***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: OBJECTIVE This controlled clinical trial evaluated the 5-year clinical performance of a self-etching primer system including selective enamel-etching with phosphoric acid and a one-bottle adhesive system . METHODS Seventy-two non-carious cervical lesions in 8 patients ( 4 male and 4 female ) with a mean age of 61.3 years ( range 45 - 78 ) participated in the study . An enamel bevel was placed and dentin lightly ground , and cavities restored with clearfil liner bond II ( LB ) or single bond ( SB ) in conjunction with a hybrid resin composite ( Clearfil AP-X ) . In the case of 27 cavities for LB , the enamel was pretreated with 37 % phosphoric acid for 10 s. Each patient received both types of restoration , which were distributed on a r and om basis . All restorations ( 37 restorations for LB and 35 restorations for SB ) were placed by one dentist . The restorations were evaluated blind after 5 years using modified USPHS criteria . The data were statistically analyzed using the Fisher 's exact test . RESULTS All but one restoration ( which was replaced by a crown after the 2-year recall ) were evaluated after 5 years . 100 % retention rates were recorded for both restorative groups . No caries was detected in association with any restorations . The only minor problem was marginal discoloration ; superficial and localized marginal discoloration occurred around 18 % of the restorations , and mainly at the dentin margin . There were no significant differences in the marginal integrity between the LB and SB groups . CONCLUSIONS Restorative material s used in this study demonstrated a good clinical effectiveness in the restoration of non-carious cervical lesions for 5 years Correctable weaknesses in the design , conduct , and analysis of biomedical and public health research studies can produce misleading results and waste valuable re sources . Small effects can be difficult to distinguish from bias introduced by study design and analyses . An absence of detailed written protocol s and poor documentation of research is common . Information obtained might not be useful or important , and statistical precision or power is often too low or used in a misleading way . Insufficient consideration might be given to both previous and continuing studies . Arbitrary choice of analyses and an overemphasis on r and om extremes might affect the reported findings . Several problems relate to the research workforce , including failure to involve experienced statisticians and method ologists , failure to train clinical research ers and laboratory scientists in research methods and design , and the involvement of stakeholders with conflicts of interest . Inadequate emphasis is placed on recording of research decisions and on reproducibility of research . Finally , reward systems incentivise quantity more than quality , and novelty more than reliability . We propose potential solutions for these problems , including improvements in protocol s and documentation , consideration of evidence from studies in progress , st and ardisation of research efforts , optimisation and training of an experienced and non-conflicted scientific workforce , and reconsideration of scientific reward systems The clinical performance of packable and conventional hybrid resin composites in Class I restorations for a period of three years was compared using a r and omized controlled double-blind clinical trial with self-matching design . A total of 50 pairs of Class I restorations were placed in 32 adult patients by one dentist in a self-matching prospect i ve clinical trial . The paired teeth were divided into the TPH Spectrum/XenoIII ( TS ) restoration group and the Synergy Compact/One Coat ( SC ) restoration group according to a r and om number table . Application of the material s followed the manufacturer 's instructions . The restorations were evaluated by two independent evaluators using US Public Health Service (USPHS)-Ryge modified criteria . Statistical analysis was performed using the McNemar 's test with Yates ' continuity correction . After three years , 40 pairs of restorations were available for evaluation . Four TS and two SC restorations failed due to fracture . Only one TS-restored tooth showed postoperative sensitivity at baseline and the symptom disappeared one week later . Alpha ratings of TS vs SC restorations were as follows : 95 % vs 98 % for color match , 85 % vs 88 % for marginal integrity , 88 % vs 90 % for anatomical form , 85 % vs 83 % for marginal discoloration , 88 % vs 93 % for occlusal contact . For both material s , Alpha ratings were 88 % for surface texture . The three-year clinical performances of the two restorative material s were satisfactory and not significantly different for each of the parameters evaluated Objective This study evaluated the 56-month clinical performance of Class I and II resin composite restorations .  Filtek P60 was compared with Filtek Z250 , which are both indicated for posterior restorations but differ in terms of h and ling characteristics . The null hypothesis tested was that there is no difference in the clinical performance of the two resin composites in posterior teeth . Material and Methods Thirty-three patients were treated by the same operator , who prepared 48 Class I and 42 Class II cavities , which were restored with Single Bond/Filtek Z250 or Single Bond/Filtek P60 restorative systems .  Restorations were evaluated by two independent examiners at baseline and after 56 months , using the modified USPHS criteria . Data were analyzed statistically using Chi-square and Fisher 's Exact tests ( a=0.05 ) . Results After 56 months , 25 patients ( 31 Class I and 36 Class II ) were analyzed . A 3 % failure rate occurred due to secondary caries and excessive loss of anatomic form for P60 . For both restorative systems , there were no significant differences in secondary caries and postoperative sensitivity . However , significant changes were observed with respect to anatomic form , marginal discoloration , and marginal adaptation . Significant decreases in surface texture were observed exclusively for the Z250 restorations . Conclusions Both restorative systems can be used for posterior restorations and can be expected to perform well in the oral environment Objective . In this intra-individual comparison ( an 18-months ' r and omized , controlled prospect i ve study ) , we evaluated the clinical performance of one self-etch and one “ etch & rinse ” adhesive in non-carious cervical lesions . Methods . Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated . Seventy-eight restorations were placed ; 39 with etch & rinse ( Single-Bond ) and 39 with self-etch ( Adper Prompt ) . Both adhesives were combined with the microfilled resin composite Filtek-A110 . The restorations were evaluated at baseline , 6 , 12 , and 18 months according to slightly modified USPHS criteria . Statistical differences between the adhesives was tested with McNemar 's test and clinical degradation over time for each material with the Fisher exact test ( α=0.05 ) . Results . Thirty pairs were evaluated at 12 and 18 months . Two self-etch restorations were lost after 18 months . Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months ( p<0.05 ) . Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration ( p<0.05 ) . Conclusions . Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions . The self-etch adhesive showed a faster progressive marginal degradation Objective We assessed the adequacy of r and omized controlled trial ( RCT ) registration , changes to registration data and reporting completeness for articles in ICMJE journals during 2.5 years after registration requirement policy . Methods For a set of 149 reports of 152 RCTs with Clinical Trials.gov registration number , published from September 2005 to April 2008 , we evaluated the completeness of 9 items from WHO 20-item Minimum Data Set relevant for assessing trial quality . We also assessed changes to the registration elements at the Archive site of Clinical Trials.gov and compared published and registry data . Results RCTs were mostly registered before 13 September 2005 deadline ( n = 101 , 66.4 % ) ; 118 ( 77.6 % ) started recruitment before and 31 ( 20.4 % ) after registration . At the time of registration , 152 RCTs had a total of 224 missing registry fields , most commonly ‘ Key secondary outcomes ’ ( 44.1 % RCTs ) and ‘ Primary outcome ’ ( 38.8 % ) . More RCTs with post- registration recruitment had missing Minimum Data Set items than RCTs with pre- registration recruitment : 57/118 ( 48.3 % ) vs. 24/31 ( 77.4 % ) ( χ2 1 = 7.255 , P = 0.007 ) . Major changes in the data entries were found for 31 ( 25.2 % ) RCTs . The number of RCTs with differences between registered and published data ranged from 21 ( 13.8 % ) for Study type to 118 ( 77.6 % ) for Target sample size . Conclusions ICMJE journals published RCTs with proper registration but the registration data were often not adequate , underwent substantial changes in the registry over time and differed in registered and published data . Editors need to establish quality control procedures in the journals so that they continue to contribute to the increased transparency of clinical trials Objectives : To evaluate and compare the clinical performance of Giomer ( Beautifil II ) and RMGIC ( Fuji II LC ) in noncarious cervical lesions . Material s and Methods : Thirty-two subjects with one or two pairs of noncarious cervical lesions were included in the study . Each pair of lesion was restored with either giomer or RMGIC assigned r and omly . Clinical evaluation of restorations was done using USPHS criteria . Data was formulated in a pre design ed format and subjected to statistical analysis using the chi square test . Results : Statistically significant difference was found between RMGIC and Giomer with respect to surface roughness with P value < 0.001 . Conclusion : Giomer showed superior surface finish compared to RMGIC . Both Giomer and RMGIC showed equal retention ability PURPOSE To compare the clinical performance of a resin composite and a polyacid-modified resin composite ( compomer ) in non-carious cervical lesions using a one-step self-etch adhesive . METHODS Thirty patients , each with two non-carious cervical lesions ( 60 restorations ) , received one composite ( Pertac-II ) restoration and one compomer ( Hytac ) restoration , both used in conjunction with a self-etch adhesive ( Prompt L-Pop ) and placed following the manufacturer 's instructions . Evaluations were at baseline , 6 , 12 and 36 months after placement for retention , margin adaptation , marginal discoloration , anatomic form , secondary caries and postoperative sensitivity . Statistical analysis with the Pearson Chi-square test was undertaken . RESULTS Retention rates were 86.6 % for composite and 86.7 % for compomer at 36 months . 3.3 % of composite and 6.7 % of compomer restorations showed a deficiency in marginal adaptation . Both material s showed a slight marginal discoloration of 7.7 % . More deterioration in anatomic form occurred with the compomer ( 11.5 % ) than the composite ( 3.8 % ) . None of the restorations exhibited secondary caries or postoperative sensitivity problems . There was no significant difference in performance between the material s in any of the categories evaluated Objective : To determine the proportion of registered trials published in the surgical literature , to compare , in registered trials , the primary outcomes registered with those published and to determine whether outcome -reporting bias favored significant primary outcomes . Background : Trial protocol registration before patient enrolment for r and omized controlled trials ( RCTs ) is a perquisite for many journals in attempt to decrease publication and selective reporting bias . Analysis of the medical literature demonstrates poor registration rates with discrepancies between reported and registered primary outcomes . This has not been evaluated in contemporary surgical journals . Methods : RCTs were identified for 2009 and 2010 from 10 high-impact factor surgical journals . One investigator identified all RCTs and extracted primary and secondary outcomes , date s of commencement and completion of study , funding source , and trial registration number . Trial registers were search ed using the trial registration number for primary and secondary outcomes , date s of commencement and completion of study , and date of registration . Trial registration rates and registration adequacy were recorded . Register and published primary outcomes were then compared . Results : A total of 246 papers were analyzed , among which 86 ( 34.9 % ) were not registered and 52 ( 21 % ) were inadequately registered . Of the 108 adequately registered trials , 32 ( 29 % ) had a discrepancy between the published primary outcome and that registered in trial register . In the 24 published studies where it was possible to assess , the discrepancy favored a statistically significant primary outcome in 22 ( 91.7 % ) whereas in 2 ( 8.3 % ) the discrepancy produced a statistically insignificant result . Conclusions : Less than half of all RCTs published in general surgical journals were adequately registered , and approximately 30 % had discrepancies in the registered and published primary outcome with 90 % of those assessable favoring a statistically positive result AIM The aim of this study was to examine clinical ly relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data . METHODS AND MATERIAL S Fourteen patients with at least one or two pairs of non-carious lesions under occlusion 
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The likelihood of such differences was significantly increased in older studies , studies with potential reporting bias , published in journals with high impact factor ( > 2 ) , longer follow-up periods , and not using USPHS- criteria .
Conclusions : The majority of dental restorative trials published from 2005 - 2015 had limited validity .