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: OBJECTIVE The effect of total arch distalization using orthodontic mini-implants ( OMIs ) combined with interproximal stripping ( IPS ) and second premolar extraction was investigated in Class I malocclusion patients . MATERIAL S AND METHODS A total of 66 consecutively treated Class I malocclusion ( Class I molar relationship ; 0 mm < overbite and overjet < 4.5 mm ) patients ranging in age from 17 to 44 years who received single-phase treatment were included in this study . Pre- and posttreatment lateral cephalograms and dental casts were measured and compared statistically . RESULTS In the distalization with IPS group , 3.6 mm and 3.8 mm of crowding in the upper and lower arches , respectively , were resolved , and 3.8 mm and 3.2 mm of upper and lower incisor retraction , respectively , were achieved simultaneously by the treatment . As a result of the second premolar extraction treatment , 3.9 mm and 3.6 mm of crowding in the upper and lower arches , respectively , were resolved , and 3.3 mm and 3.2 mm of incisor retraction , respectively , were achieved during treatment . There was no statistically significant difference in the amount of crowding and incisor retraction between the two groups . CONCLUSIONS Total arch distalization using an OMI with IPS did not yield a significantly different treatment result compared to second premolar extraction treatment OBJECTIVE To evaluate the influence of attachments and interproximal reduction on canines undergoing rotational movement with Invisalign . MATERIAL S AND METHODS In this prospect i ve clinical study , 53 canines ( 33 maxillary and 20 m and ibular ) were measured from the virtual TREAT models of 31 participants treated with anterior Invisalign .  The pretreatment virtual model of the predicted final tooth position was superimposed on the posttreatment virtual model using ToothMeasure , Invisalign 's proprietary measurement software . A one-way analysis of variance ( ANOVA ) ( P < .05 ) compared three treatment modalities : attachments only ( AO ) , interproximal reduction only ( IO ) , and neither attachments nor interproximal reduction ( N ) . Student 's t-tests ( P < .05 ) compared the mean accuracy of canine rotation between arches . RESULTS The mean accuracy of canine rotation with Invisalign was 35.8 % ( SD = 26.3 ) . Statistical analyses indicated that there was no significant difference in accuracy between groups AO , IO , and N ( P = .343 ) . There was no statistically significant difference ( P = .888 ) in rotational accuracy for maxillary and m and ibular canines for any of the treatment groups . The most commonly prescribed attachment shape was the vertical-ellipsoid ( 70.5 % ) . CONCLUSIONS Vertical-ellipsoid attachments and interproximal reduction do not significantly improve the accuracy of canine rotation with the Invisalign system OBJECTIVE To assess the surface roughness result ing after application of currently available interproximal polishing . MATERIAL S AND METHODS The analysis was carried out by means of digital subtraction radiography , profilometry , and scanning electron microscopy . The roughness of natural untreated enamel served as the reference . Five enamel reduction methods were tested ( Profin , New Metal Strips , O-Drive D30 , Air Rotor , and the Ortho-Strips ) and were applied in accordance with their manufacturers ' recommendations . Fifty-five teeth were treated by r and omly chosen methods , all of which were applied by one person . One proximal surface was only ground and left unpolished while the other received the finishing and polish recommended by the manufacturer . RESULTS Loss of tooth substance , as measured by subtraction radiography , was significantly lower ( P < .05 ) for the group treated with Ortho-Strips .  Profilometric analysis of enamel roughness showed that the use of Ortho-Strips , O-Drive D30 , and New Metal Strips in the grinding mode produced equally rough surfaces ( P > .05 ) . The Air Rotor and Profin system in the grinding mode produced the significantly ( P < .05 ) roughest surfaces . A significant ( P < .05 ) reduction of the mean roughness values was registered in all groups when treatment was followed by polishing . The Profin system and Ortho-Strips achieved the significantly smoothest surfaces ( P < .05 ) with polishing . CONCLUSIONS In general , interproximal enamel reduction should be followed by thorough polishing . Furthermore , oscillating systems seem to be advantageous INTRODUCTION Air-rotor stripping ( ARS ) is a commonly used method to alleviate crowding in the permanent dentition . Its widespread acceptance , however , has been limited by the potential increase in caries risk of the abraded enamel surface . The aim of this study was to compare the susceptibility of ARS-treated enamel surfaces with intact surfaces in patients undergoing fixed orthodontic therapy . METHODS Forty patients treated with ARS were examined clinical ly and radiographically for caries 1 to 6 years after interproximal enamel reduction . All patients were seen by their dentists for prophylaxis at 6-month intervals during active orthodontic treatment and were exposed to fluori date d water and toothpaste . Topical fluoride agents or sealants were not applied on the abraded surface after any ARS session . Caries incidence was compared between ARS-treated and unaltered surfaces within subjects . The decayed , missing , filled tooth ( DMFT ) and surface ( DMFS ) scores were used to evaluate the subjects ' overall caries risk . RESULTS Totals of 376 test and 376 control surfaces were examined . The number of interproximal lesions detected was found to be low with no statistically significant difference detected between the groups ( test = 3 ; control = 6 ; P = .33 ] . The DMFT and DMFS scores increased significantly during the study period , indicating that these patients were clearly at risk of tooth decay ( P < .001 ) . CONCLUSIONS The findings indicate that the risk of caries is not affected by ARS . Furthermore , our data show that the application of topical fluoride on the enamel surfaces immediately after ARS in patients exposed to fluori date d water and fluoride-containing toothpaste may not provide any additional benefit INTRODUCTION A prospect i ve r and omized study was design ed to compare the skeletal , dental , and soft-tissue profile changes in Class I borderline patients treated with extraction and non extraction  by means of the air-rotor stripping ( ARS ) technique and to compare the treatment times . METHODS Twenty-six borderline patients with balanced and orthognathic facial profiles were r and omly divided into 2 groups . In the first group , 13 subjects with a mean age of 18.1 + /- 3.7 years and mean maxillary and m and ibular crowding of 5.7 + /- 1.5 and 5.9 + /- 1.4 mm , respectively , were treated by removal of 4 premolars with minimum anchorage . In the second group , 13 subjects with a mean age of 17.8 + /- 2.4 years and mean maxillary and m and ibular crowding of 5.0 + /- 1.3 and 5.9 + /- 1.3 mm , respectively , were treated with ARS .  Lateral cephalometric radiographs and dental models taken before and after treatment were evaluated . RESULTS The initial skeletal , dental , and profile characteristics of both groups were similar . In the first group , the maxillary and m and ibular incisors were slightly retracted , whereas lip positions did not change . In the non extraction group , maintenance of maxillary incisor position , slight protrusion of the m and ibular incisors and the upper and lower lips were observed at the end of treatment . The nasolabial angle decreased significantly . Because of postpubertal growth of the nose and the chin , the lips appeared slightly retrusive after extraction therapy , whereas lip protrusion was compensated in the non extraction group . The main soft-tissue profile differences between the 2 groups were 1 to 1.5 mm more retruded upper and lower lip positions in the extraction patients , but both groups had well-balanced and desirable facial esthetics with all profile measurements within normal limits . Non extraction therapy with ARS reduced treatment time by 8 months . CONCLUSIONS Both extraction and ARS combined with non extraction therapies are effective treatment alternatives for Class I borderline patients with good facial profile and moderate dental crowding AIM The purpose of this study was to evaluate the ultramorphology and surface roughness of permanent tooth enamel after various post-stripping polishing methods . METHODS Sixty extracted , permanent lower incisors were r and omly assigned to two groups ( Group A and Group B ) . Group A was morphologically assessed by a scanning electron microscopy ( SEM ) and Group B was assessed by a stylus profilometer which applied a surface roughness test . Each group was divided into five subgroups of six incisors . Four of the subgroups were subjected to interpoximal enamel reduction , followed by various polishing methods ; the fifth subgroup served as a control . The polishing methods comprised ; Subgroup 1 , diamond disk followed by a fine Sof-lex disc ; Subgroup 2 , diamond disk and fine diamond bur ; Subgroup 3 , diamond disk and fine tungsten carbide bur ; Subgroup 4 , diamond disk and chemical stripping using 37 % orthophosphoric acid in conjunction with a fine 3 M finishing strip and Subgroup 5 ( control ) , no stripping nor polishing . Qualitative ( scanning electron microscopy ) and quantitative ( surface roughness test ) assessment s were performed . Surface roughness values ( Ra ) for permanent enamel were evaluated using the Welch analysis of variance ( ANOVA ) . RESULTS Subgroup 1 ( diamond disk and fine Sof-lex disc ) produced the smoothest enamel surface and Subgroup 4 ( chemical stripping ) produced the roughest enamel surface . CONCLUSIONS All proximal stripping and polishing methods significantly roughened the enamel surfaces . The best results were obtained when the stripped enamel surfaces were polished and finished with fine Sof-lex discs 
    Output:
    
agent
Complications of interproximal enamel reduction are hypersensitivity , irreversible damage of dental pulp , increased formation of plaque , the risk of caries in the stripped enamel areas and periodontal diseases .
CONCLUSION Interproximal enamel reduction is an important part of orthodontic treatment for gaining space in the dental arch , and for the correction of the Bolton index discrepancy
***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: OBJECTIVE The effect of total arch distalization using orthodontic mini-implants ( OMIs ) combined with interproximal stripping ( IPS ) and second premolar extraction was investigated in Class I malocclusion patients . MATERIAL S AND METHODS A total of 66 consecutively treated Class I malocclusion ( Class I molar relationship ; 0 mm < overbite and overjet < 4.5 mm ) patients ranging in age from 17 to 44 years who received single-phase treatment were included in this study . Pre- and posttreatment lateral cephalograms and dental casts were measured and compared statistically . RESULTS In the distalization with IPS group , 3.6 mm and 3.8 mm of crowding in the upper and lower arches , respectively , were resolved , and 3.8 mm and 3.2 mm of upper and lower incisor retraction , respectively , were achieved simultaneously by the treatment . As a result of the second premolar extraction treatment , 3.9 mm and 3.6 mm of crowding in the upper and lower arches , respectively , were resolved , and 3.3 mm and 3.2 mm of incisor retraction , respectively , were achieved during treatment . There was no statistically significant difference in the amount of crowding and incisor retraction between the two groups . CONCLUSIONS Total arch distalization using an OMI with IPS did not yield a significantly different treatment result compared to second premolar extraction treatment OBJECTIVE To evaluate the influence of attachments and interproximal reduction on canines undergoing rotational movement with Invisalign . MATERIAL S AND METHODS In this prospect i ve clinical study , 53 canines ( 33 maxillary and 20 m and ibular ) were measured from the virtual TREAT models of 31 participants treated with anterior Invisalign .  The pretreatment virtual model of the predicted final tooth position was superimposed on the posttreatment virtual model using ToothMeasure , Invisalign 's proprietary measurement software . A one-way analysis of variance ( ANOVA ) ( P < .05 ) compared three treatment modalities : attachments only ( AO ) , interproximal reduction only ( IO ) , and neither attachments nor interproximal reduction ( N ) . Student 's t-tests ( P < .05 ) compared the mean accuracy of canine rotation between arches . RESULTS The mean accuracy of canine rotation with Invisalign was 35.8 % ( SD = 26.3 ) . Statistical analyses indicated that there was no significant difference in accuracy between groups AO , IO , and N ( P = .343 ) . There was no statistically significant difference ( P = .888 ) in rotational accuracy for maxillary and m and ibular canines for any of the treatment groups . The most commonly prescribed attachment shape was the vertical-ellipsoid ( 70.5 % ) . CONCLUSIONS Vertical-ellipsoid attachments and interproximal reduction do not significantly improve the accuracy of canine rotation with the Invisalign system OBJECTIVE To assess the surface roughness result ing after application of currently available interproximal polishing . MATERIAL S AND METHODS The analysis was carried out by means of digital subtraction radiography , profilometry , and scanning electron microscopy . The roughness of natural untreated enamel served as the reference . Five enamel reduction methods were tested ( Profin , New Metal Strips , O-Drive D30 , Air Rotor , and the Ortho-Strips ) and were applied in accordance with their manufacturers ' recommendations . Fifty-five teeth were treated by r and omly chosen methods , all of which were applied by one person . One proximal surface was only ground and left unpolished while the other received the finishing and polish recommended by the manufacturer . RESULTS Loss of tooth substance , as measured by subtraction radiography , was significantly lower ( P < .05 ) for the group treated with Ortho-Strips .  Profilometric analysis of enamel roughness showed that the use of Ortho-Strips , O-Drive D30 , and New Metal Strips in the grinding mode produced equally rough surfaces ( P > .05 ) . The Air Rotor and Profin system in the grinding mode produced the significantly ( P < .05 ) roughest surfaces . A significant ( P < .05 ) reduction of the mean roughness values was registered in all groups when treatment was followed by polishing . The Profin system and Ortho-Strips achieved the significantly smoothest surfaces ( P < .05 ) with polishing . CONCLUSIONS In general , interproximal enamel reduction should be followed by thorough polishing . Furthermore , oscillating systems seem to be advantageous INTRODUCTION Air-rotor stripping ( ARS ) is a commonly used method to alleviate crowding in the permanent dentition . Its widespread acceptance , however , has been limited by the potential increase in caries risk of the abraded enamel surface . The aim of this study was to compare the susceptibility of ARS-treated enamel surfaces with intact surfaces in patients undergoing fixed orthodontic therapy . METHODS Forty patients treated with ARS were examined clinical ly and radiographically for caries 1 to 6 years after interproximal enamel reduction . All patients were seen by their dentists for prophylaxis at 6-month intervals during active orthodontic treatment and were exposed to fluori date d water and toothpaste . Topical fluoride agents or sealants were not applied on the abraded surface after any ARS session . Caries incidence was compared between ARS-treated and unaltered surfaces within subjects . The decayed , missing , filled tooth ( DMFT ) and surface ( DMFS ) scores were used to evaluate the subjects ' overall caries risk . RESULTS Totals of 376 test and 376 control surfaces were examined . The number of interproximal lesions detected was found to be low with no statistically significant difference detected between the groups ( test = 3 ; control = 6 ; P = .33 ] . The DMFT and DMFS scores increased significantly during the study period , indicating that these patients were clearly at risk of tooth decay ( P < .001 ) . CONCLUSIONS The findings indicate that the risk of caries is not affected by ARS . Furthermore , our data show that the application of topical fluoride on the enamel surfaces immediately after ARS in patients exposed to fluori date d water and fluoride-containing toothpaste may not provide any additional benefit INTRODUCTION A prospect i ve r and omized study was design ed to compare the skeletal , dental , and soft-tissue profile changes in Class I borderline patients treated with extraction and non extraction  by means of the air-rotor stripping ( ARS ) technique and to compare the treatment times . METHODS Twenty-six borderline patients with balanced and orthognathic facial profiles were r and omly divided into 2 groups . In the first group , 13 subjects with a mean age of 18.1 + /- 3.7 years and mean maxillary and m and ibular crowding of 5.7 + /- 1.5 and 5.9 + /- 1.4 mm , respectively , were treated by removal of 4 premolars with minimum anchorage . In the second group , 13 subjects with a mean age of 17.8 + /- 2.4 years and mean maxillary and m and ibular crowding of 5.0 + /- 1.3 and 5.9 + /- 1.3 mm , respectively , were treated with ARS .  Lateral cephalometric radiographs and dental models taken before and after treatment were evaluated . RESULTS The initial skeletal , dental , and profile characteristics of both groups were similar . In the first group , the maxillary and m and ibular incisors were slightly retracted , whereas lip positions did not change . In the non extraction group , maintenance of maxillary incisor position , slight protrusion of the m and ibular incisors and the upper and lower lips were observed at the end of treatment . The nasolabial angle decreased significantly . Because of postpubertal growth of the nose and the chin , the lips appeared slightly retrusive after extraction therapy , whereas lip protrusion was compensated in the non extraction group . The main soft-tissue profile differences between the 2 groups were 1 to 1.5 mm more retruded upper and lower lip positions in the extraction patients , but both groups had well-balanced and desirable facial esthetics with all profile measurements within normal limits . Non extraction therapy with ARS reduced treatment time by 8 months . CONCLUSIONS Both extraction and ARS combined with non extraction therapies are effective treatment alternatives for Class I borderline patients with good facial profile and moderate dental crowding AIM The purpose of this study was to evaluate the ultramorphology and surface roughness of permanent tooth enamel after various post-stripping polishing methods . METHODS Sixty extracted , permanent lower incisors were r and omly assigned to two groups ( Group A and Group B ) . Group A was morphologically assessed by a scanning electron microscopy ( SEM ) and Group B was assessed by a stylus profilometer which applied a surface roughness test . Each group was divided into five subgroups of six incisors . Four of the subgroups were subjected to interpoximal enamel reduction , followed by various polishing methods ; the fifth subgroup served as a control . The polishing methods comprised ; Subgroup 1 , diamond disk followed by a fine Sof-lex disc ; Subgroup 2 , diamond disk and fine diamond bur ; Subgroup 3 , diamond disk and fine tungsten carbide bur ; Subgroup 4 , diamond disk and chemical stripping using 37 % orthophosphoric acid in conjunction with a fine 3 M finishing strip and Subgroup 5 ( control ) , no stripping nor polishing . Qualitative ( scanning electron microscopy ) and quantitative ( surface roughness test ) assessment s were performed . Surface roughness values ( Ra ) for permanent enamel were evaluated using the Welch analysis of variance ( ANOVA ) . RESULTS Subgroup 1 ( diamond disk and fine Sof-lex disc ) produced the smoothest enamel surface and Subgroup 4 ( chemical stripping ) produced the roughest enamel surface . CONCLUSIONS All proximal stripping and polishing methods significantly roughened the enamel surfaces . The best results were obtained when the stripped enamel surfaces were polished and finished with fine Sof-lex discs 
    Output:
    