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: INTRODUCTION The aim of this trial was to compare clinical and radiographic success rates of direct pulp capping ( DPC ) using a novel bio material called Calcium Enriched Mixture ( CEM ) cement versus Mineral Trioxide Aggregate ( MTA ) in primary molar teeth . MATERIAL S AND METHODS In this r and omized clinical trial 42 deciduous molars in 21 patients who had at least two teeth requiring DPC , were treated . The enrolled patients were between 5 - 8 years . The molar teeth were r and omly divided into two experimental groups . Patients and operators were blinded . The teeth were anaesthetized , caries were removed and after pinpoint exposure of dental pulp , haemostasis was achieved . The exposure points were capped with MTA or CEM cement . All teeth were restored with amalgam . Patients were recalled for the 6-month follow up . Statistical analysis was carried out using McNemar test . RESULTS Thirty-eight teeth were available for follow up ( 19 in each group ) . The radiographic evaluations did not show failure in experimental groups ; however , in clinical examinations one sinus tract was found in CEM cement group . Clinical success rates in CEM cement and MTA groups were 94.8 % and 100 % , respectively . Dentinal bridge formation was not observed in the two experimental groups . CONCLUSION There is no significant difference between treatment outcomes of direct pulp capping with either CEM cement or MTA ; therefore , both bio material s can be used successfully for DPC in primary molar teeth Introduction The aim of this r and omized controlled trial was to compare the radiographic and clinical success rates of direct pulp capping ( DPC ) using ProRoot mineral trioxide aggregate ( MTA ) or calcium enriched mixture ( CEM ) . Methods and Material s A total of 42 symptom-free carious vital primary molars ( 21 pairs ) were selected in this split mouth trial and r and omly pulpotomized in two experimental groups . Pinpoint pulp exposures were covered by the same blinded operator with MTA or CEM , and then restored by amalgam .  Radiographic and clinical successes were evaluated at 20 month follow-up . Data were statistically analyzed using McNemar test . Results Nineteen patients were available for 20-month follow-up ; only one failed tooth was extracted in the CEM group . All available teeth were symptom-free , however , the final evaluated success rate was 89 % in CEM ( CI 95 % : 0.82 - 0.96 ) and 95 % in MTA ( CI 95 % : 0.85 - 1 ) groups without statistical difference ( P=0.360 ) . Worst case scenario was applied for missing value analysis ; assuming that the 2 lost cases in CEM group had failed and the only lost case in MTA group was due to treatment success , as a result the success of CEM and MTA were 81 % ( CI 95 % : 0.72 - 0.90 ) and 95 % ( CI 95%:0.85 - 1 ) , respectively , with no statistical difference ( P=0.078 ) . In the reverse scenario , the success of MTA and CEM were 86 % ( CI 95 % : 0.78 - 0.94 ) and 90 % ( CI 95 % : 0.82 - 0.98 ) , respectively ; again with no statistical difference ( P=0.479 ) . Conclusion Effectiveness of MTA and CEM bio material s for primary molars ’ DPC was similar ; CEM can be a suitable alternative for MTA AIM To evaluate the clinical and radiological response of primary molars to direct pulp capping with calcium sulfate hemihydrate . MATERIAL S AND METHODS Forty primary molar teeth in 40 healthy children aged 5 - 9 years were treated by direct pulp capping . Teeth were r and omly assigned to two groups ( n=20 ) according to material used for capping , as follows : Group 1 : calcium hydroxide cement ( Dycal ) ; Group 2 : calcium sulfate hemihydrate ( Dentogen ) . All teeth were restored with a conventional glass ionomer base ( Fuji IX ) and amalgam . RESULTS After 12 months , the overall success rate of direct pulp capping was approximately 75 % ( 24/32 teeth , excluding exfoliations ) . The success rate did not differ significantly between calcium hydroxide and calcium sulfate hemihydrate treatment . CONCLUSION Calcium sulfate hemihydrate was found to be as successful as calcium hydroxide for direct pulp capping of primary molars with Class I cavities . Further histological studies are needed to support these findings Blinding embodies a rich history spanning over two centuries . Most research ers worldwide underst and blinding terminology , but confusion lurks beyond a general comprehension . Terms such as single blind , double blind , and triple blind mean different things to different people . Moreover , many medical research ers confuse blinding with allocation concealment . Such confusion indicates misunderst and ings of both . The term blinding refers to keeping trial participants , investigators ( usually health-care providers ) , or assessors ( those collecting outcome data ) unaware of the assigned intervention , so that they will not be influenced by that knowledge . Blinding usually reduces differential assessment of outcomes ( information bias ) , but can also improve compliance and retention of trial participants while reducing biased supplemental care or treatment ( sometimes called co-intervention ) . Many investigators and readers naïvely consider a r and omised trial as high quality simply because it is double blind , as if double-blinding is the sine qua non of a r and omised controlled trial . Although double blinding ( blinding investigators , participants , and outcome assessors ) indicates a strong design , trials that are not double blinded should not automatically be deemed inferior . Rather than solely relying on terminology like double blinding , research ers should explicitly state who was blinded , and how . We recommend placing greater credence in results when investigators at least blind outcome assessment s , except with objective outcomes , such as death , which leave little room for bias . If investigators properly report their blinding efforts , readers can judge them . Unfortunately , many articles do not contain proper reporting . If an article cl aims blinding without any accompanying clarification , readers should remain sceptical about its effect on bias reduction In r and omised controlled trials , allocation concealment ( separating the process of r and omisation from the recruitment of participants ) is important for rigorously design ed trials.1–4 In 1996 many major medical journals adopted the CONSORT statement ( whereby research ers have to include a short checklist of essential items and a flow diagram when reporting trials),5 and this move encouraged the reporting of allocation concealment . We review ed the prevalence of adequate allocation concealment and its association with the statistical significance of trial results . We search ed by h and four general medical journals ( the BMJ , JAMA , the Lancet , and the New Engl and Journal of Medicine ) to identify r and omised controlled trials published from January 2002 to December 2002 . We included articles if the authors reported that participants were r and omised and if the trial was published as a full report with the results of the main analyses . We categorised articles according to whether allocation concealment was adequate ( the person who executed the allocation sequence was different from the person who recruited PURPOSE To evaluate the clinical , radiographical and histological findings in human third molars in which mechanical pulp exposures were capped with white ProRoot mineral trioxide aggregate ( WMTA ) . METHODS Forty-eight human third molars , caries-free or with incipient caries , scheduled to be extracted , were used and r and omly divided into two groups : Group A : ( n= 24 ) received WMTA and control Group B : ( n= 24 ) received chemical set calcium hydroxide ( Dycal ) . The teeth were isolated with rubber dam and Class I cavities prepared . Pulp exposure was performed using a sterile diamond bur and confirmed by frank bleeding . A sterile cotton pellet dipped in saline solution was placed over the exposure for 60 seconds . The preparation was then lightly rinsed with water and gently air-dried . WMTA or CH was placed over the exposure site followed by a small amount of a light-cured compomer . After etching with 35 % phosphoric acid gel for 15 seconds , rinsing and blot drying , Prime and Bond NT adhesive was applied and light-cured . The cavity was then restored with a resin composite and light-cured . Evaluations were performed by phone after 7 days and clinical ly at 30 + /- 5 and 136 + /- 24 days , using st and ardized tests and radiographs . The teeth were extracted after 136 + /- 24 days ; the roots were cut + /- 4 - 5 mm from the apex to allow for rapid fixation in 10 % neutral buffered formalin . They were then processed for routine histological evaluation , embedded in paraffin , sectioned and stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria . Statistical analyses were performed using a Mann-Whitney U-test , a Chi-square test , a Fisher 's exact test and an ANOVA . RESULTS No significant differences in post-operative sensitivity were reported after 7 days between the two material s ( P > 0.05 ) . Clinical examination demonstrated no significant differences at 30 + /- 5 days ( P > 0.05 ) and at 136 + /- 24 days ( P > 0.05 ) . Histological findings : 45 of 48 teeth were suitable for microscopic evaluation ( 22 with WMTA and 23 with CH ) . Twenty from the WMTA and 18 from the CH group had developed a bridge . No statistically significant differences were found for superficial and deep inflammatory cell response ( P > 0.05 ) , presence of a dentin bridge ( P > 0.01 ) , and pulp vitality ( P > 0.01 ) , between WMTA and calcium hydroxide . A statistically significant difference was found for the diameter of exposure ( P < or = 0.05 ) between WMTA ( x= 0.35 + /- 0.19 mm ) and CH ( x= 0.25 + /- 0.09 mm ) . Only a minimal association between clinical and histological findings could be established for either material PURPOSE To evaluate , prospect ively , the clinical and radiological response of primary molars , pulp-capped with calcium hydroxide and different adhesive systems  after hemorrhage control with 1.25 % sodium hypochlorite ( NaOCl ) . METHODS 100 primary molar teeth were pulp-capped in 67 children who met inclusion criteria . Hemorrhage at the exposure site was controlled with 60 seconds application of 1.25 % NaOCl . Teeth were r and omly assigned into five groups ( n=20 each ) with respect to the material /technique used for capping : ( 1 ) calcium hydroxide cement ( Dycal ) ; ( 2 ) acetone-based total-etch adhesive ( Prime&Bond NT ) ; ( 3 ) a non-rinse conditioner ( NRC ) and Prime&Bond NT ; ( 4 ) total-etching with 36 % phosphoric acid followed by Prime&Bond NT ; and ( 5 ) a self-etch adhesive system ( Xeno III ) . Teeth in Group 1 were restored with amalgam and Groups 2 - 5 with polyacid-modified resin-based composite ( Dyract AP ) . The teeth were evaluated clinical ly and radiographically for 24 months . Marginal integrity of the restorations was also recorded at recall periods using modified USPHS/Ryge criteria . RESULTS After 2 years , the overall success rate of direct pulp capping was approximately 93 % ( 78/84 teeth , excluding exfoliations ) . The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure . A majority of failures were observed in teeth that received NRC and phosphoric acid pretreatments ( Groups 3 and 4 ) . Clinical symptoms were seldom associated with failed teeth . Only one tooth failed in the Xeno III group . Marginal integrity scores were not compatible with the clinical / radiographic outcome This practice -based , r and omized clinical trial evaluated and compared the success of direct pulp capping in permanent teeth with MTA ( mineral trioxide aggregate ) or CaOH ( calcium hydroxide ) .  Thirty-five practice s in Northwest PRECEDENT were r and omized to perform direct pulp caps with either CaOH ( 16 practice s ) or MTA ( 19 practice s ) . Three hundred seventy-six individuals received a direct pulp cap with CaOH ( n = 181 ) or MTA ( n = 195 ) . They were followed for up to 2 yrs at regular recall appointments , or as dictated by tooth symptoms . The primary outcomes were the need for extraction or root canal therapy . Teeth were also evaluated for pulp vitality , and radiographs were taken at the dentist ’s discretion . The probability of failure at 24 mos was 31.5 % for CaOH vs. 19.7 % for MTA ( permutation log-rank test , p = .046 ) . This large r and omized clinical trial provided confirmatory evidence for a superior performance with MTA as a direct pulp-capping agent as compared with CaOH when evaluated in a practice -based research network for up to 2 yrs ( Clinical Trials.gov NCT00812887 ) The purpose of this study was to evaluate polymicrobial coronal leakage of mineral trioxide aggregate ( MTA ) and  amalgam . There were 108 single-rooted teeth r and omly divided into 3 groups of 32 teeth each and positive and negative control groups of 6 teeth and obturated with gutta percha and either Diaket ( 3M/ESPE , Seefeld , Germany ) , AH Plus ( Dentsply , De Trey , Konstanz , Germany ) , or Ketac Endo ( 3M/ESPE ) . These 
    Output:
    
agent
No firm evidence was reached according to trial sequential analysis .
Conclusion There is insufficient data to recommend or refute the use of a specific material .
***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: INTRODUCTION The aim of this trial was to compare clinical and radiographic success rates of direct pulp capping ( DPC ) using a novel bio material called Calcium Enriched Mixture ( CEM ) cement versus Mineral Trioxide Aggregate ( MTA ) in primary molar teeth . MATERIAL S AND METHODS In this r and omized clinical trial 42 deciduous molars in 21 patients who had at least two teeth requiring DPC , were treated . The enrolled patients were between 5 - 8 years . The molar teeth were r and omly divided into two experimental groups . Patients and operators were blinded . The teeth were anaesthetized , caries were removed and after pinpoint exposure of dental pulp , haemostasis was achieved . The exposure points were capped with MTA or CEM cement . All teeth were restored with amalgam . Patients were recalled for the 6-month follow up . Statistical analysis was carried out using McNemar test . RESULTS Thirty-eight teeth were available for follow up ( 19 in each group ) . The radiographic evaluations did not show failure in experimental groups ; however , in clinical examinations one sinus tract was found in CEM cement group . Clinical success rates in CEM cement and MTA groups were 94.8 % and 100 % , respectively . Dentinal bridge formation was not observed in the two experimental groups . CONCLUSION There is no significant difference between treatment outcomes of direct pulp capping with either CEM cement or MTA ; therefore , both bio material s can be used successfully for DPC in primary molar teeth Introduction The aim of this r and omized controlled trial was to compare the radiographic and clinical success rates of direct pulp capping ( DPC ) using ProRoot mineral trioxide aggregate ( MTA ) or calcium enriched mixture ( CEM ) . Methods and Material s A total of 42 symptom-free carious vital primary molars ( 21 pairs ) were selected in this split mouth trial and r and omly pulpotomized in two experimental groups . Pinpoint pulp exposures were covered by the same blinded operator with MTA or CEM , and then restored by amalgam .  Radiographic and clinical successes were evaluated at 20 month follow-up . Data were statistically analyzed using McNemar test . Results Nineteen patients were available for 20-month follow-up ; only one failed tooth was extracted in the CEM group . All available teeth were symptom-free , however , the final evaluated success rate was 89 % in CEM ( CI 95 % : 0.82 - 0.96 ) and 95 % in MTA ( CI 95 % : 0.85 - 1 ) groups without statistical difference ( P=0.360 ) . Worst case scenario was applied for missing value analysis ; assuming that the 2 lost cases in CEM group had failed and the only lost case in MTA group was due to treatment success , as a result the success of CEM and MTA were 81 % ( CI 95 % : 0.72 - 0.90 ) and 95 % ( CI 95%:0.85 - 1 ) , respectively , with no statistical difference ( P=0.078 ) . In the reverse scenario , the success of MTA and CEM were 86 % ( CI 95 % : 0.78 - 0.94 ) and 90 % ( CI 95 % : 0.82 - 0.98 ) , respectively ; again with no statistical difference ( P=0.479 ) . Conclusion Effectiveness of MTA and CEM bio material s for primary molars ’ DPC was similar ; CEM can be a suitable alternative for MTA AIM To evaluate the clinical and radiological response of primary molars to direct pulp capping with calcium sulfate hemihydrate . MATERIAL S AND METHODS Forty primary molar teeth in 40 healthy children aged 5 - 9 years were treated by direct pulp capping . Teeth were r and omly assigned to two groups ( n=20 ) according to material used for capping , as follows : Group 1 : calcium hydroxide cement ( Dycal ) ; Group 2 : calcium sulfate hemihydrate ( Dentogen ) . All teeth were restored with a conventional glass ionomer base ( Fuji IX ) and amalgam . RESULTS After 12 months , the overall success rate of direct pulp capping was approximately 75 % ( 24/32 teeth , excluding exfoliations ) . The success rate did not differ significantly between calcium hydroxide and calcium sulfate hemihydrate treatment . CONCLUSION Calcium sulfate hemihydrate was found to be as successful as calcium hydroxide for direct pulp capping of primary molars with Class I cavities . Further histological studies are needed to support these findings Blinding embodies a rich history spanning over two centuries . Most research ers worldwide underst and blinding terminology , but confusion lurks beyond a general comprehension . Terms such as single blind , double blind , and triple blind mean different things to different people . Moreover , many medical research ers confuse blinding with allocation concealment . Such confusion indicates misunderst and ings of both . The term blinding refers to keeping trial participants , investigators ( usually health-care providers ) , or assessors ( those collecting outcome data ) unaware of the assigned intervention , so that they will not be influenced by that knowledge . Blinding usually reduces differential assessment of outcomes ( information bias ) , but can also improve compliance and retention of trial participants while reducing biased supplemental care or treatment ( sometimes called co-intervention ) . Many investigators and readers naïvely consider a r and omised trial as high quality simply because it is double blind , as if double-blinding is the sine qua non of a r and omised controlled trial . Although double blinding ( blinding investigators , participants , and outcome assessors ) indicates a strong design , trials that are not double blinded should not automatically be deemed inferior . Rather than solely relying on terminology like double blinding , research ers should explicitly state who was blinded , and how . We recommend placing greater credence in results when investigators at least blind outcome assessment s , except with objective outcomes , such as death , which leave little room for bias . If investigators properly report their blinding efforts , readers can judge them . Unfortunately , many articles do not contain proper reporting . If an article cl aims blinding without any accompanying clarification , readers should remain sceptical about its effect on bias reduction In r and omised controlled trials , allocation concealment ( separating the process of r and omisation from the recruitment of participants ) is important for rigorously design ed trials.1–4 In 1996 many major medical journals adopted the CONSORT statement ( whereby research ers have to include a short checklist of essential items and a flow diagram when reporting trials),5 and this move encouraged the reporting of allocation concealment . We review ed the prevalence of adequate allocation concealment and its association with the statistical significance of trial results . We search ed by h and four general medical journals ( the BMJ , JAMA , the Lancet , and the New Engl and Journal of Medicine ) to identify r and omised controlled trials published from January 2002 to December 2002 . We included articles if the authors reported that participants were r and omised and if the trial was published as a full report with the results of the main analyses . We categorised articles according to whether allocation concealment was adequate ( the person who executed the allocation sequence was different from the person who recruited PURPOSE To evaluate the clinical , radiographical and histological findings in human third molars in which mechanical pulp exposures were capped with white ProRoot mineral trioxide aggregate ( WMTA ) . METHODS Forty-eight human third molars , caries-free or with incipient caries , scheduled to be extracted , were used and r and omly divided into two groups : Group A : ( n= 24 ) received WMTA and control Group B : ( n= 24 ) received chemical set calcium hydroxide ( Dycal ) . The teeth were isolated with rubber dam and Class I cavities prepared . Pulp exposure was performed using a sterile diamond bur and confirmed by frank bleeding . A sterile cotton pellet dipped in saline solution was placed over the exposure for 60 seconds . The preparation was then lightly rinsed with water and gently air-dried . WMTA or CH was placed over the exposure site followed by a small amount of a light-cured compomer . After etching with 35 % phosphoric acid gel for 15 seconds , rinsing and blot drying , Prime and Bond NT adhesive was applied and light-cured . The cavity was then restored with a resin composite and light-cured . Evaluations were performed by phone after 7 days and clinical ly at 30 + /- 5 and 136 + /- 24 days , using st and ardized tests and radiographs . The teeth were extracted after 136 + /- 24 days ; the roots were cut + /- 4 - 5 mm from the apex to allow for rapid fixation in 10 % neutral buffered formalin . They were then processed for routine histological evaluation , embedded in paraffin , sectioned and stained with hematoxylin and eosin and Brown and Brenn for recognition of bacteria . Statistical analyses were performed using a Mann-Whitney U-test , a Chi-square test , a Fisher 's exact test and an ANOVA . RESULTS No significant differences in post-operative sensitivity were reported after 7 days between the two material s ( P > 0.05 ) . Clinical examination demonstrated no significant differences at 30 + /- 5 days ( P > 0.05 ) and at 136 + /- 24 days ( P > 0.05 ) . Histological findings : 45 of 48 teeth were suitable for microscopic evaluation ( 22 with WMTA and 23 with CH ) . Twenty from the WMTA and 18 from the CH group had developed a bridge . No statistically significant differences were found for superficial and deep inflammatory cell response ( P > 0.05 ) , presence of a dentin bridge ( P > 0.01 ) , and pulp vitality ( P > 0.01 ) , between WMTA and calcium hydroxide . A statistically significant difference was found for the diameter of exposure ( P < or = 0.05 ) between WMTA ( x= 0.35 + /- 0.19 mm ) and CH ( x= 0.25 + /- 0.09 mm ) . Only a minimal association between clinical and histological findings could be established for either material PURPOSE To evaluate , prospect ively , the clinical and radiological response of primary molars , pulp-capped with calcium hydroxide and different adhesive systems  after hemorrhage control with 1.25 % sodium hypochlorite ( NaOCl ) . METHODS 100 primary molar teeth were pulp-capped in 67 children who met inclusion criteria . Hemorrhage at the exposure site was controlled with 60 seconds application of 1.25 % NaOCl . Teeth were r and omly assigned into five groups ( n=20 each ) with respect to the material /technique used for capping : ( 1 ) calcium hydroxide cement ( Dycal ) ; ( 2 ) acetone-based total-etch adhesive ( Prime&Bond NT ) ; ( 3 ) a non-rinse conditioner ( NRC ) and Prime&Bond NT ; ( 4 ) total-etching with 36 % phosphoric acid followed by Prime&Bond NT ; and ( 5 ) a self-etch adhesive system ( Xeno III ) . Teeth in Group 1 were restored with amalgam and Groups 2 - 5 with polyacid-modified resin-based composite ( Dyract AP ) . The teeth were evaluated clinical ly and radiographically for 24 months . Marginal integrity of the restorations was also recorded at recall periods using modified USPHS/Ryge criteria . RESULTS After 2 years , the overall success rate of direct pulp capping was approximately 93 % ( 78/84 teeth , excluding exfoliations ) . The Dycal and Prime&Bond NT groups did not exhibit any clinical or radiographic failure . A majority of failures were observed in teeth that received NRC and phosphoric acid pretreatments ( Groups 3 and 4 ) . Clinical symptoms were seldom associated with failed teeth . Only one tooth failed in the Xeno III group . Marginal integrity scores were not compatible with the clinical / radiographic outcome This practice -based , r and omized clinical trial evaluated and compared the success of direct pulp capping in permanent teeth with MTA ( mineral trioxide aggregate ) or CaOH ( calcium hydroxide ) .  Thirty-five practice s in Northwest PRECEDENT were r and omized to perform direct pulp caps with either CaOH ( 16 practice s ) or MTA ( 19 practice s ) . Three hundred seventy-six individuals received a direct pulp cap with CaOH ( n = 181 ) or MTA ( n = 195 ) . They were followed for up to 2 yrs at regular recall appointments , or as dictated by tooth symptoms . The primary outcomes were the need for extraction or root canal therapy . Teeth were also evaluated for pulp vitality , and radiographs were taken at the dentist ’s discretion . The probability of failure at 24 mos was 31.5 % for CaOH vs. 19.7 % for MTA ( permutation log-rank test , p = .046 ) . This large r and omized clinical trial provided confirmatory evidence for a superior performance with MTA as a direct pulp-capping agent as compared with CaOH when evaluated in a practice -based research network for up to 2 yrs ( Clinical Trials.gov NCT00812887 ) The purpose of this study was to evaluate polymicrobial coronal leakage of mineral trioxide aggregate ( MTA ) and  amalgam . There were 108 single-rooted teeth r and omly divided into 3 groups of 32 teeth each and positive and negative control groups of 6 teeth and obturated with gutta percha and either Diaket ( 3M/ESPE , Seefeld , Germany ) , AH Plus ( Dentsply , De Trey , Konstanz , Germany ) , or Ketac Endo ( 3M/ESPE ) . These 
    Output:
    