Cancer Chemotherapy Question naire ( BCQ ) proved valid as a measure of subjective health status and was able to distinguish long vs short arms . Well vali date d measures of physical and emotional function developed by the R and Corporation were unable to distinguish between the two groups . The Eastern Co-operative Oncology Group Criteria ( ECOG ) distinguished the two groups , but failed criteria of clinical sensibility as a measure of subjective health status . In a study of patients with Crohn 's disease and ulcerative colitis , the Inflammatory Bowel Disease Question naire ( IBDQ ) showed small intrasubject variability over time . Gobal ratings of change showed moderate to high correlations with changes in IBDQ score , and patients who reported overall improvement or deterioration showed large changes in IBDQ score . Each of these findings support , in different ways , the reproducibility , validity , and responsiveness of the question naire . While the same data can at times bear on both validity and responsiveness , when assessing evaluative instruments it is useful to make a conceptual distinction between the two OBJECTIVES This study examined the responsiveness of the Early Childhood Oral Health Impact Scale ( ECOHIS ) to dental treatment of early childhood caries ( ECC ) in a primary dental care setting . METHODS Parents of children participating in a r and omized controlled trial completed the ECOHIS at baseline and follow-up , and rated the global oral health transition of their child at follow-up ( ' worsened ' , ' no change ' , ' improved ' ) . Change scores were calculated and longitudinal construct validity assessed by examining the association between change scores and global oral health transition groups . ECOHIS changes from baseline to follow-up within global transition groups were also evaluated . Effect sizes , minimally important difference , and Guyatt 's responsiveness index were calculated to examine the scale 's sensitivity and responsiveness . RESULTS After 11.3 months , complete question naire data were available for 189 participants ; 59 % reported ' improved ' oral health . The follow-up scores were significantly lower in the child psychology , parental distress and family impact section , P < 0.001 , and in the child social interaction , family function and the total ECOHIS scores , P < 0.05 , Wilcoxon signed-rank test . There was a significant difference in changed scores among the global transition groups , P < 0.05 , Kruskal-Wallis test , and the difference was significant between ' worsened ' and ' improved ' groups for the family impact and the total ECOHIS scores , Dunn test , P < 0.05 . Effect sizes were small , 0.17 , 0.33 , 0.30 for the child impact , family impact and total ECOHIS scores , respectively , for those reporting ' improved ' oral health . CONCLUSIONS The responsiveness of the ECOHIS to the treatment of ECC in primary dental care setting s was modest , and its use to measure treatment effects in primary care setting s requires further investigations AIM To assess changes over time and determine the minimally important difference ( MID ) in the Oral Impact on Daily Performances ( OIDP ) index for patients with severe generalized periodontitis receiving periodontal treatment .  METHODS This study was nested in a larger r and omized controlled trial and consisted of 45 consecutive subjects of the larger trial ( 17 receiving intensive and 28 receiving conservative periodontal care ) . The OIDP index assessed impacts on quality of life ( QoL ) at baseline and 1 month after treatment . Repeated- measures ANOVA was used for comparison over time and between treatment groups . To estimate the MID , two subjective global transition scales , related to periodontal and oral health , respectively , were used as anchors , whereas the effect size ( ES ) , st and ardized response mean and st and ard error of measurement were also calculated . RESULTS The mean OIDP score after treatment was significantly lower than at baseline , indicating improvement in QoL , but there were no differences between treatment groups . Based on an agreement between different methods , the MID of the OIDP index was around five scale points and corresponded to a moderate ES . CONCLUSION The MID for the OIDP index among patients treated for severe generalized periodontitis provides meaning to change scores and facilitates interpretation of findings This study aim ed to evaluate the impact of dental caries treatment on oral health-related quality of life ( OHRQoL ) among schoolchildren and the responsiveness of the Child Perceptions Question naire ( CPQ8 - 10 ) instrument . Brazilian schoolchildren , 8 - 10 yr of age , were r and omly selected and assigned to two groups  -- dental caries treatment ( DCT ) and caries-free (CF)--according to their caries experience [ decayed , missing , or filled primary teeth ( dmft ) and decayed , missing or filled secondary teeth ( DMFT ) values of ≥ 0 ] . The CPQ8 - 10 instrument was administered at baseline and at 4 wk of follow-up ( i.e. 4 wk after completion of dental treatment ) . In the DCT group , increases in CPQ8 - 10 scores were observed between the baseline and follow-up results . However , longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ8 - 10 scores . Responsiveness of the CPQ8 - 10 instrument ( magnitude of change in CPQ8 - 10 scores ) in the DCT group was greater ( effect size > 0.7 ) than in the CF group . The findings of this study show that dental caries treatment has an important impact on OHRQoL of children . The CPQ8 - 10 was considered an acceptable instrument for longitudinal measurement of changes in Abstract Objective : Our aim was to analyze longitudinally the impact of young children ’s dental general anaesthesia ( DGA ) treatment on their OHRQoL and to determine their post-operative oral health status at the six-month follow-up together with parental ratings of their children ’s oral health . Material and methods : We conducted a prospect i ve follow-up study of OHRQoL among Lithuanian child patients treated under general anaesthesia ( n = 144 ) . The study consisted of clinical dental examinations performed by two examiners at the time of DGA and at the six-month recall , along with OHRQoL surveys and data collected from the patients ’ files . The dmft index and Silness – Löe plaque index served as clinical measures . The survey tool for assessing the children ’s OHRQoL was the previously tested Lithuanian version of the ECOHIS . The Wilcoxon signed-rank test served for the statistical analysis ( p < 0.05 ) . Results : The ECOHIS scores clearly decreased post-operatively , indicating a significant ( p < 0.001 ) improvement in the children ’s OHRQoL after the DGA treatment . The ECOHIS scores were lower immediately after the DGA treatment and remained low at the six-month recall . Parents rated their child ’s oral health as higher after the DGA treatment ( p < 0.001 ) . The majority ( 75 % ) of the patients had poor or satisfactory oral hygiene at follow-up . Conclusions : This longitudinal study showed a sustained improvement in the children ’s OHRQoL six months after their DGA treatment . Post-operative parental ratings of their child ’s oral health were higher after the DGA treatment , but the children exhibited insufficient oral hygiene and new caries lesions . An appropriate follow-up system for children receiving DGA treatment with special focus on preventive care is needed BACKGROUND The aim of this study was to compare changes in  child oral health-related quality of life ( COHRQoL ) after treatment for early childhood caries ( ECC ) using two alternative treatment approaches . METHODS A r and omized control trial with r and om allocation of parent/child dyads with ECC to test ( minimum intervention ) or control ( st and ard care ) .  Participating parents completed the Early Childhood Oral Health Impact Scale ( ECOHIS ) at baseline and follow-up . Changes in ECOHIS scores and extent of COHRQoL impacts between and within groups were tested using the chi-squared statistic for groups , Wilcoxon 's rank-sum test , and matched-pairs signed-rank test . RESULTS Two hundred and fifty-four children were r and omized ( test = 127 ; control = 127 ) . At baseline ,  mean ECOHIS  score 11.1 , sd 8.2 ; mean age = 3.8 years , sd 0.90 ; mean dmft = 4.9 , sd 4.0 ; and 59 % male . After a mean interval of 11.4 months , 210 children were followed-up and returned a completed question naire ( test = 111 ; control = 99 ) . There was no significant difference in COHRQoL changes between test and control . For all the children combined , there were significantly fewer impacts at follow-up in the child and family domains and the total ECOHIS , Wilcoxon signed-rank test , p < 0.05 . CONCLUSIONS COHRQoL improved with primary dental care for ECC , and there was no statistically significant difference between test and control in the extent of the improvement BACKGROUND Oral health-related quality of life ( OHRQoL ) 
    Output:
    
In conclusion , there is evidence that the OHRQoL of children and adolescents improved following caries intervention procedures , but the quality of the evidence was very low .
In spite of that , caries interventions are highly recommended as abstaining from treatment is likely to result in a deterioration of