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: Statement of Problem : Reattachment of the fractured tooth fragment should be considered as a conservative treatment and valid alternative to a composite restoration . Purpose : This in vitro study was to evaluate the influence of different adhesives and composite resins on fracture resistance of dental fragment reattached to the sectioned incisal edges . Material s and Method : 120 sound human maxillary central incisors were selected under st and ard conditions and r and omly divided into 3 groups , 12 sound teeth were used as a control group and the remaining teeth were assigned to 3 groups ( n=36 ) and each group into three subgroups ( n=12 ) . The incisal third of the sample s was sectioned using a diamond disk and the respective fragments were then reattached utilizing different intermediate restorative material s , namely : i ) adhesive material s alone ( OptiBond S or OptiBond XTR or OptiBond All-in-One ; ii ) Premise flowable composite and iii ) Point 4 composite in the one of the mentioned adhesive interface . After storage for two weeks at 37 ° C and 100 % humidity and then thermocycling ; shear bond strength ( SBS ) was recorded in kilogram force ( kgf ) by applying a load in the middle incisal third with a Zwick Universal Testing Machine at a cross-head speed of 1 mm/min . Data was analyzed with one-way ANOVA and Tukey HSD ( p < 0.05 ) . Results : The control group had a significantly higher SBS than other groups ( p= 0.001 ) ; the highest SBS values were obtained using the Premise flowable composite and OptiBond S adhesive ( 112.44±30.46 MPa ) ; and the lowest with OptiBond All-in-One alone ( 33.97± 15.63 MPa ) . Conclusion : Although , none of the tested material s provided fracture resistance similar to that found with the intact maxillary central incisors ; utilizing the Premise flowable composite and OptiBond S adhesive improved the SBS of the reattached fragment than other material Background Synthesis of multiple r and omized controlled trials ( RCTs ) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions . Filtering of search es is time consuming , and no single method fulfills the principal requirements of speed with accuracy . Automation of systematic review s is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making . We developed Rayyan ( http://rayyan.qcri.org ) , a free web and mobile app , that helps expedite the initial screening of abstract s and titles using a process of semi-automation while incorporating a high level of usability . For the beta testing phase , we used two published Cochrane review s in which included studies had been selected manually . Their search es , with 1030 records and 273 records , were uploaded to Rayyan . Different features of Rayyan were tested using these two review s. We also conducted a survey of Rayyan ’s users and collected feedback through a built-in feature . Results Pilot testing of Rayyan focused on usability , accuracy against manual methods , and the added value of the prediction feature . The “ taster ” review ( 273 records ) allowed a quick overview of Rayyan for early comments on usability . The second review ( 1030 records ) required several iterations to identify the previously identified 11 trials . The “ suggestions ” and “ hints , ” based on the “ prediction model , ” appeared as testing progressed beyond five included studies . Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements . The survey respondents reported 40 % average time savings when using Rayyan compared to others tools , with 34 % of the respondents reporting more than 50 % time savings . In addition , around 75 % of the respondents mentioned that screening and labeling studies as well as collaborating on review s to be the two most important features of Rayyan . As of November 2016 , Rayyan users exceed 2000 from over 60 countries conducting hundreds of review s totaling more than 1.6 M citations . Feedback from users , obtained mostly through the app web site and a recent survey , has highlighted the ease in exploration of search es , the time saved , and simplicity in sharing and comparing include-exclude decisions . The strongest features of the app , identified and reported in user feedback , were its ability to help in screening and collaboration as well as the time savings it affords to users . Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of review ers OBJECTIVES Fractured coronal fragments of incisors can be adhered to the remaining tooth with resin composite , but are prone to failure . This study explores whether mini fibre-reinforced composite ( FRC ) anchors increase fracture resistance of reattached fragments . METHODS Forty-five extracted incisors were r and omly divided into three groups . In Groups A and B coronal fragments were reattached to the remaining tooth , with additionally two anchors placed in Group B. In Group C resin composite buildups were made . Specimens were statically loaded until failure occurred . Failure modes were characterized as intact remaining tooth substrate ( adhesive or cohesive failure of coronal fragment ) or fractured remaining tooth substrate ( fracture limited to enamel or extending into dentin ) . RESULTS Mean fracture loads were 255N ( SD=108N ) for Group A , 599N ( SD=465N ) for Group B and 786N ( SD=197N ) for Group C ( values significantly different , all p values < 0.05 ) . Group A showed purely adhesive failures , while Groups B and C showed 73 and 53 % fractures of remaining tooth substrate ( p<0.05 ) . CONCLUSIONS Mini FRC anchors increase fracture resistance of reattached coronal fragments , but induce more remaining tooth substrate fractures OBJECTIVES When coronal fracture occurs in anterior teeth , fragment reattachment can be a valid alternative to a direct restoration . The aim of this study was to evaluate the influence of the material and the technique used to reattach the fragment . MATERIAL S AND METHODS Eighty sound maxillary and m and ibular incisors were selected and r and omly divided into eight groups ( n = 10 ) . The incisal third of each tooth was removed using a saw machine . The fragments in groups 1 - 4 were reattached using resin-based material s : group 1 adhesive , group 2 flow , group 3 composite , group 4 cement ; in groups 5 - 8 , the same material s mentioned before were used but a bevel was also performed on both labial and lingual surfaces . Shear bond strength ( SBS ) was calculated by applying a load incisal to the reattachment line . A two-way Anova was used to evaluate the influence of material s and techniques on the SBS . RESULTS The technique used was statistically significant ( P < 0.001 ) , while the material was not ( P = 0.793 ) . CONCLUSIONS The choice of material seems to have no influence on the SBS , whereas a bevel performed on the labial and lingual surfaces can significantly improve the SBS of the reattached fragment Fracture of anterior teeth by trauma is a common problem in children and teenagers .  Complex metal-ceramic crowns with considerable loss of remaining sound structure are no longer necessary due to adhesive techniques , such as composite restorations and re-attachment techniques . This study compared the fracture strength of sound and restored anterior teeth using a resin composite and four re-attachment techniques . A " one bottle " adhesive system ( One-Step , BISCO ) and a dual cure resin cement ( Duo-Link , BISCO ) were applied . Thirty-five sound permanent lower central incisors were fractured by an axial load applied to the buccal area and r and omly divided into five groups . The teeth were restored as follows : 1 ) bonded only = just bonding the fragment ; 2 ) chamfer-group = after bonding , a chamfer was prepared on the enamel at the bonding line and filled with composite ; 3 ) overcontour group = after bonding , a thin composite overcontour was applied on the buccal surface around the fracture line ; 4 ) internal dentinal groove = before bonding , an internal groove was made and filled with a resin composite ; 5 ) resin composite group = after a bevel preparation on the enamel edge , the adhesive system was applied and the fractured part of the teeth rebuilt by resin composite . Restored teeth were subjected to the same loading in the same buccal area . Fracture strength after restorative procedure was expressed as a percentage of the original fracture strength and the results analyzed by Kruskal-Wallis statistical analysis . The mean percentages of fracture strength were : Group 1 : 37.09 % , Group 2 : 60.62 % , Group 3 : 97.2 % , Group 4 : 90.54 % and Group 5 : 95.8 % . It was concluded that the re-attachment techniques used in Groups 3 and 4 , as well as the composite restored group ( Group 5 ) , were statistically similar and reached the highest fracture resistance , similar to the fracture resistance of sound teeth This study investigated the shear bond strengths of sectioned human m and ibular incisor edge fragments reattached using  luting cements , bonding agents or restored with composite resins . Seventy teeth were r and omly distributed among six experimental groups and a control group . Leaving half of the anatomic crowns exposed , the teeth were embedded in self-cure acrylic resins with the exposed part then sectioned . The fragments in groups 1 - 4 were bonded to their respective teeth using Clearfil Liner Bond 2V , Scotch Bond Multi Purpose Plus , Panavia-F and 3 M Opal Luting cement . The 5th and 6th groups were restored with composite resins ( Silux 3 M and Clearfil AP-X ) using their bonding agents ( Single Bond and Clearfil SE Bond ) . The results indicated that reattachment of fractured incisal fragments by using new generation bonding agents was effective against shear stresses , comparable with the intact teeth . Instead of restoration with composite resins therefore reattachment of a fractured fragment might be more preferable in cases of dental trauma AIM To evaluate and compare the fracture resistance of reattached teeth using four different material s. MATERIAL S AND METHODS 150 extracted human permanent maxillary incisors were r and omly divided into five groups of 30 teeth each of one control and four experimental groups . Teeth in experimental groups were sectioned 2.5 mm from incisal edge and reattached using four different material s. The reattached teeth were subjected to evaluate fracture resistance . RESULTS The mean fracture resistance of reattached teeth using resin modified glass ionomer cement , compomer , composite resin and dual curing resin cement was 8.10 ± 2.34 , 11.15 ± 3.36 , 17.11 ± 3.99 and 14.13 ± 3.71 kg respectively . Results showed highly significant difference between the groups ( P < 0.001 ) . CONCLUSION Fracture resistance of reattached teeth in the different groups varied from 24 - 51 % of that for an intact tooth . Reattachment with composite resin provides highest fracture resistance ( P < 0.05 ) . Reattachment with resin-modified glass ionomer cement was the weakest ( P < 0.05 ) This study evaluated the effect of fractured or sectioned fragments on the fracture strength recovery of four techniques used for reattachment and resin composite buildups . Ninety-one sound , permanent lower central incisors were used . Half the teeth were fractured in the incisal-proximal edge ; the other half had the incisal-proximal edge sectioned by a diamond saw . Teeth from each half were r and omly divided into five techniques : 1 ) bonded only ; 2 ) chamfer ; 3 ) over-contour ; 4 ) internal dentinal groove and 5 ) resin composite buildup . An adhesive system and dual cure resin cement were employed for the reattachment . Restored teeth were subjected to load in a specific point on the buccal surface . Based on the fracture strength of sound teeth , a fracture strength recovery was calculated for each tooth . A one-way ANOVA and Tukey 's test ( alpha=0.05 ) were used to evaluate differences between the techniques for each method of obtaining fragments . The fracture strength recovery of similar techniques was evaluated by a Student t-test ( alpha=0.05 ) . No differences could be detected among reattachment techniques when fragments were obtained by sectioning . In groups where the fragments were fractured , Techniques 3 and 4 showed the highest fracture strength recovery . The resin composite buildup provided fracture strength recovery similar to intact teeth regardless the way fragments were obtained The purpose of this study was to evaluate and compare the bond strengths of experimentally fractured human tooth fragments reattached with different adhesive material s and retentive techniques in vitro . Uncomplicated crown fractures were obtained on intact human m and ibular permanent incisors by applying perpendicular load to the buccal aspect of tooth crowns . Fractured teeth were r and omly assigned into one of three reattachment protocol s : ( i ) Simple reattachment , ( ii ) Overcontour preparation , and ( iii ) Internal dentin groove . The first and second groups were divided into 10 subgroups , and the third group into five subgroups ( n = 10 per group ) with respect to five different adhesive systems ( Prime&Bond NT , Adper Single Bond II , Adper Prompt L-Pop , Clearfil S(3 ) Bond , G Bond ) used with or without a hybrid resin composite ( Z250 ) . Restored teeth were subjected to thermal cycling , and subsequently to the same loading protocol used for fracturing intact teeth . Fracture strength after reattachment procedures was recorded as a percentage of the original fracture strength . Both type of adhesive material and placement of an intermediate layer of resin composite affected the fracture resistance ( P < 0.05 ) . The highest fract 
    Output:
    
agent
Fragment reattachment using a technique with no preparation and an adhesive system associated with an intermediate composite with good mechanical properties can restore part of the resistance of the fractured tooth
***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: Statement of Problem : Reattachment of the fractured tooth fragment should be considered as a conservative treatment and valid alternative to a composite restoration . Purpose : This in vitro study was to evaluate the influence of different adhesives and composite resins on fracture resistance of dental fragment reattached to the sectioned incisal edges . Material s and Method : 120 sound human maxillary central incisors were selected under st and ard conditions and r and omly divided into 3 groups , 12 sound teeth were used as a control group and the remaining teeth were assigned to 3 groups ( n=36 ) and each group into three subgroups ( n=12 ) . The incisal third of the sample s was sectioned using a diamond disk and the respective fragments were then reattached utilizing different intermediate restorative material s , namely : i ) adhesive material s alone ( OptiBond S or OptiBond XTR or OptiBond All-in-One ; ii ) Premise flowable composite and iii ) Point 4 composite in the one of the mentioned adhesive interface . After storage for two weeks at 37 ° C and 100 % humidity and then thermocycling ; shear bond strength ( SBS ) was recorded in kilogram force ( kgf ) by applying a load in the middle incisal third with a Zwick Universal Testing Machine at a cross-head speed of 1 mm/min . Data was analyzed with one-way ANOVA and Tukey HSD ( p < 0.05 ) . Results : The control group had a significantly higher SBS than other groups ( p= 0.001 ) ; the highest SBS values were obtained using the Premise flowable composite and OptiBond S adhesive ( 112.44±30.46 MPa ) ; and the lowest with OptiBond All-in-One alone ( 33.97± 15.63 MPa ) . Conclusion : Although , none of the tested material s provided fracture resistance similar to that found with the intact maxillary central incisors ; utilizing the Premise flowable composite and OptiBond S adhesive improved the SBS of the reattached fragment than other material Background Synthesis of multiple r and omized controlled trials ( RCTs ) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions . Filtering of search es is time consuming , and no single method fulfills the principal requirements of speed with accuracy . Automation of systematic review s is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making . We developed Rayyan ( http://rayyan.qcri.org ) , a free web and mobile app , that helps expedite the initial screening of abstract s and titles using a process of semi-automation while incorporating a high level of usability . For the beta testing phase , we used two published Cochrane review s in which included studies had been selected manually . Their search es , with 1030 records and 273 records , were uploaded to Rayyan . Different features of Rayyan were tested using these two review s. We also conducted a survey of Rayyan ’s users and collected feedback through a built-in feature . Results Pilot testing of Rayyan focused on usability , accuracy against manual methods , and the added value of the prediction feature . The “ taster ” review ( 273 records ) allowed a quick overview of Rayyan for early comments on usability . The second review ( 1030 records ) required several iterations to identify the previously identified 11 trials . The “ suggestions ” and “ hints , ” based on the “ prediction model , ” appeared as testing progressed beyond five included studies . Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements . The survey respondents reported 40 % average time savings when using Rayyan compared to others tools , with 34 % of the respondents reporting more than 50 % time savings . In addition , around 75 % of the respondents mentioned that screening and labeling studies as well as collaborating on review s to be the two most important features of Rayyan . As of November 2016 , Rayyan users exceed 2000 from over 60 countries conducting hundreds of review s totaling more than 1.6 M citations . Feedback from users , obtained mostly through the app web site and a recent survey , has highlighted the ease in exploration of search es , the time saved , and simplicity in sharing and comparing include-exclude decisions . The strongest features of the app , identified and reported in user feedback , were its ability to help in screening and collaboration as well as the time savings it affords to users . Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of review ers OBJECTIVES Fractured coronal fragments of incisors can be adhered to the remaining tooth with resin composite , but are prone to failure . This study explores whether mini fibre-reinforced composite ( FRC ) anchors increase fracture resistance of reattached fragments . METHODS Forty-five extracted incisors were r and omly divided into three groups . In Groups A and B coronal fragments were reattached to the remaining tooth , with additionally two anchors placed in Group B. In Group C resin composite buildups were made . Specimens were statically loaded until failure occurred . Failure modes were characterized as intact remaining tooth substrate ( adhesive or cohesive failure of coronal fragment ) or fractured remaining tooth substrate ( fracture limited to enamel or extending into dentin ) . RESULTS Mean fracture loads were 255N ( SD=108N ) for Group A , 599N ( SD=465N ) for Group B and 786N ( SD=197N ) for Group C ( values significantly different , all p values < 0.05 ) . Group A showed purely adhesive failures , while Groups B and C showed 73 and 53 % fractures of remaining tooth substrate ( p<0.05 ) . CONCLUSIONS Mini FRC anchors increase fracture resistance of reattached coronal fragments , but induce more remaining tooth substrate fractures OBJECTIVES When coronal fracture occurs in anterior teeth , fragment reattachment can be a valid alternative to a direct restoration . The aim of this study was to evaluate the influence of the material and the technique used to reattach the fragment . MATERIAL S AND METHODS Eighty sound maxillary and m and ibular incisors were selected and r and omly divided into eight groups ( n = 10 ) . The incisal third of each tooth was removed using a saw machine . The fragments in groups 1 - 4 were reattached using resin-based material s : group 1 adhesive , group 2 flow , group 3 composite , group 4 cement ; in groups 5 - 8 , the same material s mentioned before were used but a bevel was also performed on both labial and lingual surfaces . Shear bond strength ( SBS ) was calculated by applying a load incisal to the reattachment line . A two-way Anova was used to evaluate the influence of material s and techniques on the SBS . RESULTS The technique used was statistically significant ( P < 0.001 ) , while the material was not ( P = 0.793 ) . CONCLUSIONS The choice of material seems to have no influence on the SBS , whereas a bevel performed on the labial and lingual surfaces can significantly improve the SBS of the reattached fragment Fracture of anterior teeth by trauma is a common problem in children and teenagers .  Complex metal-ceramic crowns with considerable loss of remaining sound structure are no longer necessary due to adhesive techniques , such as composite restorations and re-attachment techniques . This study compared the fracture strength of sound and restored anterior teeth using a resin composite and four re-attachment techniques . A " one bottle " adhesive system ( One-Step , BISCO ) and a dual cure resin cement ( Duo-Link , BISCO ) were applied . Thirty-five sound permanent lower central incisors were fractured by an axial load applied to the buccal area and r and omly divided into five groups . The teeth were restored as follows : 1 ) bonded only = just bonding the fragment ; 2 ) chamfer-group = after bonding , a chamfer was prepared on the enamel at the bonding line and filled with composite ; 3 ) overcontour group = after bonding , a thin composite overcontour was applied on the buccal surface around the fracture line ; 4 ) internal dentinal groove = before bonding , an internal groove was made and filled with a resin composite ; 5 ) resin composite group = after a bevel preparation on the enamel edge , the adhesive system was applied and the fractured part of the teeth rebuilt by resin composite . Restored teeth were subjected to the same loading in the same buccal area . Fracture strength after restorative procedure was expressed as a percentage of the original fracture strength and the results analyzed by Kruskal-Wallis statistical analysis . The mean percentages of fracture strength were : Group 1 : 37.09 % , Group 2 : 60.62 % , Group 3 : 97.2 % , Group 4 : 90.54 % and Group 5 : 95.8 % . It was concluded that the re-attachment techniques used in Groups 3 and 4 , as well as the composite restored group ( Group 5 ) , were statistically similar and reached the highest fracture resistance , similar to the fracture resistance of sound teeth This study investigated the shear bond strengths of sectioned human m and ibular incisor edge fragments reattached using  luting cements , bonding agents or restored with composite resins . Seventy teeth were r and omly distributed among six experimental groups and a control group . Leaving half of the anatomic crowns exposed , the teeth were embedded in self-cure acrylic resins with the exposed part then sectioned . The fragments in groups 1 - 4 were bonded to their respective teeth using Clearfil Liner Bond 2V , Scotch Bond Multi Purpose Plus , Panavia-F and 3 M Opal Luting cement . The 5th and 6th groups were restored with composite resins ( Silux 3 M and Clearfil AP-X ) using their bonding agents ( Single Bond and Clearfil SE Bond ) . The results indicated that reattachment of fractured incisal fragments by using new generation bonding agents was effective against shear stresses , comparable with the intact teeth . Instead of restoration with composite resins therefore reattachment of a fractured fragment might be more preferable in cases of dental trauma AIM To evaluate and compare the fracture resistance of reattached teeth using four different material s. MATERIAL S AND METHODS 150 extracted human permanent maxillary incisors were r and omly divided into five groups of 30 teeth each of one control and four experimental groups . Teeth in experimental groups were sectioned 2.5 mm from incisal edge and reattached using four different material s. The reattached teeth were subjected to evaluate fracture resistance . RESULTS The mean fracture resistance of reattached teeth using resin modified glass ionomer cement , compomer , composite resin and dual curing resin cement was 8.10 ± 2.34 , 11.15 ± 3.36 , 17.11 ± 3.99 and 14.13 ± 3.71 kg respectively . Results showed highly significant difference between the groups ( P < 0.001 ) . CONCLUSION Fracture resistance of reattached teeth in the different groups varied from 24 - 51 % of that for an intact tooth . Reattachment with composite resin provides highest fracture resistance ( P < 0.05 ) . Reattachment with resin-modified glass ionomer cement was the weakest ( P < 0.05 ) This study evaluated the effect of fractured or sectioned fragments on the fracture strength recovery of four techniques used for reattachment and resin composite buildups . Ninety-one sound , permanent lower central incisors were used . Half the teeth were fractured in the incisal-proximal edge ; the other half had the incisal-proximal edge sectioned by a diamond saw . Teeth from each half were r and omly divided into five techniques : 1 ) bonded only ; 2 ) chamfer ; 3 ) over-contour ; 4 ) internal dentinal groove and 5 ) resin composite buildup . An adhesive system and dual cure resin cement were employed for the reattachment . Restored teeth were subjected to load in a specific point on the buccal surface . Based on the fracture strength of sound teeth , a fracture strength recovery was calculated for each tooth . A one-way ANOVA and Tukey 's test ( alpha=0.05 ) were used to evaluate differences between the techniques for each method of obtaining fragments . The fracture strength recovery of similar techniques was evaluated by a Student t-test ( alpha=0.05 ) . No differences could be detected among reattachment techniques when fragments were obtained by sectioning . In groups where the fragments were fractured , Techniques 3 and 4 showed the highest fracture strength recovery . The resin composite buildup provided fracture strength recovery similar to intact teeth regardless the way fragments were obtained The purpose of this study was to evaluate and compare the bond strengths of experimentally fractured human tooth fragments reattached with different adhesive material s and retentive techniques in vitro . Uncomplicated crown fractures were obtained on intact human m and ibular permanent incisors by applying perpendicular load to the buccal aspect of tooth crowns . Fractured teeth were r and omly assigned into one of three reattachment protocol s : ( i ) Simple reattachment , ( ii ) Overcontour preparation , and ( iii ) Internal dentin groove . The first and second groups were divided into 10 subgroups , and the third group into five subgroups ( n = 10 per group ) with respect to five different adhesive systems ( Prime&Bond NT , Adper Single Bond II , Adper Prompt L-Pop , Clearfil S(3 ) Bond , G Bond ) used with or without a hybrid resin composite ( Z250 ) . Restored teeth were subjected to thermal cycling , and subsequently to the same loading protocol used for fracturing intact teeth . Fracture strength after reattachment procedures was recorded as a percentage of the original fracture strength . Both type of adhesive material and placement of an intermediate layer of resin composite affected the fracture resistance ( P < 0.05 ) . The highest fract 
    Output:
    