***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: Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Abstract . The aim of this r and omized in vivo study was to compare antimicrobial chemotherapies in primary carious dentin . Thirty-two participants ages 5 to 7 years underwent partial caries removal from deep carious dentin lesions in primary molars and were subsequently divided into three groups : control [ chlorhexidine and resin-modified glass ionomer cement ( RMGIC ) ] , LEDTB [ photodynamic antimicrobial chemotherapy ( PACT ) with light-emitting diode associated with toluidine blue solution and RMGIC ] , and LMB [ PACT with laser associated with methylene blue solution and RMGIC ] . The participants were su bmi tted to initial clinical and radiographic examinations .  Demographic features and biofilm , gingival , and DMFT/DMFS indexes were evaluated , in addition to clinical and radiographic followups at 6 and 12 months after treatments . Carious dentin was collected before and after each treatment , and the number of Streptococcus mutans , Streptococcus sobrinus , Lactobacillus casei , Fusobacterium nucleatum , Atopobium rimae , and total bacteria was established by quantitative polymerase chain reaction . No signs of pain or restoration failure were observed . All therapies were effective in reducing the number of microorganisms , except for S. sobrinus . No statistical differences were observed among the protocol s used . All therapies may be considered as effective modern approaches to minimal intervention for the management of deep primary caries treatment OBJECTIVES : The aim of the present study was to analyze the efficacy of Papacarie ® gel compared with the traditional method ( low-speed bur ) in reducing the counts of total bacteria , Lactobacillus , total Streptococcus and Streptococcus mutans group . METHODS : A r and omized , controlled clinical trial with a split-mouth design was performed . The sample comprised 40 deciduous teeth in 20 children ( 10 males and 10 females ) aged four to seven years . The teeth were r and omly allocated to two groups : G1 , or chemomechanical caries removal with Papacarie Duo ® , and G2 , or the removal of carious dentin tissue with a low-speed bur . Infected dentin was collected prior to the procedure , and the remaining dentin was collected immediately following the removal of the carious tissue . Initial and final counts of bacterial colonies were performed to determine whether there was a reduction in the number of colony-forming units ( CFUs ) of each microorganism studied . Clinical Trials.gov : NCT01811420 . RESULTS : Reductions were found in the numbers of total bacteria , total Streptococcus and Streptococcus mutans group following either of the caries removal methods ( p<0.05 ) . A reduction was also noted in the number of Lactobacillus CFUs ; however , this difference did not achieve statistical significance ( p>0.05 ) . CONCLUSION : Papacarie ® is an excellent option for the minimally invasive removal of carious tissue , achieving significant reductions in total bacteria , total Streptococcus and S. mutans with the same effectiveness as the traditional caries removal method BACKGROUND Ultraconservative removal of carious tissue is becoming increasingly highlighted for management of deep caries lesions , and combined with an antimicrobial photochemistry-based treatment modality ( PACT ) , this approach can be enhanced favoring dental tissue repair and preservation . The aim was to investigate the effectiveness of PACT using a light emitting diode ( LED ) associated with a photosensitizer toluidine blue ortho ( TBO ) on deep caries lesions . METHODS For that , a single blind , r and omized , controlled , split-mouth clinical trial where 45 patients with at least two deep carious lesions on permanent posterior teeth was performed . The primary intervention was deep caries lesion management with disinfection of remaining dentin tissue using PACT .  Bacterial counts were measured following treatments as the main outcome . The remaining dentinal sample s of each lesion were treated with either non-PACT-control or PACT . The PACT procedure were characterized by 100 μg mL(-1 ) TBO followed by 94J cm(-2 ) LED irradiation . Sample s of dentin were collected before and immediately after treatments for microbiological analysis of total viable bacteria , mutans streptococci and Lactobacillus spp . counts . Microbial reduction was data were su bmi tted to unpaired t test ( α=5 % ) . RESULTS PACT led to statistically significant reductions in mutans streptococci ( 1.08 ± 1.20 log ) , Lactobacillus spp . ( 1.69 ± 1.37 log ) , and total viable bacteria ( 1.07 ± 1.01 log ) compared to the control , which showed log reductions respectively of 0.05 ± 0.49 , 0.52 ± 0.89 , and 0.47 ± 0.77 for the same microorganisms . CONCLUSION Dentin from deep carious lesions treated with PACT showed a decrease in cariogenic microbial load 
    Output:
    
All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth .
Based on these findings , there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions