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 Up-to- date studies comparing endodontic treatment versus implant-supported prosthesis have shown similar clinical outcome and survival rates . However , no data are available comparing both treatment modalities based on the patient 's perception of quality of life . This study was design ed to qualitatively describe and compare the quality of life of patients with restored , single endodontically treated teeth versus patients with single implant-supported fixed prostheses . METHODS Forty-eight patients agreed to participate in the study ( n = 24 from each treatment modality ) . Of those , 37 actually participated in the study : 17 were endodontically treated and 20 had an implant-supported prosthesis . Patients in each of the two groups were r and omly selected from the Graduate Endodontics and Graduate Periodontics Departments , respectively . Six focus group discussion s ( n = 3 per treatment group ) were held and audio-recorded for subsequent thematic analysis . Data were analyzed to identify common themes within each category and compared to assess any differences in quality of life between the two treatments . Additionally , a quality of life survey , the shortened version of the Oral Health Impact Profile ( OHIP-14 ) , was given before the discussion group and the responses analyzed . RESULTS The results obtained from this study show similar overall OHIP scores and show a high rate of satisfaction with both treatment modalities . Content analysis of the discussion groups revealed several themes and subthemes . The major themes were importance of overall health , financial implication s of the treatments , perception of the treatments and its outcomes , time since treatment , and follow-up dental visits . CONCLUSIONS The results help identify patients ' perception and concerns with each treatment modality and assist the clinician and patient in the selection of an optimal treatment for their given situation . In addition to the prognosis and outcomes , clinicians should consider patients ' perceptions and preferences as well as the influence each therapy may have on their quality of life , both short- and long-term . Overall , all the participants in this study were pleased with the treatment received and expressed a clear message to save their natural dentition whenever possible AIM This longitudinal , prospect i ve study ( 1 ) investigated the prevalence of post-obturation pain after root canal treatment  and ( 2 ) evaluated the influence of factors affecting the pain experience . METHODOLOGY Twenty practitioners , comprising general dental practitioners , MSc graduates and Endodontists , participated in this study . The patient sample ( n = 415 ) was derived from consecutive patients attending the practitioners ' surgeries for root canal treatment on a single tooth . Demographic , medical history , preoperative and intra-operative data as well as  pain experience on day 1 and day 2 after root canal obturation were recorded . Intensity of pain experienced was recorded on a visual analogue scale ( VAS ) of 0 - 5 . The data were analysed using logistic regression models . RESULTS The prevalence of post-obturation pain within 48 h after treatment was 40.2 % ( n = 167 ) but less than 12 % of patients experienced severe pain ( VAS 4 or 5 ) on either day 1 or day 2 . The factors that significantly influenced post-obturation pain experience were : gender ( OR = 0.434 , P < 0.001 ) , tooth type ( OR = 1.733 , P = 0.007 ) , size of periapical lesion ( OR = 0.493 , P = 0.004 ) , history of post-preparation pain ( OR = 4.110 , P = < 0.001 ) or generalized swelling ( OR = 3.435 , P = 0.005 ) and number of treatment visits ( OR = 2.604 , P < 0.001 ) . CONCLUSIONS The prevalence of post-obturation pain was high ( 40.2 % ) . The important prognostic determinants of post-obturation pain were female , molar tooth , size of periapical lesion smaller than 3 mm , history of post-preparation pain or generalized swelling and single-visit treatment AIM To assess previous patient experience of endodontic treatment  and to quantify their satisfaction with the endodontic treatment provided in a dental school clinic . DESIGN Self-completed question naire . SETTING Hacettepe University , Faculty of Dentistry , Department of Endodontics , Ankara , Turkey . PARTICIPANTS 200 r and omly selected , scheduled non-emergency patients in good health and older than 11 years who were to be treated by undergraduate , graduate students and academics . MAIN OUTCOME MEASURES Patient satisfaction and attitudes to root canal therapy .  RESULTS 96 per cent of patients , regardless their level of education , age and sex , reported that they expected RCT would save their teeth . 15 per cent of the patients were in favour of extraction versus RCT  before the therapy , but this reduced to only 2.5 per cent post treatment . 82 per cent of patients reported that they were satisfied with their treatment and the clinic . CONCLUSIONS Increasing public knowledge of and interest in endodontic treatment indicates that the need for an increase in teaching of the subject and associated re sources will be required Aim . To evaluate the incidence and severity of  postendodontic treatment pain ( PEP ) subsequent to root canal treatment ( RCT )  in vital and necrotic pulps and after retreatment . Methodology . A prospect i ve study . Participants were all patients ( n = 274 ) who underwent RCT in teeth with vital pulp , necrotic pulp , or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment , by one clinician , during an eight-month period . Exclusion criteria were swelling , purulence , and antibiotic use during initial treatment . A structured question naire accessed age , gender , tooth location , and pulpal diagnosis . Within 24 h of treatment , patients were asked to grade their pain at 6 and 18 hours posttreatment , using a 1–5 point scale . Results . RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP ( 63.8 % ; 2.46 ± 1.4 , resp . ) than RCT of teeth with necrotic pulp ( 38.5 % ; 1.78 ± 1.2 , resp . ) or of retreated teeth ( 48.8 % ; 1.89 ± 1.1 , resp . ) . No statistical relation was found between type of pain ( spontaneous or stimulated ) and pulp condition . Conclusion . RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth To determine whether a relatively large dose of oral dexamethasone given for a short period of time would be effective in reducing endodontic interappointment pain , the current double-blind , placebo-controlled study was undertaken . After the visit for instrumentation , 40 patients with asymptomatic teeth having vital-inflamed pulps were r and omly given either dexamethasone ( 3 tablets of 4 mg each ) or a dextrose placebo identical in appearance ( same dosage schedule ) . The outcome showed that the oral administration of dexamethasone result ed in a statistically significant reduction in endodontic interappointment pain at all three time periods evaluated , that is , at 8 hours , 24 hours , and 48 hours ( p less than 0.01 ) . It appears from the results of this study that this dosage schedule of oral dexamethasone is sufficient to significantly reduce endodontic interappointment pain for teeth with asymptomatic vital-inflamed pulps . Further studies are needed for teeth with other endodontic pulpal-periapical conditions and for symptomatic teeth AIM To investigate the probability of and factors influencing tooth survival  following primary ( 1 ° RCT x ) or secondary ( 2 ° RCT x ) root canal treatment .  METHODOLOGY This prospect i ve study involved annual follow-up of 2 ( 100 % ) to 4 years ( 50 % ) of 1 ° RCT x ( 759 teeth , 572 patients ) and 2 ° RCT x ( 858 teeth , 642 patients ) carried out by Endodontic postgraduate students . Pre- , intra- and post-operative data were collected prospect ively from consented patients . Information about extraction of the root filled tooth was sought from the patient , the referring dentist or derived from the patient 's records and included the timing and reasons for extraction . Tooth survival was estimated and prognostic factors were investigated using Cox regression . Clustering effects within patients were adjusted in all models using robust st and ard error . RESULTS The 4-year cumulative tooth survival following 1 ° RCT x [ 95.4 % ( 93.6 % , 96.8 % ) ] or 2 ° RCT x [ 95.3 % ( 93.6 % , 96.5 % ) ] was similar . Thirteen prognostic factors were identified . Significant patient factors included history of diabetes and systemic steroid therapy . Significant pre-operative factors included narrow but deep periodontal probing depth ; pain ; discharging sinus ; and iatrogenic perforation ( for 2 ° RCT x cases only ) . Significant intra-operative factors included iatrogenic perforation ; patency at apical terminus ; and extrusion of root fillings . Significant post-operative restorative factors included  presence of cast restoration versus temporary restoration ; presence of cast post and core ; proximal contacts with both mesial and distal adjacent teeth ; and terminal location of the tooth . The presence of pre-operative pain had a profound effect on tooth loss within the first 22 months after treatment [ hazard ratio ( HR ) = 3.1 ; P = 0.001 ] with a lesser effect beyond 22 months ( HR = 2.4 ; P = 0.01 ) . Patency at the apical terminus reduced tooth loss ( HR = 0.3 ; P < 0.01 ) within the first 22 months after treatment but had no significant effect on tooth survival beyond 22 months . Extrusion of gutta-percha root filling did not have any effect on tooth survival ( HR = 1.1 ; P = 0.2 ) within the first 22 months but significantly increased the hazard of tooth loss beyond 22 months ( HR = 3.0 ; P = 0.003 ) . CONCLUSIONS The 4-year tooth survival following primary or secondary root canal treatment was 95 % , with thirteen prognostic factors common to both Since single-tooth implant restorations were introduced 12 years ago ( Jemt 1986 ) , there has been continuous development both in the technical design and the aesthetic outcome of the treatment . In order to ensure high quality in single-tooth implant treatments a clinical follow-up study was carried out on patients treated with modifications to the original regimen . In this study 69 consecutive patients were provided with 80 single-tooth implant restorations .  The patients were followed for 3 years . There was continuous development of the prosthetic design during the time of the study , allowing us to analyse possible prognostic differences for the different prosthetic treatments . This study confirms earlier reports which describe the single-tooth implant treatment as a safe method with few surgical complications and minimal marginal bone loss . Only 1 implant was lost during the follow-up period and the average marginal bone loss was 0.48 mm over the 3-year follow-up period . Crowns veneered with acrylic and with gold casted directly to the abutments , screwed onto the implants , led to recurring prosthetic complications and gave an appearance of rapid ageing . The first generation of crowns made following the Cera-One design , sometimes produced a gap between the crown and the abutment associated with significant marginal bone loss during the first year . Few surgical or prosthetic complications were noted with cemented all-ceramic constructions , although the number of these crowns in this study was limited The purpose of this prospect i ve , r and omized , double-blind , placebo-controlled study was to determine the effect of prophylactic amoxicillin on the occurrence of endodontic flare-up in asymptomatic , necrotic teeth . Seventy patients participated and had a clinical diagnosis of an asymptomatic , necrotic tooth with associated periapical radiolucency . One hour before endodontic treatment , patients r and omly received either 3 g of amoxicillin or 3 g of a placebo control in a double-blind manner . After endodontic treatment , each patient received : ibuprofen ; acetaminophen with codeine ( 30 mg ) ; and a 5 1/2-day  diary  to record pain , swelling , percussion pain , and number and type of pain medication taken . The results demonstrated 10 % of the 70 patients had a flare-up characterized by moderate-to-severe postoperative pain or swelling that began approximately 30 h after endodontic treatment and persisted for an average of 74 h. Of the seven patients who had flare-ups , 4 were in the amoxicillin group and 3 were not . Prophylactic amoxicillin did not significantly ( p = 0.80 ) influence the endodontic flare-up . We concluded that a prophylactic dose of amoxicillin before endodontic treatment of asymptomatic , necrotic teeth had no effect on the endodontic flare-up BACKGROUND More knowledge about the relationship between blood-injury-injection phobia ( BIIP ) and dental anxiety ( DA ) may give new clinical ly relevant information in the assessment and management of children with DA . OBJECTIVE The aims of this study were to explore the relationships between BIIP and DA , and to explore to what extent the two subtypes of BIIP in combination with DA are related to self-reported probability of avoiding dental treatment if a dental injection is needed . METHODS The subjects were a r and om sample of 1385 1 
    Output:
    
agent
RESULTS Application of the Oral Health Impact Profile ( OHIP ) demonstrated that disease of pulpal origin affects quality of life with moderate severity , primarily through physical pain and psychological discomfort , and that RCT results in broad improvement of quality of life .
Satisfaction with RCT is extremely high , but cost is the primary reason for dissatisfaction .
Anxiety and fear affect RCT patients , profoundly influencing their behaviors , including treatment avoidance , and their pain experience .
Fear of pain is " fair " to " very much " prior to RCT .
Pain is widely feared , disliked , and remembered ; however , disease of pulpal origin generally produces moderate , but not severe pain .
RCT causes a dramatic decrease in pain prevalence and severity over the week following treatment .
Survival rates of teeth after RCT are very high ; complication rates are low .
Cost is a barrier to RCT , but initial costs , lifetime costs , cost effectiveness , cost utility , and cost benefit all compare extremely well to the alternatives involving replacement using implants or fixed prostheses .
***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 Up-to- date studies comparing endodontic treatment versus implant-supported prosthesis have shown similar clinical outcome and survival rates . However , no data are available comparing both treatment modalities based on the patient 's perception of quality of life . This study was design ed to qualitatively describe and compare the quality of life of patients with restored , single endodontically treated teeth versus patients with single implant-supported fixed prostheses . METHODS Forty-eight patients agreed to participate in the study ( n = 24 from each treatment modality ) . Of those , 37 actually participated in the study : 17 were endodontically treated and 20 had an implant-supported prosthesis . Patients in each of the two groups were r and omly selected from the Graduate Endodontics and Graduate Periodontics Departments , respectively . Six focus group discussion s ( n = 3 per treatment group ) were held and audio-recorded for subsequent thematic analysis . Data were analyzed to identify common themes within each category and compared to assess any differences in quality of life between the two treatments . Additionally , a quality of life survey , the shortened version of the Oral Health Impact Profile ( OHIP-14 ) , was given before the discussion group and the responses analyzed . RESULTS The results obtained from this study show similar overall OHIP scores and show a high rate of satisfaction with both treatment modalities . Content analysis of the discussion groups revealed several themes and subthemes . The major themes were importance of overall health , financial implication s of the treatments , perception of the treatments and its outcomes , time since treatment , and follow-up dental visits . CONCLUSIONS The results help identify patients ' perception and concerns with each treatment modality and assist the clinician and patient in the selection of an optimal treatment for their given situation . In addition to the prognosis and outcomes , clinicians should consider patients ' perceptions and preferences as well as the influence each therapy may have on their quality of life , both short- and long-term . Overall , all the participants in this study were pleased with the treatment received and expressed a clear message to save their natural dentition whenever possible AIM This longitudinal , prospect i ve study ( 1 ) investigated the prevalence of post-obturation pain after root canal treatment  and ( 2 ) evaluated the influence of factors affecting the pain experience . METHODOLOGY Twenty practitioners , comprising general dental practitioners , MSc graduates and Endodontists , participated in this study . The patient sample ( n = 415 ) was derived from consecutive patients attending the practitioners ' surgeries for root canal treatment on a single tooth . Demographic , medical history , preoperative and intra-operative data as well as  pain experience on day 1 and day 2 after root canal obturation were recorded . Intensity of pain experienced was recorded on a visual analogue scale ( VAS ) of 0 - 5 . The data were analysed using logistic regression models . RESULTS The prevalence of post-obturation pain within 48 h after treatment was 40.2 % ( n = 167 ) but less than 12 % of patients experienced severe pain ( VAS 4 or 5 ) on either day 1 or day 2 . The factors that significantly influenced post-obturation pain experience were : gender ( OR = 0.434 , P < 0.001 ) , tooth type ( OR = 1.733 , P = 0.007 ) , size of periapical lesion ( OR = 0.493 , P = 0.004 ) , history of post-preparation pain ( OR = 4.110 , P = < 0.001 ) or generalized swelling ( OR = 3.435 , P = 0.005 ) and number of treatment visits ( OR = 2.604 , P < 0.001 ) . CONCLUSIONS The prevalence of post-obturation pain was high ( 40.2 % ) . The important prognostic determinants of post-obturation pain were female , molar tooth , size of periapical lesion smaller than 3 mm , history of post-preparation pain or generalized swelling and single-visit treatment AIM To assess previous patient experience of endodontic treatment  and to quantify their satisfaction with the endodontic treatment provided in a dental school clinic . DESIGN Self-completed question naire . SETTING Hacettepe University , Faculty of Dentistry , Department of Endodontics , Ankara , Turkey . PARTICIPANTS 200 r and omly selected , scheduled non-emergency patients in good health and older than 11 years who were to be treated by undergraduate , graduate students and academics . MAIN OUTCOME MEASURES Patient satisfaction and attitudes to root canal therapy .  RESULTS 96 per cent of patients , regardless their level of education , age and sex , reported that they expected RCT would save their teeth . 15 per cent of the patients were in favour of extraction versus RCT  before the therapy , but this reduced to only 2.5 per cent post treatment . 82 per cent of patients reported that they were satisfied with their treatment and the clinic . CONCLUSIONS Increasing public knowledge of and interest in endodontic treatment indicates that the need for an increase in teaching of the subject and associated re sources will be required Aim . To evaluate the incidence and severity of  postendodontic treatment pain ( PEP ) subsequent to root canal treatment ( RCT )  in vital and necrotic pulps and after retreatment . Methodology . A prospect i ve study . Participants were all patients ( n = 274 ) who underwent RCT in teeth with vital pulp , necrotic pulp , or vital pulp that had been treated for symptomatic irreversible pulpitis or who received root canal retreatment , by one clinician , during an eight-month period . Exclusion criteria were swelling , purulence , and antibiotic use during initial treatment . A structured question naire accessed age , gender , tooth location , and pulpal diagnosis . Within 24 h of treatment , patients were asked to grade their pain at 6 and 18 hours posttreatment , using a 1–5 point scale . Results . RCT of teeth with vital pulp induced a significantly higher incidence and severity of PEP ( 63.8 % ; 2.46 ± 1.4 , resp . ) than RCT of teeth with necrotic pulp ( 38.5 % ; 1.78 ± 1.2 , resp . ) or of retreated teeth ( 48.8 % ; 1.89 ± 1.1 , resp . ) . No statistical relation was found between type of pain ( spontaneous or stimulated ) and pulp condition . Conclusion . RCT of teeth with vital pulp induced a significantly higher incidence and intensity of PEP compared to teeth with necrotic pulp or retreated teeth To determine whether a relatively large dose of oral dexamethasone given for a short period of time would be effective in reducing endodontic interappointment pain , the current double-blind , placebo-controlled study was undertaken . After the visit for instrumentation , 40 patients with asymptomatic teeth having vital-inflamed pulps were r and omly given either dexamethasone ( 3 tablets of 4 mg each ) or a dextrose placebo identical in appearance ( same dosage schedule ) . The outcome showed that the oral administration of dexamethasone result ed in a statistically significant reduction in endodontic interappointment pain at all three time periods evaluated , that is , at 8 hours , 24 hours , and 48 hours ( p less than 0.01 ) . It appears from the results of this study that this dosage schedule of oral dexamethasone is sufficient to significantly reduce endodontic interappointment pain for teeth with asymptomatic vital-inflamed pulps . Further studies are needed for teeth with other endodontic pulpal-periapical conditions and for symptomatic teeth AIM To investigate the probability of and factors influencing tooth survival  following primary ( 1 ° RCT x ) or secondary ( 2 ° RCT x ) root canal treatment .  METHODOLOGY This prospect i ve study involved annual follow-up of 2 ( 100 % ) to 4 years ( 50 % ) of 1 ° RCT x ( 759 teeth , 572 patients ) and 2 ° RCT x ( 858 teeth , 642 patients ) carried out by Endodontic postgraduate students . Pre- , intra- and post-operative data were collected prospect ively from consented patients . Information about extraction of the root filled tooth was sought from the patient , the referring dentist or derived from the patient 's records and included the timing and reasons for extraction . Tooth survival was estimated and prognostic factors were investigated using Cox regression . Clustering effects within patients were adjusted in all models using robust st and ard error . RESULTS The 4-year cumulative tooth survival following 1 ° RCT x [ 95.4 % ( 93.6 % , 96.8 % ) ] or 2 ° RCT x [ 95.3 % ( 93.6 % , 96.5 % ) ] was similar . Thirteen prognostic factors were identified . Significant patient factors included history of diabetes and systemic steroid therapy . Significant pre-operative factors included narrow but deep periodontal probing depth ; pain ; discharging sinus ; and iatrogenic perforation ( for 2 ° RCT x cases only ) . Significant intra-operative factors included iatrogenic perforation ; patency at apical terminus ; and extrusion of root fillings . Significant post-operative restorative factors included  presence of cast restoration versus temporary restoration ; presence of cast post and core ; proximal contacts with both mesial and distal adjacent teeth ; and terminal location of the tooth . The presence of pre-operative pain had a profound effect on tooth loss within the first 22 months after treatment [ hazard ratio ( HR ) = 3.1 ; P = 0.001 ] with a lesser effect beyond 22 months ( HR = 2.4 ; P = 0.01 ) . Patency at the apical terminus reduced tooth loss ( HR = 0.3 ; P < 0.01 ) within the first 22 months after treatment but had no significant effect on tooth survival beyond 22 months . Extrusion of gutta-percha root filling did not have any effect on tooth survival ( HR = 1.1 ; P = 0.2 ) within the first 22 months but significantly increased the hazard of tooth loss beyond 22 months ( HR = 3.0 ; P = 0.003 ) . CONCLUSIONS The 4-year tooth survival following primary or secondary root canal treatment was 95 % , with thirteen prognostic factors common to both Since single-tooth implant restorations were introduced 12 years ago ( Jemt 1986 ) , there has been continuous development both in the technical design and the aesthetic outcome of the treatment . In order to ensure high quality in single-tooth implant treatments a clinical follow-up study was carried out on patients treated with modifications to the original regimen . In this study 69 consecutive patients were provided with 80 single-tooth implant restorations .  The patients were followed for 3 years . There was continuous development of the prosthetic design during the time of the study , allowing us to analyse possible prognostic differences for the different prosthetic treatments . This study confirms earlier reports which describe the single-tooth implant treatment as a safe method with few surgical complications and minimal marginal bone loss . Only 1 implant was lost during the follow-up period and the average marginal bone loss was 0.48 mm over the 3-year follow-up period . Crowns veneered with acrylic and with gold casted directly to the abutments , screwed onto the implants , led to recurring prosthetic complications and gave an appearance of rapid ageing . The first generation of crowns made following the Cera-One design , sometimes produced a gap between the crown and the abutment associated with significant marginal bone loss during the first year . Few surgical or prosthetic complications were noted with cemented all-ceramic constructions , although the number of these crowns in this study was limited The purpose of this prospect i ve , r and omized , double-blind , placebo-controlled study was to determine the effect of prophylactic amoxicillin on the occurrence of endodontic flare-up in asymptomatic , necrotic teeth . Seventy patients participated and had a clinical diagnosis of an asymptomatic , necrotic tooth with associated periapical radiolucency . One hour before endodontic treatment , patients r and omly received either 3 g of amoxicillin or 3 g of a placebo control in a double-blind manner . After endodontic treatment , each patient received : ibuprofen ; acetaminophen with codeine ( 30 mg ) ; and a 5 1/2-day  diary  to record pain , swelling , percussion pain , and number and type of pain medication taken . The results demonstrated 10 % of the 70 patients had a flare-up characterized by moderate-to-severe postoperative pain or swelling that began approximately 30 h after endodontic treatment and persisted for an average of 74 h. Of the seven patients who had flare-ups , 4 were in the amoxicillin group and 3 were not . Prophylactic amoxicillin did not significantly ( p = 0.80 ) influence the endodontic flare-up . We concluded that a prophylactic dose of amoxicillin before endodontic treatment of asymptomatic , necrotic teeth had no effect on the endodontic flare-up BACKGROUND More knowledge about the relationship between blood-injury-injection phobia ( BIIP ) and dental anxiety ( DA ) may give new clinical ly relevant information in the assessment and management of children with DA . OBJECTIVE The aims of this study were to explore the relationships between BIIP and DA , and to explore to what extent the two subtypes of BIIP in combination with DA are related to self-reported probability of avoiding dental treatment if a dental injection is needed . METHODS The subjects were a r and om sample of 1385 1 
    Output:
    