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: OBJECTIVES The objective was to evaluate the response of human pulps capped with different components from a total-etch three-step adhesive system . METHODS Direct pulp capping was performed in 25 caries-free human premolars scheduled for extraction due to orthodontic treatment . The teeth were r and omly divided in five groups , and capped with the following material s : Group 1-acid+primer+adhesive were used as recommended ; Group 2-only primer was applied ; Group 3-only bonding resin ( light-cured for 10s ) ; Group 4-only composite resin ( light-cured for 40s ) ; Group 5-calcium hydroxide . After capping , all teeth were restored with ScotchBond Multi Purpose Plus and Z-100 was placed incrementally . After 60 days , the teeth were extracted and processed for light microscopic examination ( H/E ) according to a histological score system . These were subjected to non-parametric tests ( alpha<0.05 ) . RESULTS Overall , the histological features showed that groups 1 - 4 were quite similar and inferior to group 5 . In groups 1 - 4 the pulp response varied from acute inflammatory cell infiltrate with varying degrees to necrosis . The groups 3 and 4 showed a trend towards better pulp response , since a normal connective tissue could be observed in more than half of the sample . All teeth from group 5 showed normal connective tissue below an amorphous dentin bridge . SIGNIFICANCE Adhesive components ( primer or adhesive ) as well as a composite should be avoided for pulp capping . Ca(OH)(2 ) should be the first choice for pulp capping 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 AIM To characterize the hard tissue formed in human teeth experimentally pulp capped either with calcium hydroxide or with Emdogain Gel  ( Biora AB , Malmö , Sweden ) - a derivative of enamel matrix ( EMD ) , using two markers for dentine ; dentine sialoprotein ( DSP ) and type 1 collagen ( Col I ) . METHODOLOGY Affinity-purified rabbit anti-Col I and anti-DSP polyclonal antibodies were used to stain histological sections from nine pairs of contra-lateral premolars that had been experimentally pulp amputated and r and omly capped with EMDgel or calcium hydroxide .  Twelve weeks after the teeth had been pulp capped , they were extracted , fixed , demineralized and serially sectioned prior to immunohistochemical staining . RESULTS In the calcium hydroxide treated teeth DSP was seen in the new hard tissue which formed a bridge . DSP was also seen in the newly formed hard tissue in the EMDgel-treated teeth . Proliferated pulp tissue partly filled the space initially occupied by EMDgel and DSP-stained hard tissue was observed alongside exposed dentine surfaces as well as in isolated masses within the proliferated pulp tissue , although the new hard tissue did not cover the pulp exposure . DSP staining was also seen in the cells lining the hard tissue in both groups . Col I staining was seen in the newly formed hard tissue in both groups . CONCLUSIONS The new hard tissue formed after pulp capping with EMDgel or calcium hydroxide contained DSP and Col I , considered to be markers for dentine . Thus , the newly formed hard tissue can be characterized as dentine rather than unspecific hard tissue Objective . This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system . Methods . Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated . The pulps of 22 teeth were mechanically exposed and r and omly assigned to 1 of 2 groups : Single Bond Universal or calcium hydroxide . Another group of 6 teeth acted as the intact control group . The periapical response was assayed , and a clinical examination was performed . The teeth were extracted after 6 weeks , and a histological analysis was performed . The pulp status was assessed , and the thickness of the dentin bridge was measured and categorized using a histological scoring system . Results . The clinical phase was asymptomatic for Single Bond Universal patients . Patients in the calcium hydroxide group reported mild symptoms of pain , although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth . The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis ( P > 0.05 ) and a significantly weaker thin mineralized tissue layer ( P < 0.001 ) compared with the calcium hydroxide group . Conclusion . The results suggest that Single Bond Universal is inappropriate for human pulp capping ; however , further long-term studies are needed to determine the biocompatibility of this agent 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 ) Introduction Direct pulp capping treatment is intended to preserve pulp vitality , to avoid or retard root canal treatment , and , in cases with an open apex , to allow continued root development . Historically , calcium hydroxide ( CH ) was the gold st and ard material , but nowadays calcium silicate material s ( CSMs ) are displacing CH because of their high bioactivity , biocompatibility , sealing ability , and mechanical properties . However , more r and omized clinical trials are needed to confirm the appropriateness of CSMs as replacement material s for CH in direct pulp capping procedures . Methods A r and omized clinical trial was conducted that included 169 patients ( mean age , 11.3 years ) from the Maipo district ( Chile ) . The inclusion criterion was patients with 1 carious permanent tooth with pulpal exposure , a c and i date for a direct pulp capping procedure . The patients were r and omly allocated to one of the experimental groups ( CH , Biodentine , or mineral trioxide aggregate [ MTA ] ) . Clinical follow‐up examinations were performed at 1 week , 3 months , 6 months , and 1 year . The Fisher exact test was performed . Results At the follow‐up examination at 1 week , the patients showed 100 % clinical success . At 3 months , there was 1 failure in the CH group . At 6 months , there were 4 new failures ( 1 in the CH group and 3 in the MTA group ) . At 1 year , there was another failure in the CH group . There were no statistically significant differences among the experimental groups . Conclusions CSMs appear to be suitable material s to replace CH . Although no significant differences were found among the material s studied , Biodentine and MTA offered some advantages over CH . HighlightsThis trial compared the efficacy of calcium hydroxide , MTA , and Biodentine as pulp capping material s in young permanent molars . MTA and Biodentine are suitable material s to replace calcium hydroxide in pulp capping procedures .Pulp capping in carious teeth is a successful treatment when done under good clinical protocol At the present time , evidence -based , best practice s have yet to be established for maintaining the vitality of teeth by managing caries-associated pulp exposure in permanent teeth . In terms of biomechanical and esthetic considerations , pulp capping has proven to be more effective than root-canal therapy . Given the low success rate of conventional methods , new techniques , such as laser-assisted repairs , should be developed . The purpose of this study was to compare the effectiveness of conventional and diode laser-assisted methods  in direct pulp capping of carious teeth . Ten patients ranging in age from 12 to 40 were assigned r and omly to experimental and control groups in this clinical trial in which the participants ’ teeth were treated with different techniques , i.e. , conventional treatment and diode 808-nm , laser-assisted treatment . For each of these groups , five cases were chosen for treatment with the same method under rubber dam isolation . The data were analyzed by the runs test using SPSS software . The success rate was significantly different between conventional ( 60 % ) and diode 808-nm , laser-assisted ( 100 % ) groups after one year ( P > 0.05 ) . The laser-assisted procedure proved to be more effective than the  conventional technique in enhancing the outcomes of pulp-capping therapy in carious exposures AIM Pulp capping represents the boundary between conservative and endodontic therapy . The importance of this technique , which considerably improves the prognosis of the tooth , justifies the quest for new techniques and technologies : the most recent literature reports more predictable results ( approximately 90 % ) with cappings performed using laser of different wavelengths , compared to traditional procedures , which report a success rate of approximately 60 % . The purpose of this work is to assess the efficiency of laser technology combined with the use of a self-hardening calcium hydroxide base in pulp capping procedures performed on decayed permanent teeth . MATERIAL S AND METHODS This study was carried out on 34 patients , aged between 11 and 18 years ( average 14,5 ) who needed pulp cappings for deep caries affecting permanent teeth ( 8 front and 26 back ) . They were divided into three groups based on the operative protocol employed : traditional technique , laser-assisted technique using Er , Cr : YSGG lasers ( 2780 nm ) and laser assisted technique using Erbium : YAG lasers ( 2940 nm ) ; all patients were asked to return for follow-up visits ( anamnesis , vitality testing and intraoral x-ray ) scheduled at 1 , 3 , 6 , 12 months , 2 and 4 years ; other 30 cases on adult patients ( 19 to 40 years , average 27,1 ) , treated with the same methods , were used as control group . RESULTS Traditional technique group showed a success of 63 % ( adult control group 50 % ) ; Er , Cr : YSGG laser-assisted technique showed a success rate of 80 % ( adult 
    Output:
    
agent
Conclusions MTA cements have a higher success rate , with a lower inflammatory response and a more predictable hard dentin barrier formation  than calcium hydroxide cements .
However , there were no differences , in these parameters , when MTA cement was compared with tricalcium silicate cements .
Dental adhesives systems showed the lowest success rates
***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: OBJECTIVES The objective was to evaluate the response of human pulps capped with different components from a total-etch three-step adhesive system . METHODS Direct pulp capping was performed in 25 caries-free human premolars scheduled for extraction due to orthodontic treatment . The teeth were r and omly divided in five groups , and capped with the following material s : Group 1-acid+primer+adhesive were used as recommended ; Group 2-only primer was applied ; Group 3-only bonding resin ( light-cured for 10s ) ; Group 4-only composite resin ( light-cured for 40s ) ; Group 5-calcium hydroxide . After capping , all teeth were restored with ScotchBond Multi Purpose Plus and Z-100 was placed incrementally . After 60 days , the teeth were extracted and processed for light microscopic examination ( H/E ) according to a histological score system . These were subjected to non-parametric tests ( alpha<0.05 ) . RESULTS Overall , the histological features showed that groups 1 - 4 were quite similar and inferior to group 5 . In groups 1 - 4 the pulp response varied from acute inflammatory cell infiltrate with varying degrees to necrosis . The groups 3 and 4 showed a trend towards better pulp response , since a normal connective tissue could be observed in more than half of the sample . All teeth from group 5 showed normal connective tissue below an amorphous dentin bridge . SIGNIFICANCE Adhesive components ( primer or adhesive ) as well as a composite should be avoided for pulp capping . Ca(OH)(2 ) should be the first choice for pulp capping 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 AIM To characterize the hard tissue formed in human teeth experimentally pulp capped either with calcium hydroxide or with Emdogain Gel  ( Biora AB , Malmö , Sweden ) - a derivative of enamel matrix ( EMD ) , using two markers for dentine ; dentine sialoprotein ( DSP ) and type 1 collagen ( Col I ) . METHODOLOGY Affinity-purified rabbit anti-Col I and anti-DSP polyclonal antibodies were used to stain histological sections from nine pairs of contra-lateral premolars that had been experimentally pulp amputated and r and omly capped with EMDgel or calcium hydroxide .  Twelve weeks after the teeth had been pulp capped , they were extracted , fixed , demineralized and serially sectioned prior to immunohistochemical staining . RESULTS In the calcium hydroxide treated teeth DSP was seen in the new hard tissue which formed a bridge . DSP was also seen in the newly formed hard tissue in the EMDgel-treated teeth . Proliferated pulp tissue partly filled the space initially occupied by EMDgel and DSP-stained hard tissue was observed alongside exposed dentine surfaces as well as in isolated masses within the proliferated pulp tissue , although the new hard tissue did not cover the pulp exposure . DSP staining was also seen in the cells lining the hard tissue in both groups . Col I staining was seen in the newly formed hard tissue in both groups . CONCLUSIONS The new hard tissue formed after pulp capping with EMDgel or calcium hydroxide contained DSP and Col I , considered to be markers for dentine . Thus , the newly formed hard tissue can be characterized as dentine rather than unspecific hard tissue Objective . This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system . Methods . Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated . The pulps of 22 teeth were mechanically exposed and r and omly assigned to 1 of 2 groups : Single Bond Universal or calcium hydroxide . Another group of 6 teeth acted as the intact control group . The periapical response was assayed , and a clinical examination was performed . The teeth were extracted after 6 weeks , and a histological analysis was performed . The pulp status was assessed , and the thickness of the dentin bridge was measured and categorized using a histological scoring system . Results . The clinical phase was asymptomatic for Single Bond Universal patients . Patients in the calcium hydroxide group reported mild symptoms of pain , although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth . The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis ( P > 0.05 ) and a significantly weaker thin mineralized tissue layer ( P < 0.001 ) compared with the calcium hydroxide group . Conclusion . The results suggest that Single Bond Universal is inappropriate for human pulp capping ; however , further long-term studies are needed to determine the biocompatibility of this agent 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 ) Introduction Direct pulp capping treatment is intended to preserve pulp vitality , to avoid or retard root canal treatment , and , in cases with an open apex , to allow continued root development . Historically , calcium hydroxide ( CH ) was the gold st and ard material , but nowadays calcium silicate material s ( CSMs ) are displacing CH because of their high bioactivity , biocompatibility , sealing ability , and mechanical properties . However , more r and omized clinical trials are needed to confirm the appropriateness of CSMs as replacement material s for CH in direct pulp capping procedures . Methods A r and omized clinical trial was conducted that included 169 patients ( mean age , 11.3 years ) from the Maipo district ( Chile ) . The inclusion criterion was patients with 1 carious permanent tooth with pulpal exposure , a c and i date for a direct pulp capping procedure . The patients were r and omly allocated to one of the experimental groups ( CH , Biodentine , or mineral trioxide aggregate [ MTA ] ) . Clinical follow‐up examinations were performed at 1 week , 3 months , 6 months , and 1 year . The Fisher exact test was performed . Results At the follow‐up examination at 1 week , the patients showed 100 % clinical success . At 3 months , there was 1 failure in the CH group . At 6 months , there were 4 new failures ( 1 in the CH group and 3 in the MTA group ) . At 1 year , there was another failure in the CH group . There were no statistically significant differences among the experimental groups . Conclusions CSMs appear to be suitable material s to replace CH . Although no significant differences were found among the material s studied , Biodentine and MTA offered some advantages over CH . HighlightsThis trial compared the efficacy of calcium hydroxide , MTA , and Biodentine as pulp capping material s in young permanent molars . MTA and Biodentine are suitable material s to replace calcium hydroxide in pulp capping procedures .Pulp capping in carious teeth is a successful treatment when done under good clinical protocol At the present time , evidence -based , best practice s have yet to be established for maintaining the vitality of teeth by managing caries-associated pulp exposure in permanent teeth . In terms of biomechanical and esthetic considerations , pulp capping has proven to be more effective than root-canal therapy . Given the low success rate of conventional methods , new techniques , such as laser-assisted repairs , should be developed . The purpose of this study was to compare the effectiveness of conventional and diode laser-assisted methods  in direct pulp capping of carious teeth . Ten patients ranging in age from 12 to 40 were assigned r and omly to experimental and control groups in this clinical trial in which the participants ’ teeth were treated with different techniques , i.e. , conventional treatment and diode 808-nm , laser-assisted treatment . For each of these groups , five cases were chosen for treatment with the same method under rubber dam isolation . The data were analyzed by the runs test using SPSS software . The success rate was significantly different between conventional ( 60 % ) and diode 808-nm , laser-assisted ( 100 % ) groups after one year ( P > 0.05 ) . The laser-assisted procedure proved to be more effective than the  conventional technique in enhancing the outcomes of pulp-capping therapy in carious exposures AIM Pulp capping represents the boundary between conservative and endodontic therapy . The importance of this technique , which considerably improves the prognosis of the tooth , justifies the quest for new techniques and technologies : the most recent literature reports more predictable results ( approximately 90 % ) with cappings performed using laser of different wavelengths , compared to traditional procedures , which report a success rate of approximately 60 % . The purpose of this work is to assess the efficiency of laser technology combined with the use of a self-hardening calcium hydroxide base in pulp capping procedures performed on decayed permanent teeth . MATERIAL S AND METHODS This study was carried out on 34 patients , aged between 11 and 18 years ( average 14,5 ) who needed pulp cappings for deep caries affecting permanent teeth ( 8 front and 26 back ) . They were divided into three groups based on the operative protocol employed : traditional technique , laser-assisted technique using Er , Cr : YSGG lasers ( 2780 nm ) and laser assisted technique using Erbium : YAG lasers ( 2940 nm ) ; all patients were asked to return for follow-up visits ( anamnesis , vitality testing and intraoral x-ray ) scheduled at 1 , 3 , 6 , 12 months , 2 and 4 years ; other 30 cases on adult patients ( 19 to 40 years , average 27,1 ) , treated with the same methods , were used as control group . RESULTS Traditional technique group showed a success of 63 % ( adult control group 50 % ) ; Er , Cr : YSGG laser-assisted technique showed a success rate of 80 % ( adult 
    Output:
    