***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 INTRODUCTION Despite the many advances to improve the practice of orthodontics , white spot lesions , or decalcifications , remain a common complication in patients with poor oral hygiene . The purpose of this study was to assess the perceptions and level of awareness of patients , parents , orthodontists , and general dentists toward the development of white spot lesions during orthodontic treatment . METHODS This was a prospect i ve epidemiologic survey of the perceptions of  orthodontic patients ( n = 315 ) , parents ( n = 279 ) , orthodontists ( n = 305 ) , and general dentists ( n = 191 ) regarding the significance , prevention , and treatment of white spot lesions . RESULTS All surveyed groups indicated that white spot lesions detracted from the overall appearance of straight teeth , attributed primary responsibility for the prevention of white spot lesions to the patients themselves , and thought that the general dentist should be responsible for treating white spot lesions . Patients regarded themselves as ultimately responsible for the prevention of white spot lesions ( P < 0.05 ) . CONCLUSIONS The patients , parents , orthodontists , and general dentists had similar perceptions regarding the significance , prevention , and treatment of white spot lesions . All groups indicated that patients were the most responsible for the prevention of white spot lesions . Communication among patients , parents , orthodontists , and general dentists needs to improve to decrease the incidence of white spot lesions in the orthodontic population INTRODUCTION Enamel demineralization is a problem in orthodontics . Fluoride is partially effective in addressing this problem , but additional treatment options are needed . The objective of this prospect i ve r and omized controlled trial was to determine the effectiveness of a new product , MI Paste Plus ( GC America , Alsip , Ill ) , in the prevention or reduction of white spot lesions in orthodontic patients . METHODS Sixty patients who were undergoing routine orthodontic treatment were recruited for this prospect i ve r and omized clinical trial . A double-blind method of r and omization was used to determine whether each patient received the MI Paste Plus or a placebo paste ( Tom 's of Maine , Salisbury , United Kingdom ) . Each patient was asked to administer the paste by using a fluoride tray for a minimum of 3 to 5 minutes each day at night after brushing . Photographic records obtained in a light-controlled environment were used to record the presence or absence of white spot lesions in both groups . The enamel decalcification index was used to determine the number of white spot lesions per surface at each time interval . Patients were followed at 4-week intervals for 3 months . A scoring system from 0 to 6 was used to determine the level of caries or cavitations . This system was also used for each tooth at each time interval . RESULTS Fifty patients ( 26 using MI Paste Plus , 24 using the placebo paste ) completed the study . The enamel decalcification index scores for all surfaces were 271 and 135 at the start of treatment and 126 and 258 at the end of treatment for the MI Paste Plus and placebo paste groups , respectively . The enamel decalcification index scores in the MI Paste Plus group reduced by 53.5 % , whereas the placebo group increased by 91.1 % during the study period . A 3-way analysis of variance ( ANOVA ) was done for the average enamel decalcification index scores . The surface type , the product/time interactions , and the product/surface interactions of the mean enamel decalcification index scores were significant ( P < 0.05 ) . CONCLUSIONS MI Paste Plus helped prevent the development of new white spot lesions during orthodontic treatment and decreased the number of white spot lesions already present . The placebo paste had no preventive action on white spot development during orthodontic treatment ; the number of lesions actually increased . MI Paste Plus reduced white spots on the gingival surfaces ; the placebo paste had the opposite effect . The incisal surface effect on the mean enamel decalcification index scores over time and between products was highly significant . The incisal enamel decalcification index scores were consistently higher than those for the other surfaces ( mesial , distal , and gingival ) 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 A prospect i ve examination of 10 consecutively treated orthodontic patients was undertaken to examine the effectiveness of  fluoride varnish in reducing enamel demineralization .  Pairs of dental quadrants for each patient 's mouth ( ie , maxillary right and m and ibular left ; maxillary left and m and ibular right ) were r and omly assigned to an experimental or control group . After placement of resin-bonded orthodontic brackets , fluoride varnish was applied to the 2 experimental dental quadrants for each patient . Subsequent applications were done every 3 months during 12 months of orthodontic treatment . A double-blinded examination of intraoral photographs of the 100 experimental and 100 control teeth was done . The presence of white spot lesions was registered using the enamel decalcification index and the 2 groups were compared using paired Student t tests with a significance level of 5 % ( P < .05 ) . There was no statistically significant difference between the mean enamel decalcification index for the control and experimental groups before or after treatment , since demineralization increased for both groups . Most importantly , the change in mean enamel decalcification index was significantly smaller for the experimental group ( 0.34 ) , compared to the control group ( 0.51 ) . In other words , there was 44.3 % ( P < .05 ) less demineralization noted for teeth that had been treated with fluoride varnish during orthodontic treatment Background The ' Hawthorne Effect ' may be an important factor affecting the generalisability of clinical research to routine practice , but has been little studied . Hawthorne Effects have been reported in previous clinical trials in dementia but to our knowledge , no attempt has been made to quantify them . Our aim was to compare minimal follow-up to intensive follow-up in participants in a placebo controlled trial of Ginkgo biloba for treating mild-moderate dementia . Methods Participants in a dementia trial were r and omised to intensive follow-up ( with comprehensive assessment visits at baseline and two , four and six months post r and omisation ) or minimal follow-up ( with an abbreviated assessment at baseline and a full assessment at six months ) . Our primary outcomes were cognitive functioning ( ADAS-Cog ) and participant and carer-rated quality of life ( QOL-AD ) . Results We recruited 176 participants , mainly through general practice s. The main analysis was based on Intention to treat ( ITT ) , with available data . In the ANCOVA model with baseline score as a co-variate , follow-up group had a significant effect on outcome at six months on the ADAS-Cog score ( n = 140 ; mean difference = -2.018 ; 95%CI -3.914 , -0.121 ; p = 0.037 favouring the intensive follow-up group ) , and on participant-rated quality of life score ( n = 142 ; mean difference = -1.382 ; 95%CI -2.642 , -0.122 ; p = 0.032 favouring minimal follow-up group ) . There was no significant difference on carer quality of life . Conclusion We found that more intensive follow-up of individuals in a placebo-controlled clinical trial of Ginkgo biloba for treating mild-moderate dementia result ed in a better outcome than minimal follow-up , as measured by their cognitive functioning . Trial registration Current controlled trials : IS RCT The aim of this study was to test a particular type of intra-oral fluoride releasing device ( IFRD ) , design ed to release 0.0 
    Output:
    
Reports of adverse effects from topical fluoride applications were rare and unlikely to be significant .
AUTHORS ' CONCLUSIONS This review found a low level of certainty that 12,300 ppm F foam applied by a professional every 6 to 8 weeks throughout fixed orthodontic treatment , might be effective in reducing the proportion of orthodontic patients with new DLs .