human
***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: Background Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to caries . The objective of the study was to assess and compare the effect of a single application of 38 % SDF with ART sealants and no treatment in preventing dentinal ( D3 ) caries lesions on occlusal surfaces of permanent first molars of school children who participated in a daily school-based toothbrushing program with fluoride toothpaste . Methods The prospect i ve community clinical trial in the Philippines was conducted over a period of 18 months and included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based fluoride toothpaste brushing program . Children were r and omly assigned for SDF application or ART sealant treatment . Children from two of the eight schools did not receive SDF or ART sealant treatment and served as controls . SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars . Surfaces that were originally defined as sound at baseline but which changed to dentinal ( D3 ) caries lesions were defined as surfaces with new caries ( caries increment ) . Non-compliance to the daily toothbrushing program in three schools offered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste brushing and in non-toothbrushing children . Results In the brushing group , caries increment in the SDF treatment group was comparable with the non-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a statistically significant lower hazard ratio of 0.12 ( 0.02 - 0.61 ) . In the non-brushing group , caries increment in the SDF treatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only statistically significant for the sealant group ( HR 0.33 ; 0.20 - 0.54 ) . Caries increment was lower in toothbrushing children than in non-toothbrushing children . Hazard ratios reached statistical significance for the non-treated children ( HR 0.43 ; 0.21 - 0.87 ) and the sealant-treated children ( HR 0.15 ; 0.03 - 0.072 ) . Conclusions A one-time application of 38 % SDF on the occlusal surfaces of permanent first molars of six- to eight-year-old children is not an effective method to prevent dentinal ( D3 ) caries lesions . ART sealants significantly reduced the onset of caries over a period of 18 months . Trial registration numberGerman Clinical Trial Register BACKGROUND Failed restorations in primary teeth are not always re-restored . Is re-restoration not required anymore ? OBJECTIVE To compare survival rates of primary molars with intact and defective amalgam and ART restorations . METHODS A total of 649 restored primary molars , of which 162 were assessed with defective restorations for mechanical reasons , from a cluster-r and omised controlled clinical trial , were followed up over a period of 3.5 years . Restored primary molars , extracted because of dental sepsis or toothache , were considered a failure . Primary molars with defective restorations were followed up from the time they were assessed defective . Data were analysed using PHREG model with frailty correction , Wald test , t-test , and jackknife procedure . RESULTS The survival rate of primary molars with intact restorations ( 96.3 % ) was statistically significantly higher than that of primary molars with defective restorations ( 75.9 % ) over a 3-year period ( P < 0.0001 ) . Neither the effect of treatment protocol ( amalgam or ART ) ( P = 0.05 ) nor the type of surface ( single or multiple ) ( P = 0.73 ) was observed with respect to the survival rate of restored primary molars . CONCLUSIONS Survival rates for primary molars with intact and defective amalgam and ART restorations were high . The 3-year survival rate of primary molars with intact restorations was significantly higher than that of primary molars with defective restorations Clinical trials are normally performed with well-known br and s of glass ionomer cement ( GIC ) , but the cost of these material s is high for public healthcare in less-affluent communities . Given the need to research cheaper material s , it seems pertinent to investigate the retention rate of a low-cost GIC applied as atraumatic restorative treatment ( ART ) sealants in two centers in Brazil . Four hundred and thirty-seven 6-to-8-year-old schoolchildren were selected in two cities in Brazil . The children were r and omly divided into two groups , according to the tested GIC applied in the first permanent molars . The retention rate was evaluated after 3 , 6 and 12 months . Kaplan-Meier survival analysis and the log-rank test were performed . The variables were tested for association with sealant longevity , using logistic regression analyses ( α = 5 % ) . The retention rate of sealants after 12 months was 19.1 % . The high-cost GIC br and presented a 2-fold-more-likely-to-survive rate than the low-cost br and ( p < 0.001 ) . Significant difference was also found between the cities where the treatments were performed , in that Barueri presented a higher sealant survival rate than Recife ( p < 0.001 ) . The retention rate of a low-cost GIC sealant br and was markedly lower than that of a well-known GIC sealant br and Objectives This study aim ed to test the hypothesis that there is no difference in the survival rates of molars treated according to the conventional restorative treatment ( CRT ) using amalgam , atraumatic restorative treatment ( ART ) using high-viscosity glass ionomer , and ultraconservative treatment ( UCT ) protocol after 3.5 years . Material s and methods Cavitated primary molars were treated according to CRT , ART , and UCT ( small cavities were restored with ART and medium/large cavities were daily cleaned with toothpaste/toothbrush under supervision ) . Molar extraction s result ing from toothache , sepsis , or pulp exposure were failures . The Kaplan – Meier method was used to estimate the survival curves . Results The numbers of treated teeth , among the 302 6–7-year-old children , were 341 ( CRT ) , 244 ( ART ) , and 281 ( for UCT group : 109 small ART , 166 open cavities , and 6 combinations ) . Protocol groups were similar at baseline regarding gender and mean decayed missing filled tooth score , but not regarding age and type of surface . The numbers of molars extracted were 22 ( CRT ) , 16 ( ART ) , and 26 ( UCT ) . Fistulae were most often recorded . After 3.5 years , the cumulative survival rate ± st and ard error for all molars treated was 90.9 ± 2.0 % with CRT , 90.4 ± 2.4 % with ART , and 88.6 ± 1.9 % with UCT ( p = 0.13 ) . Only a type of surface effect was observed over the 3.5-year period : survival rates for molars were higher for single- than for multiple-surface cavities . Conclusion There was no difference in the cumulative survival rates of primary molars treated according to the CRT , ART , and UCT protocol s over a 3.5-year period . Clinical relevance Keeping cavities in primary molars biofilm-free might be another treatment option alongside restoring such cavities through conventional and ART protocol The aim was to test the null-hypothesis that there is no difference in the cumulative survival rate of retained composite resin ( CR ) sealants and a high-viscosity glass-ionomer Atraumatic Restorative Treatment ( ART ) sealant in first permanent molars calculated according to the traditional and the modified retention assessment criteria over a period of 3 years . This cluster-r and omized controlled clinical trial consisted of 123 schoolchildren , 6 - 7-years-old . At baseline , high-caries risk pits and fissures of fully erupted first permanent molars were treated with CR and ART sealants . Evaluations were performed after 0.5 , 1 , 2 and 3 years . Retention was scored for free-smooth surface and for each of three sections into which the occlusal surface had been divided . The modified criterion differed from the traditional in that it determined an occlusal sealant to be a failure when at least one section contained no visible sealant material . Data were analysed according to the PHREG model with frailty correction , Wald-test , ANOVA and t-test , using the Jackknife procedure . The cumulative survival rates for retained CR and ART sealants in free-smooth and occlusal surfaces for both criteria were not statistically significantly different over the 3 years . A higher percentage of retained CR sealants on occlusal surfaces was observed at longer evaluations . Cumulative survival rates were statistically significantly lower for the modified criterion in comparison to the traditional . The modified retention assessment criterion should be used in future sealant-retention studies OBJECTIVES The aim of the present study was to investigate the caries-preventive effect of sealants produced with a high-viscosity glass-ionomer with an elevated powder-liquid ratio ( ART ) , of having energy added to this glass-ionomer , and that of glass-carbomer , in comparison to that of resin composite sealants . METHODS The r and omized controlled trial covered 407 children , with a mean age of 8 years . At a school compound three dentists placed sealants in pits and fissures of high caries-risk children . Evaluation by two independent evaluators was conducted after 0.5 , 1 and 2 years . The Kaplan-Meier survival method , ANOVA and t-test were used in analyzing the data . RESULTS 1352 first permanent molars were sealed . 6.6 % of children and 6.8 % of sealants dropped out within 2 years . 27 re-exposed pits and fissures , 20 in occlusal and 7 in smooth surfaces , in 25 children , developed a dentin carious lesion . The cumulative survival of dentin carious lesion-free pits and fissures in the  glass-carbomer sealant group was statistically significantly lower ( 97.4 % ) than those in the high-viscosity glass-ionomer with energy supplied ( 99 % ) and the resin-composite ( 98.9 % ) sealant groups . There was no statistically significant difference in the cumulative survival of dentin carious lesion-free pits and fissures , between the high-viscosity glass-ionomer with ( 99 % ) and without ( 98.3 % ) energy supplied sealant groups , after 2 years . SIGNIFICANCE The survival of dentin carious lesion-free pits and fissures was high in all sealant types . More dentin carious lesions were observed in the glass-carbomer sealant group OBJECTIVES To assess and compare the cumulative survival rate of amalgam and atraumatic restorative treatment ( ART ) restorations in primary molars over 3 years . METHODS 280 children aged 6 - 7 years old were enrolled in a cluster r and omized controlled clinical trial using a parallel group design covering two treatment groups : conventional restorative treatment with amalgam ( CRT ) and atraumatic restorative treatment ( ART ) using a high-viscosity glass-ionomer ( HVGIC ) Ketac Molar Easymix . Three pedodontists placed 750 restorations ( 364 amalgam and 386 ART in 126 and 154 children , respectively ) which were evaluated at 0.5 , 1 , 2 and 3 years . The proportional hazard rate regression model with frailty correction , ANOVA and Wald tests , and the Jackknife procedure were applied in analysing the data . RESULTS The cumulative survival rates over 3 years for all , single- and multiple-surface CRT/amalgam restorations ( 72.6 % , 93.4 % , 64.7 % , respectively ) were no different from those of comparable ART/HVGIC restorations ( 66.8 % ; 90.1 % and 56.4 % , respectively ) ( p=0.10 ) . Single-surface restorations had higher survival rates than multiple-surface restorations for the both treatment procedures ( p<0.0001 ) . A higher proportion of restorations failed because of mechanical reasons ( 94.8 % ) than of secondary caries ( 5.2 % ) . No difference in reasons for restoration failures between all types of amalgam and ART/HVGIC restorations were observed ( p=0.24 ) . SIGNIFICANCE The high-viscosity glass-ionomer used in this study in conjunction with the ART is a viable option for restoring carious dentin lesions in single surfaces in vital primary molars OBJECTIVE The purpose of this study was to investigate the remineralization activation of the application of three fissure sealants ( FSs ) , alone or with gaseous ozone ( GO ) , on non-cavitated initial caries and evaluate the clinical success of FS . STUDY DESIGN Sixty children who had DIAGNOdent scores between 10 - 30 on bilateral symmetric m and ibular first permanent molars were included in study . In a split-mouth design , teeth were assigned to experimental ( with GO ) and control ( without GO ) groups . GO was applied to teeth on one side and then the same br and of r and omly selected FSs was applied to the teeth on both sides . Children were divided into 3 groups based on type of FS ( Group 1 : Aegis { Bosworth Co , North Hamlin Avenue Skokie , Illinois , USA } , Group 2 : Fuji Triage { GC , Tokyo , Japan } , Group 3 : Helioseal { Iv 
    Output:
    
agent
Conclusions ART single-surface restorations  presented high survival percentages in both primary and permanent posterior teeth , whilst ART multiple-surface restorations presented lower survival percentages .
ART sealants presented a high-caries-preventive effect .
Clinical relevance ART is an effective evidence -based option for treating and preventing carious lesions in primary and permanent posterior teeth
***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: Background Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to caries . The objective of the study was to assess and compare the effect of a single application of 38 % SDF with ART sealants and no treatment in preventing dentinal ( D3 ) caries lesions on occlusal surfaces of permanent first molars of school children who participated in a daily school-based toothbrushing program with fluoride toothpaste . Methods The prospect i ve community clinical trial in the Philippines was conducted over a period of 18 months and included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based fluoride toothpaste brushing program . Children were r and omly assigned for SDF application or ART sealant treatment . Children from two of the eight schools did not receive SDF or ART sealant treatment and served as controls . SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars . Surfaces that were originally defined as sound at baseline but which changed to dentinal ( D3 ) caries lesions were defined as surfaces with new caries ( caries increment ) . Non-compliance to the daily toothbrushing program in three schools offered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste brushing and in non-toothbrushing children . Results In the brushing group , caries increment in the SDF treatment group was comparable with the non-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a statistically significant lower hazard ratio of 0.12 ( 0.02 - 0.61 ) . In the non-brushing group , caries increment in the SDF treatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only statistically significant for the sealant group ( HR 0.33 ; 0.20 - 0.54 ) . Caries increment was lower in toothbrushing children than in non-toothbrushing children . Hazard ratios reached statistical significance for the non-treated children ( HR 0.43 ; 0.21 - 0.87 ) and the sealant-treated children ( HR 0.15 ; 0.03 - 0.072 ) . Conclusions A one-time application of 38 % SDF on the occlusal surfaces of permanent first molars of six- to eight-year-old children is not an effective method to prevent dentinal ( D3 ) caries lesions . ART sealants significantly reduced the onset of caries over a period of 18 months . Trial registration numberGerman Clinical Trial Register BACKGROUND Failed restorations in primary teeth are not always re-restored . Is re-restoration not required anymore ? OBJECTIVE To compare survival rates of primary molars with intact and defective amalgam and ART restorations . METHODS A total of 649 restored primary molars , of which 162 were assessed with defective restorations for mechanical reasons , from a cluster-r and omised controlled clinical trial , were followed up over a period of 3.5 years . Restored primary molars , extracted because of dental sepsis or toothache , were considered a failure . Primary molars with defective restorations were followed up from the time they were assessed defective . Data were analysed using PHREG model with frailty correction , Wald test , t-test , and jackknife procedure . RESULTS The survival rate of primary molars with intact restorations ( 96.3 % ) was statistically significantly higher than that of primary molars with defective restorations ( 75.9 % ) over a 3-year period ( P < 0.0001 ) . Neither the effect of treatment protocol ( amalgam or ART ) ( P = 0.05 ) nor the type of surface ( single or multiple ) ( P = 0.73 ) was observed with respect to the survival rate of restored primary molars . CONCLUSIONS Survival rates for primary molars with intact and defective amalgam and ART restorations were high . The 3-year survival rate of primary molars with intact restorations was significantly higher than that of primary molars with defective restorations Clinical trials are normally performed with well-known br and s of glass ionomer cement ( GIC ) , but the cost of these material s is high for public healthcare in less-affluent communities . Given the need to research cheaper material s , it seems pertinent to investigate the retention rate of a low-cost GIC applied as atraumatic restorative treatment ( ART ) sealants in two centers in Brazil . Four hundred and thirty-seven 6-to-8-year-old schoolchildren were selected in two cities in Brazil . The children were r and omly divided into two groups , according to the tested GIC applied in the first permanent molars . The retention rate was evaluated after 3 , 6 and 12 months . Kaplan-Meier survival analysis and the log-rank test were performed . The variables were tested for association with sealant longevity , using logistic regression analyses ( α = 5 % ) . The retention rate of sealants after 12 months was 19.1 % . The high-cost GIC br and presented a 2-fold-more-likely-to-survive rate than the low-cost br and ( p < 0.001 ) . Significant difference was also found between the cities where the treatments were performed , in that Barueri presented a higher sealant survival rate than Recife ( p < 0.001 ) . The retention rate of a low-cost GIC sealant br and was markedly lower than that of a well-known GIC sealant br and Objectives This study aim ed to test the hypothesis that there is no difference in the survival rates of molars treated according to the conventional restorative treatment ( CRT ) using amalgam , atraumatic restorative treatment ( ART ) using high-viscosity glass ionomer , and ultraconservative treatment ( UCT ) protocol after 3.5 years . Material s and methods Cavitated primary molars were treated according to CRT , ART , and UCT ( small cavities were restored with ART and medium/large cavities were daily cleaned with toothpaste/toothbrush under supervision ) . Molar extraction s result ing from toothache , sepsis , or pulp exposure were failures . The Kaplan – Meier method was used to estimate the survival curves . Results The numbers of treated teeth , among the 302 6–7-year-old children , were 341 ( CRT ) , 244 ( ART ) , and 281 ( for UCT group : 109 small ART , 166 open cavities , and 6 combinations ) . Protocol groups were similar at baseline regarding gender and mean decayed missing filled tooth score , but not regarding age and type of surface . The numbers of molars extracted were 22 ( CRT ) , 16 ( ART ) , and 26 ( UCT ) . Fistulae were most often recorded . After 3.5 years , the cumulative survival rate ± st and ard error for all molars treated was 90.9 ± 2.0 % with CRT , 90.4 ± 2.4 % with ART , and 88.6 ± 1.9 % with UCT ( p = 0.13 ) . Only a type of surface effect was observed over the 3.5-year period : survival rates for molars were higher for single- than for multiple-surface cavities . Conclusion There was no difference in the cumulative survival rates of primary molars treated according to the CRT , ART , and UCT protocol s over a 3.5-year period . Clinical relevance Keeping cavities in primary molars biofilm-free might be another treatment option alongside restoring such cavities through conventional and ART protocol The aim was to test the null-hypothesis that there is no difference in the cumulative survival rate of retained composite resin ( CR ) sealants and a high-viscosity glass-ionomer Atraumatic Restorative Treatment ( ART ) sealant in first permanent molars calculated according to the traditional and the modified retention assessment criteria over a period of 3 years . This cluster-r and omized controlled clinical trial consisted of 123 schoolchildren , 6 - 7-years-old . At baseline , high-caries risk pits and fissures of fully erupted first permanent molars were treated with CR and ART sealants . Evaluations were performed after 0.5 , 1 , 2 and 3 years . Retention was scored for free-smooth surface and for each of three sections into which the occlusal surface had been divided . The modified criterion differed from the traditional in that it determined an occlusal sealant to be a failure when at least one section contained no visible sealant material . Data were analysed according to the PHREG model with frailty correction , Wald-test , ANOVA and t-test , using the Jackknife procedure . The cumulative survival rates for retained CR and ART sealants in free-smooth and occlusal surfaces for both criteria were not statistically significantly different over the 3 years . A higher percentage of retained CR sealants on occlusal surfaces was observed at longer evaluations . Cumulative survival rates were statistically significantly lower for the modified criterion in comparison to the traditional . The modified retention assessment criterion should be used in future sealant-retention studies OBJECTIVES The aim of the present study was to investigate the caries-preventive effect of sealants produced with a high-viscosity glass-ionomer with an elevated powder-liquid ratio ( ART ) , of having energy added to this glass-ionomer , and that of glass-carbomer , in comparison to that of resin composite sealants . METHODS The r and omized controlled trial covered 407 children , with a mean age of 8 years . At a school compound three dentists placed sealants in pits and fissures of high caries-risk children . Evaluation by two independent evaluators was conducted after 0.5 , 1 and 2 years . The Kaplan-Meier survival method , ANOVA and t-test were used in analyzing the data . RESULTS 1352 first permanent molars were sealed . 6.6 % of children and 6.8 % of sealants dropped out within 2 years . 27 re-exposed pits and fissures , 20 in occlusal and 7 in smooth surfaces , in 25 children , developed a dentin carious lesion . The cumulative survival of dentin carious lesion-free pits and fissures in the  glass-carbomer sealant group was statistically significantly lower ( 97.4 % ) than those in the high-viscosity glass-ionomer with energy supplied ( 99 % ) and the resin-composite ( 98.9 % ) sealant groups . There was no statistically significant difference in the cumulative survival of dentin carious lesion-free pits and fissures , between the high-viscosity glass-ionomer with ( 99 % ) and without ( 98.3 % ) energy supplied sealant groups , after 2 years . SIGNIFICANCE The survival of dentin carious lesion-free pits and fissures was high in all sealant types . More dentin carious lesions were observed in the glass-carbomer sealant group OBJECTIVES To assess and compare the cumulative survival rate of amalgam and atraumatic restorative treatment ( ART ) restorations in primary molars over 3 years . METHODS 280 children aged 6 - 7 years old were enrolled in a cluster r and omized controlled clinical trial using a parallel group design covering two treatment groups : conventional restorative treatment with amalgam ( CRT ) and atraumatic restorative treatment ( ART ) using a high-viscosity glass-ionomer ( HVGIC ) Ketac Molar Easymix . Three pedodontists placed 750 restorations ( 364 amalgam and 386 ART in 126 and 154 children , respectively ) which were evaluated at 0.5 , 1 , 2 and 3 years . The proportional hazard rate regression model with frailty correction , ANOVA and Wald tests , and the Jackknife procedure were applied in analysing the data . RESULTS The cumulative survival rates over 3 years for all , single- and multiple-surface CRT/amalgam restorations ( 72.6 % , 93.4 % , 64.7 % , respectively ) were no different from those of comparable ART/HVGIC restorations ( 66.8 % ; 90.1 % and 56.4 % , respectively ) ( p=0.10 ) . Single-surface restorations had higher survival rates than multiple-surface restorations for the both treatment procedures ( p<0.0001 ) . A higher proportion of restorations failed because of mechanical reasons ( 94.8 % ) than of secondary caries ( 5.2 % ) . No difference in reasons for restoration failures between all types of amalgam and ART/HVGIC restorations were observed ( p=0.24 ) . SIGNIFICANCE The high-viscosity glass-ionomer used in this study in conjunction with the ART is a viable option for restoring carious dentin lesions in single surfaces in vital primary molars OBJECTIVE The purpose of this study was to investigate the remineralization activation of the application of three fissure sealants ( FSs ) , alone or with gaseous ozone ( GO ) , on non-cavitated initial caries and evaluate the clinical success of FS . STUDY DESIGN Sixty children who had DIAGNOdent scores between 10 - 30 on bilateral symmetric m and ibular first permanent molars were included in study . In a split-mouth design , teeth were assigned to experimental ( with GO ) and control ( without GO ) groups . GO was applied to teeth on one side and then the same br and of r and omly selected FSs was applied to the teeth on both sides . Children were divided into 3 groups based on type of FS ( Group 1 : Aegis { Bosworth Co , North Hamlin Avenue Skokie , Illinois , USA } , Group 2 : Fuji Triage { GC , Tokyo , Japan } , Group 3 : Helioseal { Iv 
    Output:
    