***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: The purpose of this study was to compare the effectiveness of a 1100 ppm fluoride toothpaste used alone , or together with a 0.05 % NaF rinse used once daily or a 0.4 % SnF2 gel applied twice daily , in controlling the decalcification that often accompanies orthodontic treatment . Ninety-five consecutively treated adolescent patients were matched for age and sex and assigned to one of these three regimens . Single blind assessment s of decalcification were performed on all labial surfaces of all erupted teeth before appliances were placed and 3 months after appliances were removed . Because the first molars had the highest decalcification scores , data for the whole mouth and for first molars were analyzed separately . When pre-treatment levels of decalcification were subtracted from post-treatment values , significantly lower decalcification scores ( p < 0.05 ) were found for both whole mouth and first molars in the rinse and gel groups as compared with the control group ( toothpaste alone ) . Although the gel group consistently had less decalcification than the rinse group , this difference only approached statistical significance . These results indicate that twice daily use of a 1100 ppm fluoride toothpaste and either a once-daily 0.05 % NaF rinse or a twice-daily 0.4 % SnF2 gel provides additional protection against decalcification beyond that achieved with toothpaste alone OBJECTIVES The aims of this study were to compare the local and systemic uptake of fluoride released from a compomer material ( Dyract Ortho ) and a resin-modified glass ionomer cement ( Vitremer ) with that of a conventional resin adhesive ( Right-On ) and to compare the cariostatic ability of each of the test material s with that of the resin control . METHODS Twenty six patients were r and omly allocated to have a bracket bonded to a premolar on one side of the arch with one of the test material s and on the opposite side with the control material . Premolars destined for extraction as part of an orthodontic treatment plan were selected for bonding . A non-fluoride toothpaste was used by all participants for 4 weeks prior to bracket bonding and throughout the 4 week trial period . Fluoride release was measured in saliva , plaque and urine sample s taken pre-bonding and 4 weeks post-bonding . Enamel demineralisation was assessed by scoring the buccal surface of each extracted tooth using a caries index . RESULTS Neither Vitremer nor  Dyract Ortho altered salivary or urinary fluoride concentration significantly 4 weeks post-bonding but plaque fluoride concentration increased significantly around premolars bonded with Vitremer . The test material s as a combined group were associated with significantly less demineralisation than the control material but there was no significant difference in cariostatic ability detected between either Dyract Ortho or Vitremer when each group was compared separately with the control . CONCLUSIONS Fluoride released from Dyract Ortho or Vitremer is likely to exert a local and not a systemic effect . In a 4-week clinical study , the cariostatic ability of the fluoride-releasing cements , as a combined group , was superior to that of the non-fluoride releasing control but there was no significant difference in cariostatic ability between the two test material s when each test group was compared separately with the control The study aim ed to compare the survival time and cariostatic potential of a compomer to that of a resin adhesive when used to bond stainless steel orthodontic brackets to labial segment teeth only . The effect of the patients ' sex , age at the start of treatment and presenting malocclusion on bracket survival time was assessed also . Forty-five consecutive patients who attended for fixed appliance therapy were r and omly selected . Four hundred twenty-six brackets were bonded ( 213 with compomer and 213 with resin adhesive ) with a split mouth design ; the right or left side allocation of compomer in either arch was alternated . Color transparencies of the maxillary incisors , m and ibular incisors , or both , and transparencies of the canines , were taken before treatment . At the debond stage , the transparencies were projected ( 20x ) and assessed by an experienced examiner , who used a caries index . The survival time distributions for brackets bonded with each bonding agent were not significantly different ( P = .74 , paired Prentice-Wilcoxon test ; P = .75 , Akritas test ) , with bracket failure rates of 17 % and 20 % recorded for compomer and resin adhesive , respectively . Neither the patients ' sex ( P = .85 ) nor malocclusion ( P = .26 ) appear to affect significantly bracket survival , but patient age was identified as a useful prognostic indicator of bracket survival ( P < .001 ) . On average , there was more decalcification related to brackets bonded with resin adhesive than with compomer ( P = .0075 ) . Survival time distributions of brackets bonded with compomer or resin adhesive appear comparable , but decalcification was reduced significantly by bonding with compomer One tenet of successful orthodontic therapy is to complete treatment without decalcification , hypocalcification , or discoloration of the natural dentition . Fluoride application has been shown to reduce demineralization of enamel . The purpose of this study was to see if fluoride could be incorporated into enamel before orthodontic bracketing without adversely affecting bond strength . Forty extract adolescent human premolars were r and omly divided into two equal groups with 20 teeth each . Group 1 served as control group , and group 2 ( experimental ) was immersed in 1.23 % acidulated phosphate fluoride for 4 minutes after acid etching . The buccal surfaces of all 40 teeth were then bonded with the same type of metal bracket and debonded with an Instron machine . The debonding interface was observed with scanning electron microscopy ( SEM ) . The mapping was calculated with energy dispersive x-ray spectrometry . The results showed that the bond strength of group 1 was significantly greater than that of group 2 . The enamel detachment ( enamel fracture ) was found in the experimental group only . Although the application of acidulated phosphate fluoride to a tooth can prevent dental decay or decalcification , the bond strength decreases and enamel detachment is found after debonding . The result shows that the application of acidulated phosphate fluoride after acid etching enamel has an adverse effect on orthodontic bond strength of human enamel The prevalence of enamel decalcification beneath orthodontic b and s has indicated the need for a fluoride-releasing , enamel-adhesive orthodontic luting cement . The purpose of this study was to compare the retentive bond strengths of orthodontic b and s cemented with two new fluoride-releasing cements , a zinc polycarboxylate and a glass ionomer , with the retentive bond strength of b and s cemented with the st and ard orthodontic cement zinc phosphate . The site of cement failure was also evaluated . One hundred eighty extracted human molar teeth were embedded in resin blocks and r and omly assigned to three cement groups . Adapted b and s were cemented by a clinical ly acceptable technique . The cemented teeth were then assigned to one of three time intervals--24 hours , 7 days , and 60 days-- and thermocycled in synthetic saliva . The force required to initially fracture the cement bond was used as a measure of cement retention . By means of the Instron , a tensile load was applied to each cemented b and . The maximum retentive strength ( cement failure ) was interpreted from the stress-strain curve at the point where linearity deviated . The failure site was judged subjectively : between cement and enamel , within the cement , or between cement and the b and . Using stress at failure , an analysis of variance showed no significant differences among the retentive strengths of the three cements . The chi-square test revealed a significant difference ( P less than 0.01 ) between failure sites of the zinc phosphate and glass ionomer cements . Significantly more b and s cemented with the glass ionomer failed at the cement/b and interface , leaving the cement adhered to the tooth . ( ABSTRACT TRUNCATED AT 250 WORDS The purpose of this study was to determine whether conventional toothbrushing and twice daily use of a brush-on 0.4 % stannous fluoride ( SnF2 ) gel containing more than 90 % available Sn2 + would be more effective for controlling plaque accumulation and gingivitis in the presence of orthodontic appliances than conventional toothbrushing alone . Consecutively treated adolescents who were to receive full-mouth fixed orthodontic appliances were assigned to one of two groups according to age and sex criteria . The first group ( control , n = 35 ) used toothbrushing with a st and ard fluoride toothpaste , whereas the second group ( treatment , n = 30 ) used toothbrushing supplemented with a 0.4 % SnF2 gel used twice daily for the entire 18-month study period . Clinical assessment s ( Plaque Index , Gingival Index , bleeding tendency , and coronal staining ) were made single blind before appliances were placed and 1 , 3 , 6 , 9 , 12 , and 18 months after appliances were placed . Complete data were obtained for 32 control and 23 SnF2 gel subjects . The results indicated that the SnF2 gel group had significantly lower scores for plaque index ( p < 0.01 ) , gingival index ( p < 0.001 ) , and bleeding tendency ( p < 0.001 ) at all examinations than did the control group . In the SnF2 group , one subject developed mild coronal staining , and two subjects developed moderate staining . We conclude that the use of a 0.4 % SnF2 gel containing more than 90 % available Sn2 + is an effective adjunct to mechanical tooth cleaning in preventing gingivitis in adolescents undergoing orthodontic treatment with fixed appliances The aim of this investigation was to examine the fluoride uptake by enamel after application of glass ionomer cement for orthodontic b and cementation compared with zinc phosphate cement . The study was conducted on 21 children whose mean age was 14 years . All the children were reared in the Middle Anatolian cities where the water fluoride concentration was below the level of 0.50 ppm . The subjects were r and omly divided into three groups . The first experimental group , had seven subjects whose teeth were topically fluori date d with 2 per cent NaF solution , before orthodontic b and cementation with zinc phosphate cement . The second experimental group also had seven subjects whose orthodontic b and s were cemented with glass ionomer cement . The third group , consisted of seven control subjects and no dental procedures were performed in this group . All the participants were followed for 3 months and at the end of this period maxillary first premolars , which were in the ninth developmental stage according to Nolla ( 1960 ) , were extracted for orthodontic purpose s. The enamel fluoride concentrations were determined on the left maxillary first premolars at three successive etch depths by means of a fluor ion electrode , whereas the calcium concentrations were determined with an atomic absorption spectrophotometer . The results of this investigation showed that in both cementation groups enamel fluoride concentrations at three successive etch depths were highly increased compared with the control group . However , the difference between the cementation groups was not statistically significant Glass ionomer orthodontic adhesives cause less enamel demineralization during fixed orthodontic appliance treatment than do traditional resin-based products . An in vivo r and omized clinical trial was performed comparing the clinical performance of a resin-modified glass ionomer ( RMGI ) adhesive with a no-mix , resin-based ( the control ) adhesive over a 12-month period . The split-mouth technique was used to analyze bracket retention , bracket failure causes , and mode of failure for both adhesives in 61 patients .  Bracket-failure rates were 10 % for the RMGI and 4 % for the resin-based adhesive . Both adhesives had 4 times more bracket failures when opposing occlusion was present . The resin-based product demonstrated a higher proportion of resin-to-enamel adhesive failures than did the RMGI . Compared with the resin-based adhesive , the RMGI-bracketed teeth showed improved clinical performance , no enamel surface loss , less enamel demineralization , and faster adhesive removal . However , the RMGI had a 2.6 times greater bracket-failure rate than did the resin-based product The purpose of this study was to compare the effectiveness of toothbrushing followed by fluoride rinsing , fluoride gel brushing , or fluoride gel dentifrice brushing alone in controlling the demineralization that often follows orthodontic treatment . Seventy-eight consecutive adolescent patients undergoing orthodontic care were divided into 3 groups : group 1 ( control ) used a low-potency , high-frequency fluoride rinse ; group 2 used a high-potency , high-frequency fluoride brush-on gel ; and group 3 used a high-potency , high-frequency fluoride gel dentifrice . When pretreatment levels of demineralization were subtracted from posttreatment values , both gel groups displayed a significant difference ( P < .05 ) in smooth surface demineralization sites when compared to controls . Reversal of white-spot lesions occurred in 15 % of sites that exhibited pathology as a result of the fluoride and preventive regimen . These results indicate that a daily use of a 5000-ppm fluoride gel along with toothbrushing with a fluoride paste or brushing twice daily with a 5000-ppm fluoride dentifrice alone provides greater protection beyond that of tooth-brushing with a fluoride paste ( 1000 ppm ) and rinsing with a 0.05 % sodium fluoride rinse 
    Output:
    
REVIEW ERS ' CONCLUSIONS There is some evidence that the use of topical fluoride or fluoride-containing bonding material s during orthodontic treatment reduces the occurrence and severity of white spot lesions , however there is little evidence as to which method or combination of methods to deliver the fluoride is the most effective .