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: The aim of this study was to evaluate the effects of a proanthocyanidin-rich grape seed extract ( GSE ) on the in vitro demineralization of root dentine . Root fragments were obtained from sound human teeth . The fragments were r and omly assigned to different treatments solutions : GSE , fluoride ( F ) , GSE+F and distilled water ( control ) . Sample s were treated daily for 30 min and subjected to a pH cycling artificial caries protocol using demineralization cycles ( 2.2 mM CaCl2 × H2O , 2.2 mM KH2PO4 , 50 mM acetic acid , pH 4.3 ) for 6 h and remineralization cycles ( 20 mM HEPES , 2.25 mM CaCl2 × H2O , 1.35 mM KH2PO4 , 130 mM KCl , pH 7.0 ) for 17.5 h. Mineral loss ( ΔZ ) and lesion depth ( LD ) were determined after 18 days of treatment/pH cycling , by transverse microradiography . GSE was able to minimize ΔZ and LD compared with the control group ( p < 0.0001 ) . The GSE+F and F groups showed the lowest values of ΔZ and LD ( p < 0.05 ) , with no statistically significant differences between them ( p = 0.554 and p = 0.726 , respectively ) . A biomimetic approach to strengthen root dentine using GSE results in decreased rates of root demineralization and may be used in conjunction with F to prevent root caries Dental caries is considered a disease of high prevalence and a constant problem in public health . Proanthocyanidins ( PAs ) are substances that have been the target of recent studies aim ing to control or treat caries . Objective The aim of this in vitro study was to evaluate the efficacy of a treatment with grape seed extract , under cariogenic challenge , to minimize or even prevent the onset of caries in the enamel and dentin . Material and Methods Blocks of enamel and dentin ( 6.0x6.0 mm ) were obtained from bovine central incisors , polished , and selected by analysis of surface microhardness ( SH ) . The blocks were r and omly divided into 3 groups ( n=15 ) , according to the following treatments : GC ( control ) , GSE ( grape seed extract ) , GF ( fluoride – 1,000 ppm ) . The blocks were subjected to 6 daily pH cycles for 8 days . Within the daily cycling , the specimens were stored in buffered solution . The blocks were then analyzed for perpendicular and surface hardness and polarized light microscopy . Results The means were subjected to statistical analysis using the ANOVA and Fisher ’s PLSD tests ( p<0.05 ) . For enamel SH , GF showed the highest hardness values . In the dentin , GF was also the one that showed higher hardness values , followed by GSE . Regarding the cross-sectional hardness values , all groups behaved similarly in both the enamel and dentin . The sample s that were treated with GSE and fluoride ( GF ) showed statistically higher values than the control . Conclusion Based on the data obtained in this in vitro study , it is suggested that grape seed extract  inhibits demineralization of artificial carious lesions in both the enamel and dentin , but in a different scale in each structure and in a smaller scale when compared to fluoride The aim of this study was to evaluate the effects of UVA-activated riboflavin ( UVA-RF ) on the mechanical properties of non-demineralized human dentin . Dentin specimens obtained from 20 teeth were r and omly divided into the following four groups : group 1 ( control ) : no treatment , group 2 ( low UVA-RF ) : specimens were exposed to UVA-RF for 10 min , group 3 ( medium UVA-RF ) : specimens were exposed to UVA-RF for 30 min , and group 4 ( high UVA-RF ) : specimens were exposed to UVA-RF for 60 min . Three-point flexural test and Raman spectroscopic analyses were performed . The mean flexural strengths ( MPa ) were 129.96 , 128.96 , 144.21 , and 147.54 , and the mean elastic modulus ( GPa ) were 8.59 , 8.38 , 10.21 , and 9.87 for groups 1 to 4 , respectively . Raman spectra showed chemical modifications of dental collagen under medium and high UVA-RF treatment . We conclude that medium and high UVA-RF increases the strength of non-demineralized human dentin  by collagen crosslinking This study was undertaken to investigate whether using a protein cross-linker , 1-ethyl-3-(3-dimethylaminopropyl ) carbodiimide ( EDC ) , improves bonding stability of fiber posts to root dentin using three resin cements . Sixty human maxillary central incisor roots were r and omly divided into six groups after endodontic treatment , according to the cements used with and without EDC pretreatment . In the etch- and -rinse group , 0.3 M EDC aqueous solution was applied on acid-etched root dentin prior to Excite DSC/Variolink II for post cementation . In the self-etch and self-adhesive groups , EDC was used on EDTA-conditioned root space prior to application of ED Primer II/Panavia F2.0 and Clearfil SA , respectively . After microslicing the root dentin , a push-out bond strength ( BS ) test was performed immediately or after one-year of water storage for each group . Data were analyzed using three-way analysis of variance and Tukey tests ( α=0.05 ) . A significant effect of cement type , time , EDC , and Time × Cement and Time × EDC interactions were observed ( p≤0.001 ) . EDC pretreatment did not affect immediate bonding of the three cements ( p>0.05 ) . Aging significantly reduced the BS in all the groups ( p≤0.001 ) , but EDC groups exhibited a higher BS compared with the respective control groups ( p<0.001 ) . Despite the significant effect of aging on decreasing the BS of fiber post to radicular dentin , EDC could diminish this effect for the three tested cements ABSTRACT Objective Green tea extract has been advocated as a matrix metalloproteinase ( MMP ) inhibitor ; however , its effect on bond durability to caries-affected dentin has never been reported . Thus , the aim of this in vitro study was to evaluate the effect of two MMP inhibitors ( 2 % chlorhexidine and 2 % green tea extract ) , applied after acid etching , on bond durability of an etch- and -rinse adhesive system to caries-affected dentin . Material and Methods Occlusal enamel was removed from third molars to expose the dentin surface , and the molars were su bmi tted to a caries induction protocol for 15 days . After removal of infected dentin , specimens were conditioned with 37 % phosphoric acid ( 15 seconds ) and r and omly divided into three groups , according to the type of dentin pretreatment ( n=10 ) : NT : no treatment ; GT : 2 % green tea extract ; CLX : 2 % chlorhexidine . The etch- and -rinse adhesive system ( Adper ™ Single Bond 2 , 3 M ESPE , St. Paul , MN , USA ) was applied according to the manufacturer 's instructions , and composite resin restorations were built on the dentin . After 24 hours , at 37 ° C , the resin-tooth blocks were sectioned perpendicularly to the adhesive interface in the form of sticks ( 0.8 mm2 of adhesive area ) and r and omly subdivided into two groups according to when they were to be su bmi tted to microtensile bond strength ( μTBS ) testing : immediately or 6 months after storage in distilled water . Data were reported in MPa and su bmi tted to two-way ANOVA for completely r and omized blocks , followed by Tukey ’s test ( α=0.05 ) . Results After 24 hours , there was no significant difference in the μTBS of the groups . After 6 months , the GT group had significantly higher μTBS values . Conclusion It was concluded that the application of 2 % green tea extract was able to increase bond durability of the etch- and -rinse system to dentin . Neither the application of chlorhexidine nor non-treatment ( NT - control ) had any effect on bond strength after water storage Aim : To evaluate whether the application of two simplified etch- and -rinse adhesives to biomodified dentin using ethanol-wet bonding ( EWB ) and collagen cross-linker ( CCL ) pretreatment improves their sealing ability . Material s and Methods : In 176 extracted human molars , the pulp-chambers were deroofed , and teeth were sectioned horizontally . Sample s were r and omly divided into eight groups according to four bonding techniques using two simplified etch- and -rinse adhesives ; Adper Single Bond 2 ( ASB ) and XP Bond ( XPB ) . The bonding protocol s included : ( a ) Water-wet bonding ( WWB ) ; ( b ) EWB ; ( c ) WWB and CCL application ; ( d ) EWB and CCL application . After composite resin restorations , dye leakage evaluation and scanning electron microscope analysis were done . Leakage scores were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests at a significance level of P < 0.05 . Result : For both ASB and XPB adhesives , least dye leakage was observed in EWB groups ( b and d ) ( P = 0.918 and P = 0.399 respectively ) which showed no significant difference , while maximum leakage scores were seen in WWB groups ( a and c ) . Regardless of CCL application and adhesives used , EWB technique depicted ( P = 0.003 and P = 0.004 ) significantly greater sealing ability than WWB . Conclusion : Bonding of ASB and XPB using EWB significantly improved their sealing ability . Biomodification using CCL pretreatment had no significant effect on the sealing ability of adhesives bonded with either WWB or EWB PURPOSE To evaluate the effect of the inclusion of glutaraldehyde on the shear bond strength of new ethanol-based adhesives ( Gluma Comfort Bond & Desensitizer , GCBD and Gluma Comfort Bond , GCB ) versus acetone-based Gluma One Bond ( GOB ) and a conventional three-step adhesive as a control . MATERIAL S AND METHODS Forty bovine incisors were mounted in acrylic ,  polished  to 600-grit , and r and omly assigned to four groups ( n=10 ) . Dentin was etched for 15 s using 35 % phosphoric acid , rinsed , and lightly dried . After adhesive application and curing , Charisma composite was applied in a # 5 gelatin capsule and light-cured . Specimens were loaded in shear using an Instron at 5 mm/min . Shear bond strengths were calculated by dividing failure load by bonded surface area . ANOVA showed a significant difference in means at P < 0.01 , so Tukey 's test was used for pairwise comparisons . RESULTS Mean SBS ( + /- SD , MPa ) were : GOB : 8 (4.4)ab ; GCB : 10 (4.4)ab ; GCBD : 14 (6)bc ; SBMP : 17.7 (6.4)c . Superscript letters indicate Tukey 's homogeneous subsets ( P < 0.05 ) This study aim ed to evaluate the bonding strength and thermal properties of demineralized dentin with and without EDC treatment .  Sound human molars were r and omly divided into seven treatment groups ( n = 20 ) : control , 80 % ethanol , and five EDC ethanol solutions ( 0.01–1.0 M ) . In each group , 16 sample s were used for bond strength assessment and 4 sample s were used for scanning electron microscopy ( SEM ) analysis . A further 70 intact molars were used to obtain a fine demineralized dentin powder , treated with the same solutions and were evaluated the crosslink degree by ninhydrin test and denaturation temperature ( Td ) by differential scanning calorimetry . EDC-treated specimens ( < 1.0 M ) had a higher bond strength , especially 0.3 and 0.5 M group , than the control counterpart . There was a significant drop in bond strength of 1.0 M EDC group . SEM revealed a homogeneous and regular interface under all treatments . EDC treatment significantly increased the demineralized dentin cross-link degree and Td compared with the control and ethanol treatments . The 0.3 and 0.5 M treatments showed the highest cross-link degree and Td . In terms of mechnical and theramal properties consideration , 0.3 and 0.5 M EDC solutions may be favorable for when applied with etch- and -rinse adhesives , but it is still needed further long-term study BACKGROUND This study evaluated the synergistic effect of proanthocyanidin ( PA ) and casein phosphopeptide amorphous calcium fluoride phosphate ( CPP-ACFP ) on remineralization of artificial root caries . METHODS Demineralized root fragments ( n = 90 ) were r and omly divided into six groups based on treatments : ( 1 ) 6.5 % PA ; ( 2 ) CPP-ACP ; ( 3 ) CPP-ACFP ; ( 4 ) CPP-ACFP + 6.5 % PA ; ( 5 ) 1000 ppm fluoride ; and ( 6 ) deionized water ( control ) . Each specimen was immersed in demineralizing solution for 
    Output:
    
agent
Both synthetic and naturally derived crosslinkers have been found to exhibit significant effects in biomodification of dentine via their multiple interactions with the dentine matrix .
A stable matrix network or a durable hybrid layer in dentine bonding could be achieved , where the dentine collagen fibrils show improved biochemical and biomechanical properties and enzymatic biodegradation is reduced .
***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 aim of this study was to evaluate the effects of a proanthocyanidin-rich grape seed extract ( GSE ) on the in vitro demineralization of root dentine . Root fragments were obtained from sound human teeth . The fragments were r and omly assigned to different treatments solutions : GSE , fluoride ( F ) , GSE+F and distilled water ( control ) . Sample s were treated daily for 30 min and subjected to a pH cycling artificial caries protocol using demineralization cycles ( 2.2 mM CaCl2 × H2O , 2.2 mM KH2PO4 , 50 mM acetic acid , pH 4.3 ) for 6 h and remineralization cycles ( 20 mM HEPES , 2.25 mM CaCl2 × H2O , 1.35 mM KH2PO4 , 130 mM KCl , pH 7.0 ) for 17.5 h. Mineral loss ( ΔZ ) and lesion depth ( LD ) were determined after 18 days of treatment/pH cycling , by transverse microradiography . GSE was able to minimize ΔZ and LD compared with the control group ( p < 0.0001 ) . The GSE+F and F groups showed the lowest values of ΔZ and LD ( p < 0.05 ) , with no statistically significant differences between them ( p = 0.554 and p = 0.726 , respectively ) . A biomimetic approach to strengthen root dentine using GSE results in decreased rates of root demineralization and may be used in conjunction with F to prevent root caries Dental caries is considered a disease of high prevalence and a constant problem in public health . Proanthocyanidins ( PAs ) are substances that have been the target of recent studies aim ing to control or treat caries . Objective The aim of this in vitro study was to evaluate the efficacy of a treatment with grape seed extract , under cariogenic challenge , to minimize or even prevent the onset of caries in the enamel and dentin . Material and Methods Blocks of enamel and dentin ( 6.0x6.0 mm ) were obtained from bovine central incisors , polished , and selected by analysis of surface microhardness ( SH ) . The blocks were r and omly divided into 3 groups ( n=15 ) , according to the following treatments : GC ( control ) , GSE ( grape seed extract ) , GF ( fluoride – 1,000 ppm ) . The blocks were subjected to 6 daily pH cycles for 8 days . Within the daily cycling , the specimens were stored in buffered solution . The blocks were then analyzed for perpendicular and surface hardness and polarized light microscopy . Results The means were subjected to statistical analysis using the ANOVA and Fisher ’s PLSD tests ( p<0.05 ) . For enamel SH , GF showed the highest hardness values . In the dentin , GF was also the one that showed higher hardness values , followed by GSE . Regarding the cross-sectional hardness values , all groups behaved similarly in both the enamel and dentin . The sample s that were treated with GSE and fluoride ( GF ) showed statistically higher values than the control . Conclusion Based on the data obtained in this in vitro study , it is suggested that grape seed extract  inhibits demineralization of artificial carious lesions in both the enamel and dentin , but in a different scale in each structure and in a smaller scale when compared to fluoride The aim of this study was to evaluate the effects of UVA-activated riboflavin ( UVA-RF ) on the mechanical properties of non-demineralized human dentin . Dentin specimens obtained from 20 teeth were r and omly divided into the following four groups : group 1 ( control ) : no treatment , group 2 ( low UVA-RF ) : specimens were exposed to UVA-RF for 10 min , group 3 ( medium UVA-RF ) : specimens were exposed to UVA-RF for 30 min , and group 4 ( high UVA-RF ) : specimens were exposed to UVA-RF for 60 min . Three-point flexural test and Raman spectroscopic analyses were performed . The mean flexural strengths ( MPa ) were 129.96 , 128.96 , 144.21 , and 147.54 , and the mean elastic modulus ( GPa ) were 8.59 , 8.38 , 10.21 , and 9.87 for groups 1 to 4 , respectively . Raman spectra showed chemical modifications of dental collagen under medium and high UVA-RF treatment . We conclude that medium and high UVA-RF increases the strength of non-demineralized human dentin  by collagen crosslinking This study was undertaken to investigate whether using a protein cross-linker , 1-ethyl-3-(3-dimethylaminopropyl ) carbodiimide ( EDC ) , improves bonding stability of fiber posts to root dentin using three resin cements . Sixty human maxillary central incisor roots were r and omly divided into six groups after endodontic treatment , according to the cements used with and without EDC pretreatment . In the etch- and -rinse group , 0.3 M EDC aqueous solution was applied on acid-etched root dentin prior to Excite DSC/Variolink II for post cementation . In the self-etch and self-adhesive groups , EDC was used on EDTA-conditioned root space prior to application of ED Primer II/Panavia F2.0 and Clearfil SA , respectively . After microslicing the root dentin , a push-out bond strength ( BS ) test was performed immediately or after one-year of water storage for each group . Data were analyzed using three-way analysis of variance and Tukey tests ( α=0.05 ) . A significant effect of cement type , time , EDC , and Time × Cement and Time × EDC interactions were observed ( p≤0.001 ) . EDC pretreatment did not affect immediate bonding of the three cements ( p>0.05 ) . Aging significantly reduced the BS in all the groups ( p≤0.001 ) , but EDC groups exhibited a higher BS compared with the respective control groups ( p<0.001 ) . Despite the significant effect of aging on decreasing the BS of fiber post to radicular dentin , EDC could diminish this effect for the three tested cements ABSTRACT Objective Green tea extract has been advocated as a matrix metalloproteinase ( MMP ) inhibitor ; however , its effect on bond durability to caries-affected dentin has never been reported . Thus , the aim of this in vitro study was to evaluate the effect of two MMP inhibitors ( 2 % chlorhexidine and 2 % green tea extract ) , applied after acid etching , on bond durability of an etch- and -rinse adhesive system to caries-affected dentin . Material and Methods Occlusal enamel was removed from third molars to expose the dentin surface , and the molars were su bmi tted to a caries induction protocol for 15 days . After removal of infected dentin , specimens were conditioned with 37 % phosphoric acid ( 15 seconds ) and r and omly divided into three groups , according to the type of dentin pretreatment ( n=10 ) : NT : no treatment ; GT : 2 % green tea extract ; CLX : 2 % chlorhexidine . The etch- and -rinse adhesive system ( Adper ™ Single Bond 2 , 3 M ESPE , St. Paul , MN , USA ) was applied according to the manufacturer 's instructions , and composite resin restorations were built on the dentin . After 24 hours , at 37 ° C , the resin-tooth blocks were sectioned perpendicularly to the adhesive interface in the form of sticks ( 0.8 mm2 of adhesive area ) and r and omly subdivided into two groups according to when they were to be su bmi tted to microtensile bond strength ( μTBS ) testing : immediately or 6 months after storage in distilled water . Data were reported in MPa and su bmi tted to two-way ANOVA for completely r and omized blocks , followed by Tukey ’s test ( α=0.05 ) . Results After 24 hours , there was no significant difference in the μTBS of the groups . After 6 months , the GT group had significantly higher μTBS values . Conclusion It was concluded that the application of 2 % green tea extract was able to increase bond durability of the etch- and -rinse system to dentin . Neither the application of chlorhexidine nor non-treatment ( NT - control ) had any effect on bond strength after water storage Aim : To evaluate whether the application of two simplified etch- and -rinse adhesives to biomodified dentin using ethanol-wet bonding ( EWB ) and collagen cross-linker ( CCL ) pretreatment improves their sealing ability . Material s and Methods : In 176 extracted human molars , the pulp-chambers were deroofed , and teeth were sectioned horizontally . Sample s were r and omly divided into eight groups according to four bonding techniques using two simplified etch- and -rinse adhesives ; Adper Single Bond 2 ( ASB ) and XP Bond ( XPB ) . The bonding protocol s included : ( a ) Water-wet bonding ( WWB ) ; ( b ) EWB ; ( c ) WWB and CCL application ; ( d ) EWB and CCL application . After composite resin restorations , dye leakage evaluation and scanning electron microscope analysis were done . Leakage scores were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests at a significance level of P < 0.05 . Result : For both ASB and XPB adhesives , least dye leakage was observed in EWB groups ( b and d ) ( P = 0.918 and P = 0.399 respectively ) which showed no significant difference , while maximum leakage scores were seen in WWB groups ( a and c ) . Regardless of CCL application and adhesives used , EWB technique depicted ( P = 0.003 and P = 0.004 ) significantly greater sealing ability than WWB . Conclusion : Bonding of ASB and XPB using EWB significantly improved their sealing ability . Biomodification using CCL pretreatment had no significant effect on the sealing ability of adhesives bonded with either WWB or EWB PURPOSE To evaluate the effect of the inclusion of glutaraldehyde on the shear bond strength of new ethanol-based adhesives ( Gluma Comfort Bond & Desensitizer , GCBD and Gluma Comfort Bond , GCB ) versus acetone-based Gluma One Bond ( GOB ) and a conventional three-step adhesive as a control . MATERIAL S AND METHODS Forty bovine incisors were mounted in acrylic ,  polished  to 600-grit , and r and omly assigned to four groups ( n=10 ) . Dentin was etched for 15 s using 35 % phosphoric acid , rinsed , and lightly dried . After adhesive application and curing , Charisma composite was applied in a # 5 gelatin capsule and light-cured . Specimens were loaded in shear using an Instron at 5 mm/min . Shear bond strengths were calculated by dividing failure load by bonded surface area . ANOVA showed a significant difference in means at P < 0.01 , so Tukey 's test was used for pairwise comparisons . RESULTS Mean SBS ( + /- SD , MPa ) were : GOB : 8 (4.4)ab ; GCB : 10 (4.4)ab ; GCBD : 14 (6)bc ; SBMP : 17.7 (6.4)c . Superscript letters indicate Tukey 's homogeneous subsets ( P < 0.05 ) This study aim ed to evaluate the bonding strength and thermal properties of demineralized dentin with and without EDC treatment .  Sound human molars were r and omly divided into seven treatment groups ( n = 20 ) : control , 80 % ethanol , and five EDC ethanol solutions ( 0.01–1.0 M ) . In each group , 16 sample s were used for bond strength assessment and 4 sample s were used for scanning electron microscopy ( SEM ) analysis . A further 70 intact molars were used to obtain a fine demineralized dentin powder , treated with the same solutions and were evaluated the crosslink degree by ninhydrin test and denaturation temperature ( Td ) by differential scanning calorimetry . EDC-treated specimens ( < 1.0 M ) had a higher bond strength , especially 0.3 and 0.5 M group , than the control counterpart . There was a significant drop in bond strength of 1.0 M EDC group . SEM revealed a homogeneous and regular interface under all treatments . EDC treatment significantly increased the demineralized dentin cross-link degree and Td compared with the control and ethanol treatments . The 0.3 and 0.5 M treatments showed the highest cross-link degree and Td . In terms of mechnical and theramal properties consideration , 0.3 and 0.5 M EDC solutions may be favorable for when applied with etch- and -rinse adhesives , but it is still needed further long-term study BACKGROUND This study evaluated the synergistic effect of proanthocyanidin ( PA ) and casein phosphopeptide amorphous calcium fluoride phosphate ( CPP-ACFP ) on remineralization of artificial root caries . METHODS Demineralized root fragments ( n = 90 ) were r and omly divided into six groups based on treatments : ( 1 ) 6.5 % PA ; ( 2 ) CPP-ACP ; ( 3 ) CPP-ACFP ; ( 4 ) CPP-ACFP + 6.5 % PA ; ( 5 ) 1000 ppm fluoride ; and ( 6 ) deionized water ( control ) . Each specimen was immersed in demineralizing solution for 
    Output:
    