***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: PURPOSE To determine differences in interproximal plaque mass and fluoride retention with different modes of toothbrushing and flossing . MATERIAL S AND METHODS Forty-seven subjects in good health used four treatments in a four-period , r and omized , crossover design : 1 ) manual brushing only ; 2 ) manual brushing and daily flossing ; 3 ) electric brushing using a rotational oscillation toothbrush ; and 4 ) electric brushing using a sonic toothbrush . Subjects used a st and ard sodium fluoride dentifrice during the eight-day experimental periods and a fluoride-free dentifrice during the seven-day washout periods between treatments . Interproximal plaque sample s were taken on Day 1 and on Day 8 , weighed , and analyzed for fluoride content . RESULTS The amount of interproximal plaque was lowest with sonic brushing , which left 43 - 65 % less plaque than all other treatments . Manual brushing and flossing yielded less plaque than manual brushing alone and rotational oscillation brushing . Differences were statistically significant ( p < 0.05 ) for treatment ; there was no time effect on plaque mass . For fluoride retention , at Day 1 sonic brushing gave at least 54 % more fluoride in the interproximal plaque than all other treatments , which was significant . All treatments demonstrated a significant increase in fluoride concentration with time except manual brushing and flossing , which showed a significant decrease . At Day 8 , the fluoride concentration was significantly higher for sonic brushing than for manual brushing or rotational oscillation brushing by over 40 % , and all treatments exhibited significantly greater fluoride than the manual brushing and flossing combination . CONCLUSION The mode of toothbrushing may impact the amount of plaque retained interproximally and its fluoride concentration OBJECTIVE The purpose of this twenty-eight day , r and omized , single-blind clinical trial was to assess the efficacy of the addition of daily oral irrigation to both power and manual tooth brushing , compared to a traditional regimen of manual tooth brushing and flossing , to determine which regimen had the greatest effect on the reduction of gingival bleeding , gingivitis , and supragingival plaque .  METHODOLOGY The study was design ed for a total of 105 subjects to participate in a twenty-eight day trial , with 35 subjects r and omly assigned to one of three groups : Group 1-manual toothbrush and floss ; Group 2-manual toothbrush and dental water jet ; and Group 3-sonic toothbrush and dental water jet . All subjects received written and verbal instructions for using their regimens . Subjects were asked to brush for a timed two minutes , twice per day , with the brush and the dentifrice provided , and to refrain from using any additional oral hygiene aids . Subjects using the dental water jet were instructed to use the water jet on a medium setting , irrigating once per day with 500 ml of luke warm water . Subjects using the dental floss were instructed to use the floss once daily . Subjects were examined by two calibrated examiners , and data were collected at baseline ( BSL ) , 14 days ( D14 ) , and 28 days ( D28 ) . Subjects were asked to abstain from any oral hygiene for 12 hours prior to each study visit . Subjects were scored using the Carter and Barnes Bleeding Index , Löe and Silness Gingival Index , and the Proximal/Marginal Plaque Index . Mean scores on the three indices for the three groups were used for statistical analysis at each time point . Additionally , the means were used for comparisons as change from baseline and percent change from baseline at D14 and D28 . The significance of percentage change in each index from baseline to D14 and D28 was evaluated using a one-tailed t-test . Significant differences are reported at alpha < or = 0.05 for these planned group comparisons . RESULTS Thirty-one subjects in Group 1 , 32 subjects in Group 2 , and 32 subjects in Group 3 completed the study . Bleeding Index : Groups 2 and 3 , the irrigation groups , were statistically significantly more effective than Group 1 in reducing the bleeding index at D14 and D28 , whether measured by mean reduction or percentage reduction . Gingival Index : At D14 , both irrigation groups demonstrated a statistically significantly greater reduction in the gingival index compared to brushing and flossing for the facial surfaces . There was no significant difference between groups for the lingual surface at D14 . At D28 there was a significant difference between Groups 1 and 2 for both the facial and lingual surfaces . Plaque Index : There was one significant difference between groups for the plaque index measured on the lingual surfaces . The manual toothbrush and floss were less effective than the sonic toothbrush and irrigation . Group 3 was also significantly better than Group 1 in reducing the plaque index on the facial surfaces at both D14 and D28 . On plaque percentage reduction on the facial surface , Group 2 was significantly better than Group 1 at D14 . There was no statistical difference between Group 1 and Group 2 at D28 . CONCLUSION The results of this clinical trial indicate that when combined with manual or sonic tooth brushing , oral irrigation is an effective alternative to manual tooth brushing and dental floss for reducing bleeding , gingival inflammation , and plaque removal BACKGROUND AND OBJECTIVE Dental calculus occurs as a consequence of supersaturation of saliva with respect to calcium phosphates . This mineralization of dental plaque can be delayed by the presence of crystallization inhibitors , such as pyrophosphate or bisphosphonates . Phytate inhibits brushite and hydroxyapatite crystallization and has the potential to prevent dental calculi formation . The aim of the present study was to examine the effects of phytate and zinc , administered in a mouthwash solution , to prevent the formation of dental calculus . MATERIAL AND METHODS Healthy dental plaque-forming volunteers ( n = 25 ) took part in a r and omized , double-blind , three-period crossover clinical study to assess the efficacy of a phytate-containing mouthwash in relation to control and placebo effects . Subjects rinsed their mouths for 1 min , twice each day , with 20 mL of the test solution , without ingestion . Mouthwash efficacy was assessed through quantification of the amounts of calcium , phosphorus and magnesium present in the residues obtained by dental cleaning , performed by a single trained examiner . RESULTS A good correlation was found among total calcium , magnesium and phosphorus in calcified dental plaque residues , indicating that any of these variables is adequate for evaluating the reduction of plaque crystallization as calcium phosphate . A statistically significant decrease in total calcium , magnesium and phosphorus was found in the phytate-treatment period compared with control and placebo periods , demonstrating the efficacy of the proposed treatment in reducing dental calculus formation . CONCLUSION The high efficacy of phytate in reducing dental calculus formation suggests that this substance may be an effective treatment for preventing the development of calculus deposits The purpose of the present study was to compare in untreated patients suffering from moderate to severe periodontitis the efficacy of dental floss ( DF ) and interdental brushes ( IDB ) in the reduction of plaque , gingival inflammation , and probing depth in a 6-week period prior to subgingival debridement . Twenty-six patients ( 12 female , 14 male ; mean age 37.4 years ; range 27 to 72 years ) were instructed to use DF for one side of the dentition and IDB for the other side as an adjunct to the daily toothbrushing for 6 weeks . Oral hygiene instructions for toothbrushing and the use of the two devices were given at baseline and at week 3 . Measurements were carried out at baseline and at 6 weeks including plaque scores , probing depth , and 2 bleeding scores ( periodontal pocket bleeding index and angulated bleeding index ) . With the IDB , the approximal plaque score at baseline of 3.09 reduced to 2.15 at 6 weeks and with DF from 3.10 to 2.47 , respectively . IDB proved to remove significantly more plaque than DF . Baseline probing depth of 5.84 mm for IDB sites and 5.59 mm for DF sites was reduced to 5.01 mm at 6 weeks for both regimens . Analysis showed that the use of IDB result ed in a greater pocket reduction . Both bleeding indices were slightly reduced with IDB and DF , but no differences between devices were found . In relation to patient acceptance , more problems were observed with DF , and IDB were felt to be more efficacious . In conclusion , the results of the present study indicate that in combination with a manual toothbrush , the use of interdental brushes is more effective in removal of plaque and results in a larger reduction of probing depth than the use of dental floss . Although the differences were small , they indicate , in combination with patient preferences , that interdental brushes are to be considered preferable to floss for interdental plaque removal in patients suffering from moderate to severe periodontitis OBJECTIVE The study was conducted to compare the performance of three interdental products to dental floss in the control and removal of plaque , and in the reduction of gingivitis . METHODOLOGY One-hundred and twenty subjects were screened for the presence of interproximal sites of a size suitable for a GUMO Go-Betweens cleaner , and for being in compliance with inclusion and exclusion criteria . They were then assessed with the Plaque , Gingivitis , and Eastman Interdental Bleeding Indices ( EIBI ) at baseline , given a prophylaxis , r and omly assigned to one of four products ( Glide dental floss , Butler flossers , GUM Go-Betweens cleaners , and GUM Soft-Picks cleaners ) , and given product use instructions . Subjects returned at three weeks for a compliance review and at six weeks for a final visit . Plaque was assessed at the final visit before and after using the assigned products . Plaque , gingivitis , and bleeding scores were evaluated by analysis of covariance using the baseline measurements as the covariate . RESULTS All four interdental products significantly reduced interdental plaque from baseline to before-use at the final visit ( after six weeks ) employing baseline plaque as a covariate . Reductions were 16 % to 24 % . Similarly , use of the products at the final visit result ed in 26 % to 31 % reductions in plaque with the before-use plaque as a covariate . Interdental gingivitis scores showed a reduction both lingually and buccally , with reductions ranging from 27 % to 36 % for the former and 34 % to 53 % for the latter ( baseline was the covariate ) . No statistical differences were found between the products on the lingual interdental sites . The Go-Betweens cleaners showed a statistically greater reduction in the Gingival Index score buccally than the other three products . No differences were noted among the products for the EIBI . CONCLUSION In this study , dental floss , the recognized " gold st and ard " for gingivitis reduction , was matched in performance by flossers and an interdental cleaner with small elastomeric fingers , and surpassed by an interdental brush . All products performed comparably for plaque reduction and removal AIM Regular dental flossing has been widely recommended to prevent periodontal diseases . Nevertheless , compliance is below a desirable level . This study evaluates the effects of a brief behavioural intervention on dental flossing  and determines whether the effects of such an intervention are stronger in a specific subgroup of individuals ( those intending to floss regularly = implemental mindset ) . MATERIAL S AND METHOD Behavioural intervention ( planning when , where and how to floss ) trial was conducting with 194 participants assigned to an intervention or a control group by a r and om time schedule ; the primary outcome was vali date d self-report of flossing behaviour . Follow-up data were collected 2 and 8 weeks post-intervention . RESULTS Individuals receiving the planning intervention significantly outperformed those in the control condition at both the 2- and the 8-week follow-up ( 4.24 times flossing/week versus 3.9 at 2 weeks ; 4.02 versus 2.98 at 8 weeks ) . Intervention effects were stronger in individuals in the implemental mindset . Dropout rates were higher for participants who received the planning intervention  but were not in the implemental mindset . CONCLUSION Planning interventions are an economic and effective way to change oral self-care behaviour , and are more effective in individuals in an implemental mindset The purpose of the present study was to compare the bleeding tendency as elicited by probing the marginal gingiva ( BOMP ) and probing to the bottom of the pocket ( BOPP ) in smokers and non-smokers in natural gingivitis and during experimental gingivitis . 11 smokers ( sm ) and 14 non-smokers ( nsm ) were recruited . When they had less than 20 % approximal bleeding sites , they entered a 14-day trial period of ' experimental gingivitis ' . Subjects returned 30 days later , after resuming normal oral hygiene procedures , for a final gingival assessment . A split-mouth design was chosen using 2 contra-lateral quadrants for each index ( being either BOMP or BOPP ) . A consistently higher bleeding score of approximately 10 % was observed by probing to the bottom of the pocket . At day 14 with both indices , a significant difference between smokers and non-smokers was detected ( BOMP : sm=15 % , nsm=30 % ; BOPP : sm=27 % , nsm=44 % ) . The increment between gingival health and experimental gingivitis was significantly higher in non-smokers than in smokers but comparable for both indices ( BOMP : sm=8 % , nsm=23 % ; BOPP : sm=9 % , n 
    Output:
    
No studies reported the effectiveness of flossing plus toothbrushing for preventing dental caries