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: PURPOSE To evaluate the success of posterior NuSmile ( ® ) and Kinder ™ Krown and to determine the level of parental satisfaction with this treatment option . METHODS Forty-eight crowns were placed in 18 children with a mean age of 5 years . A split mouth design was used . Each participant r and omly received each crown type on 2 or 4 pair matched molars . Two trained operators completed all treatments . Two additional trained and calibrated clinicians blindly re-evaluated crowns according to specified variables . A visual analogue scale was used to determine parental satisfaction . Examiner reliability was determined by Cohen 's kappa scores and results were analysed statistically using Fisher 's exact test . RESULTS All crowns were retained after 12 months with no statistical difference in the clinical and radiographic success of posterior NuSmile ( ® ) and Kinder ™ Krowns . Overall success was high with 81 % of facings intact and 83 % free of gingival inflammation after 12 months . Radiographically , 81 % were successful . Veneer facing wear was significantly more likely to occur with opposing crowns ( P=.02 ) . Parental satisfaction was excellent with a mean score of 9.3 out of 10 . CONCLUSIONS These crowns combine the durability of conventional stainless steel crowns with improved esthetics and are proposed as a suitable alternative where esthetic dem and is increased Dental caries in early childhood can have a very significant effect not only on the oral health of young children but on their quality of life and that of their families . Added to this are the long-term infective risks to the host of untreated caries in primary teeth but also the risk of damage to successor permanent teeth . Traditional restoration of damaged primary teeth has been shown to have only moderate outcomes depending on the techniques and material s used and the ability of children to cooperate because of age or other factors . The Hall technique has outperformed other techniques in r and omised clinical trials . In this Opinion Article I will take a look back at the Innes et al. paper , first published in this Journal in 2006 , that introduced the Hall Technique and the subsequent scientific literature which provided us with high quality scientific evidence of the efficacy of the technique . I will evaluate how this new technique has affected the management of early childhood caries  and hence its influence on wider oral and general health Background There is a lack of evidence for effective management of  dental caries ( decay ) in children ’s primary ( baby ) teeth and an apparent failure of conventional dental restorations ( fillings ) to prevent dental pain and infection for UK children in Primary Care . UK dental schools ’ teaching has been based on British Society of Paediatric Dentistry guidance which recommends that caries in primary teeth should be removed and a restoration placed . However , the evidence base for this is limited in volume and quality , and comes from studies conducted in either secondary care or specialist practice s. Restorations provided in specialist environments can be effective but the generalisability of this evidence to Primary Care has been question ed . The FiCTION trial addresses the Health Technology Assessment ( HTA ) Programme ’s commissioning brief and research question “ What is the clinical and cost effectiveness of restoration caries in primary teeth , compared to no treatment ? ” It compares conventional restorations with an intermediate treatment strategy based on the biological ( sealing-in ) management of caries and with no restorations . Methods / Design This is a Primary Care-based multi-centre , three-arm , parallel group , patient-r and omised controlled trial . Practitioners are recruiting 1461 children , ( 3–7 years ) with at least one primary molar tooth where caries extends into dentine . Children are r and omized and treated according to one of three treatment approaches ; conventional caries management with best practice prevention , biological management of caries with best practice prevention or best practice prevention alone . Baseline measures and outcome data ( at review /treatment during three year follow-up ) are assessed through direct reporting , clinical examination including blinded radiograph assessment , and child/parent question naires . The primary outcome measure is the incidence of either pain or infection related to dental caries . Secondary outcomes are ; incidence of caries in primary and permanent teeth , patient quality of life , cost-effectiveness , acceptability of treatment strategies to patients and parents and their experiences , and dentists ’ preferences . Discussion FiCTION will provide evidence for the most clinical ly-effective and cost-effective approach to managing caries in children ’s primary teeth in Primary Care . This will support general dental practitioners in treatment decision making for child patients to minimize pain and infection in primary teeth . The trial is currently recruiting patients .Trial registration Protocol ID : NCTU : IS RCT Aims To prospect ively report on the survival of resin-modified glass ionomer cement ( RMGIC ) , photac-fil and pre-formed stainless steel crown ( SSC ) restorations in primary molar teeth placed over a seven-year period in a specialist paediatric dental practice under private contract of remuneration . Method All primary molar restorations placed by a specialist paediatric dentist over a seven-year period were review ed and the outcome results recorded . Data were recorded at review visits until June 30 , 2003 . Data recorded included Class I restorations , Class II restorations and SSC . The Class II cavities were either mesial or distal , with or without buccal/palatal extensions . If both proximal surfaces were decayed or if after cavity preparation the result ant outline form was significantly larger than the minimal classical form , RMGIC was not used ; an SSC was placed instead . Stainless steel crown preparation followed conventional guidelines . The crowns were cemented with reinforced zinc oxide and eugenol ( Kalzinol ) . The status was recorded as satisfactory restoration , tooth exfoliated , tooth extracted for orthodontic reasons with the date of extraction , or needing replacement . If replaced then the reason for replacement was also recorded . Results A total of 544 Class I RMGICs , 962 Class II RMGICs , and 1,010 SSCs  were placed . At the last review of each restoration , 98.3 % of Class I , 97.3 % of Class II RMGICs and 97.0 % of SSCs were either satisfactory or withdrawn intact . Conclusion Under the conditions of private specialist practice -based study SSCs continued to prove very successful for the restoration of larger cavities and for pulp-treated primary molar teeth . For the smaller cavities RMGIC were also very successful BACKGROUND Limited information is available from r and omized clinical trials comparing the longevity of  amalgam and resin-based compomer/composite restorations . The authors compared replacement rates of these types of restorations in posterior teeth during the five-year follow-up of the New Engl and Children 's Amalgam Trial . METHODS The authors r and omized children aged 6 to 10 years who had two or more posterior occlusal carious lesions into groups that received amalgam ( n=267 ) or compomer ( primary teeth)/composite ( permanent teeth ) ( n=267 ) restorations  and followed them up semiannually . They compared the longevity of restorations placed on all posterior surfaces using r and om effects survival analysis . RESULTS The average+/-st and ard deviation follow-up was 2.8+/-1.4 years for primary tooth restorations and 3.4+/-1.9 years for permanent tooth restorations . In primary teeth , the replacement rate was 5.8 percent of compomers versus 4.0 percent of amalgams ( P=.10 ) , with 3.0 percent versus 0.5 percent ( P=.002 ) , respectively , due to recurrent caries . In permanent teeth , the replacement rate was 14.9 percent of composites versus 10.8 percent of amalgams ( P=.45 ) , and the repair rate was 2.8 percent of composites versus 0.4 percent of amalgams ( P=.02 ) . CONCLUSION Although the overall difference in longevity was not statistically significant , compomer was replaced significantly more frequently owing to recurrent caries , and composite restorations required seven times as many repairs as did amalgam restorations . CLINICAL IMPLICATION S Compomer/composite restorations on posterior tooth surfaces in children may require replacement or repair at higher rates than amalgam restorations , even within five years of placement The development of adhesive restorative material s has led to more conservative cavity design with greater reliance being placed upon the bond of a material with tooth tissue for retention of the restoration . Glass-ionomer cements may offer particular advantages but have yet to achieve the durability reported for amalgam . This study reports on the results of a 2.5-year prospect i ve clinical trial comparing the durability of two glass-ionomer cements , a conventional material ( Ketac Fil ) and a metal reinforced cermet ( Ketac Silver ) in the restoration of Class II lesions in primary molars . Forty-six pairs of restorations were assessed in 37 children . The failure rate of Ketac Fil , 23 % , was significantly lower than that of Ketac Silver , 41 % ( P < 0.05 ) . The median survival time of the Ketac Fil restorations was significantly greater , 25.3 months , than that of the Ketac Silver restorations , 20.3 months ( P < 0.05 ) . These values may be an underestimate of the true longevity of both restoration types as many of the restorations survived intact at the censor date . Neither the age of the child nor the tooth restored influenced the durability of the restoration . The deterioration in both marginal integrity and anatomic form of the Ketac Silver restorations  was significantly greater than the Ketac Fil restorations ( P < 0.05 ) . The durability of Ketac Silver was such that it can not be recommended for use in restoring carious primary PURPOSE To evaluate the 1-year clinical performance of Dyract in primary molars . MATERIAL S AND METHODS 55 children ( aged 4 - 9 years ) received 1 - 3 restorations ( n = 91 ) utilizing Dyract , a new restorative material combining properties of both glass ionomers and composites . RESULTS The so-called compomer material showed good h and ling characteristics and a survival rate of 97 % after 1 year . Nevertheless , the material demonstrated an average wear of 190 microns during 1 year , with 67 % of the restorations having occlusal wear of less than 200 microns . The combination of a low failure rate and the ease of application makes the compomer material very suitable for application in the primary dentition OBJECTIVE The aim of this in vitro study was to evaluate the interaction between two sources of fluoride ( restorative systems and dentifrices ) in inhibiting artificial root caries development . METHODS One hundred and eighty tooth segments were embedded in polyester resin , and s and ed flat . Cylindrical cavities 1.0mm-deep and 1.5mm-diameter were prepared in root dentin and r and omly restored by fluoride-containing restorative systems : Ketac-fil/Espe ( Ke ) , Fuji II LC/GC Corp ( Fj ) , F2000/3 M ( F2 ) , Surefil/Dentsply ( Su ) or a control : Filtek Z250/3 M ( Z2 ) . Ten experimental groups were made to test the association among the five restorative systems and two dentifrices : with F(- ) ( Sensodyne Baking Soda ) or without F(- ) ( Sensodyne Original ) ( n=18 ) . After surface polishing , a 1mm-wide margin around the restorations was demarcated and initial dentin surface Knoop microhardness values ( KHN(i ) ) were obtained . The specimens were su bmi tted to a pH-cycling model , and to applications of slurries of dentifrice . Afterwards the final dentin surface Knoop microhardness values ( KHN(f ) ) were measured . RESULTS The differences between KHN(i ) and KHN(f ) , and the covariate KHN(i ) were considered by the ANCOVA and Tukey 's test ( alpha=0.05 ) . The interaction between restorative system and dentifrice was statistically significant ( p=0.0026 ) . All restorative systems provided some protection against artificial caries challenge when associated with the fluoride-containing dentifrice treatment . The means ( st and ard deviation ) of reductions in Knoop hardness values for systems associated with the fluoride-containing dentifrice were : Ke : 40.0(1.02)(a ) , Fj : 41.9(1.02)(b ) , F2 : 43.3(1.04)(c ) , Su : 43.5(1.00)(c ) , Z2 : 44.0(1.02)(c ) ; and with the non-fluoride-containing dentifrice were : Ke : 42.9(1.02)(a ) , Fj : 44.7(1.01)(b ) , F2 : 45.2(1.09)(bc ) , Su : 46.0(0.99)(c ) , Z2 : 46.6(0.99)(c ) ( statistical differences were expressed by different letters ) . CONCLUSION The cariostatic effect shown by the fluoride-containing dentifrice could enhance that shown by Ketac-fil and Fuji II LC , and could mask that shown by F2000 There is no consensus about an association between microleakage and secondary caries , especially considering the presence of fluoride ( F ) at the tooth/restoration interface . Thus , a r and omized , double-blind , crossover study was carried out to evaluate in situ the effect of microleakage on caries around enamel-dentine restorations in the presence of F from dental material s or dentifrice , either alone or in combination . In 4 phases of 14 days each , 14 volunteers wore palatal devices containing dental slabs restored with composite resin ( CR ) or resin-modified glass ionomer cement ( GI ) . Restorations were made without leakage ( L– ) , following the recommended ad 
    Output:
    
agent
Class I restorations and restorations placed using rubber dam presented better AFR .
An elevated number of failures were observed due to recurrent caries , highlighting the need for professionals to work with a health-promoting approach .
***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: PURPOSE To evaluate the success of posterior NuSmile ( ® ) and Kinder ™ Krown and to determine the level of parental satisfaction with this treatment option . METHODS Forty-eight crowns were placed in 18 children with a mean age of 5 years . A split mouth design was used . Each participant r and omly received each crown type on 2 or 4 pair matched molars . Two trained operators completed all treatments . Two additional trained and calibrated clinicians blindly re-evaluated crowns according to specified variables . A visual analogue scale was used to determine parental satisfaction . Examiner reliability was determined by Cohen 's kappa scores and results were analysed statistically using Fisher 's exact test . RESULTS All crowns were retained after 12 months with no statistical difference in the clinical and radiographic success of posterior NuSmile ( ® ) and Kinder ™ Krowns . Overall success was high with 81 % of facings intact and 83 % free of gingival inflammation after 12 months . Radiographically , 81 % were successful . Veneer facing wear was significantly more likely to occur with opposing crowns ( P=.02 ) . Parental satisfaction was excellent with a mean score of 9.3 out of 10 . CONCLUSIONS These crowns combine the durability of conventional stainless steel crowns with improved esthetics and are proposed as a suitable alternative where esthetic dem and is increased Dental caries in early childhood can have a very significant effect not only on the oral health of young children but on their quality of life and that of their families . Added to this are the long-term infective risks to the host of untreated caries in primary teeth but also the risk of damage to successor permanent teeth . Traditional restoration of damaged primary teeth has been shown to have only moderate outcomes depending on the techniques and material s used and the ability of children to cooperate because of age or other factors . The Hall technique has outperformed other techniques in r and omised clinical trials . In this Opinion Article I will take a look back at the Innes et al. paper , first published in this Journal in 2006 , that introduced the Hall Technique and the subsequent scientific literature which provided us with high quality scientific evidence of the efficacy of the technique . I will evaluate how this new technique has affected the management of early childhood caries  and hence its influence on wider oral and general health Background There is a lack of evidence for effective management of  dental caries ( decay ) in children ’s primary ( baby ) teeth and an apparent failure of conventional dental restorations ( fillings ) to prevent dental pain and infection for UK children in Primary Care . UK dental schools ’ teaching has been based on British Society of Paediatric Dentistry guidance which recommends that caries in primary teeth should be removed and a restoration placed . However , the evidence base for this is limited in volume and quality , and comes from studies conducted in either secondary care or specialist practice s. Restorations provided in specialist environments can be effective but the generalisability of this evidence to Primary Care has been question ed . The FiCTION trial addresses the Health Technology Assessment ( HTA ) Programme ’s commissioning brief and research question “ What is the clinical and cost effectiveness of restoration caries in primary teeth , compared to no treatment ? ” It compares conventional restorations with an intermediate treatment strategy based on the biological ( sealing-in ) management of caries and with no restorations . Methods / Design This is a Primary Care-based multi-centre , three-arm , parallel group , patient-r and omised controlled trial . Practitioners are recruiting 1461 children , ( 3–7 years ) with at least one primary molar tooth where caries extends into dentine . Children are r and omized and treated according to one of three treatment approaches ; conventional caries management with best practice prevention , biological management of caries with best practice prevention or best practice prevention alone . Baseline measures and outcome data ( at review /treatment during three year follow-up ) are assessed through direct reporting , clinical examination including blinded radiograph assessment , and child/parent question naires . The primary outcome measure is the incidence of either pain or infection related to dental caries . Secondary outcomes are ; incidence of caries in primary and permanent teeth , patient quality of life , cost-effectiveness , acceptability of treatment strategies to patients and parents and their experiences , and dentists ’ preferences . Discussion FiCTION will provide evidence for the most clinical ly-effective and cost-effective approach to managing caries in children ’s primary teeth in Primary Care . This will support general dental practitioners in treatment decision making for child patients to minimize pain and infection in primary teeth . The trial is currently recruiting patients .Trial registration Protocol ID : NCTU : IS RCT Aims To prospect ively report on the survival of resin-modified glass ionomer cement ( RMGIC ) , photac-fil and pre-formed stainless steel crown ( SSC ) restorations in primary molar teeth placed over a seven-year period in a specialist paediatric dental practice under private contract of remuneration . Method All primary molar restorations placed by a specialist paediatric dentist over a seven-year period were review ed and the outcome results recorded . Data were recorded at review visits until June 30 , 2003 . Data recorded included Class I restorations , Class II restorations and SSC . The Class II cavities were either mesial or distal , with or without buccal/palatal extensions . If both proximal surfaces were decayed or if after cavity preparation the result ant outline form was significantly larger than the minimal classical form , RMGIC was not used ; an SSC was placed instead . Stainless steel crown preparation followed conventional guidelines . The crowns were cemented with reinforced zinc oxide and eugenol ( Kalzinol ) . The status was recorded as satisfactory restoration , tooth exfoliated , tooth extracted for orthodontic reasons with the date of extraction , or needing replacement . If replaced then the reason for replacement was also recorded . Results A total of 544 Class I RMGICs , 962 Class II RMGICs , and 1,010 SSCs  were placed . At the last review of each restoration , 98.3 % of Class I , 97.3 % of Class II RMGICs and 97.0 % of SSCs were either satisfactory or withdrawn intact . Conclusion Under the conditions of private specialist practice -based study SSCs continued to prove very successful for the restoration of larger cavities and for pulp-treated primary molar teeth . For the smaller cavities RMGIC were also very successful BACKGROUND Limited information is available from r and omized clinical trials comparing the longevity of  amalgam and resin-based compomer/composite restorations . The authors compared replacement rates of these types of restorations in posterior teeth during the five-year follow-up of the New Engl and Children 's Amalgam Trial . METHODS The authors r and omized children aged 6 to 10 years who had two or more posterior occlusal carious lesions into groups that received amalgam ( n=267 ) or compomer ( primary teeth)/composite ( permanent teeth ) ( n=267 ) restorations  and followed them up semiannually . They compared the longevity of restorations placed on all posterior surfaces using r and om effects survival analysis . RESULTS The average+/-st and ard deviation follow-up was 2.8+/-1.4 years for primary tooth restorations and 3.4+/-1.9 years for permanent tooth restorations . In primary teeth , the replacement rate was 5.8 percent of compomers versus 4.0 percent of amalgams ( P=.10 ) , with 3.0 percent versus 0.5 percent ( P=.002 ) , respectively , due to recurrent caries . In permanent teeth , the replacement rate was 14.9 percent of composites versus 10.8 percent of amalgams ( P=.45 ) , and the repair rate was 2.8 percent of composites versus 0.4 percent of amalgams ( P=.02 ) . CONCLUSION Although the overall difference in longevity was not statistically significant , compomer was replaced significantly more frequently owing to recurrent caries , and composite restorations required seven times as many repairs as did amalgam restorations . CLINICAL IMPLICATION S Compomer/composite restorations on posterior tooth surfaces in children may require replacement or repair at higher rates than amalgam restorations , even within five years of placement The development of adhesive restorative material s has led to more conservative cavity design with greater reliance being placed upon the bond of a material with tooth tissue for retention of the restoration . Glass-ionomer cements may offer particular advantages but have yet to achieve the durability reported for amalgam . This study reports on the results of a 2.5-year prospect i ve clinical trial comparing the durability of two glass-ionomer cements , a conventional material ( Ketac Fil ) and a metal reinforced cermet ( Ketac Silver ) in the restoration of Class II lesions in primary molars . Forty-six pairs of restorations were assessed in 37 children . The failure rate of Ketac Fil , 23 % , was significantly lower than that of Ketac Silver , 41 % ( P < 0.05 ) . The median survival time of the Ketac Fil restorations was significantly greater , 25.3 months , than that of the Ketac Silver restorations , 20.3 months ( P < 0.05 ) . These values may be an underestimate of the true longevity of both restoration types as many of the restorations survived intact at the censor date . Neither the age of the child nor the tooth restored influenced the durability of the restoration . The deterioration in both marginal integrity and anatomic form of the Ketac Silver restorations  was significantly greater than the Ketac Fil restorations ( P < 0.05 ) . The durability of Ketac Silver was such that it can not be recommended for use in restoring carious primary PURPOSE To evaluate the 1-year clinical performance of Dyract in primary molars . MATERIAL S AND METHODS 55 children ( aged 4 - 9 years ) received 1 - 3 restorations ( n = 91 ) utilizing Dyract , a new restorative material combining properties of both glass ionomers and composites . RESULTS The so-called compomer material showed good h and ling characteristics and a survival rate of 97 % after 1 year . Nevertheless , the material demonstrated an average wear of 190 microns during 1 year , with 67 % of the restorations having occlusal wear of less than 200 microns . The combination of a low failure rate and the ease of application makes the compomer material very suitable for application in the primary dentition OBJECTIVE The aim of this in vitro study was to evaluate the interaction between two sources of fluoride ( restorative systems and dentifrices ) in inhibiting artificial root caries development . METHODS One hundred and eighty tooth segments were embedded in polyester resin , and s and ed flat . Cylindrical cavities 1.0mm-deep and 1.5mm-diameter were prepared in root dentin and r and omly restored by fluoride-containing restorative systems : Ketac-fil/Espe ( Ke ) , Fuji II LC/GC Corp ( Fj ) , F2000/3 M ( F2 ) , Surefil/Dentsply ( Su ) or a control : Filtek Z250/3 M ( Z2 ) . Ten experimental groups were made to test the association among the five restorative systems and two dentifrices : with F(- ) ( Sensodyne Baking Soda ) or without F(- ) ( Sensodyne Original ) ( n=18 ) . After surface polishing , a 1mm-wide margin around the restorations was demarcated and initial dentin surface Knoop microhardness values ( KHN(i ) ) were obtained . The specimens were su bmi tted to a pH-cycling model , and to applications of slurries of dentifrice . Afterwards the final dentin surface Knoop microhardness values ( KHN(f ) ) were measured . RESULTS The differences between KHN(i ) and KHN(f ) , and the covariate KHN(i ) were considered by the ANCOVA and Tukey 's test ( alpha=0.05 ) . The interaction between restorative system and dentifrice was statistically significant ( p=0.0026 ) . All restorative systems provided some protection against artificial caries challenge when associated with the fluoride-containing dentifrice treatment . The means ( st and ard deviation ) of reductions in Knoop hardness values for systems associated with the fluoride-containing dentifrice were : Ke : 40.0(1.02)(a ) , Fj : 41.9(1.02)(b ) , F2 : 43.3(1.04)(c ) , Su : 43.5(1.00)(c ) , Z2 : 44.0(1.02)(c ) ; and with the non-fluoride-containing dentifrice were : Ke : 42.9(1.02)(a ) , Fj : 44.7(1.01)(b ) , F2 : 45.2(1.09)(bc ) , Su : 46.0(0.99)(c ) , Z2 : 46.6(0.99)(c ) ( statistical differences were expressed by different letters ) . CONCLUSION The cariostatic effect shown by the fluoride-containing dentifrice could enhance that shown by Ketac-fil and Fuji II LC , and could mask that shown by F2000 There is no consensus about an association between microleakage and secondary caries , especially considering the presence of fluoride ( F ) at the tooth/restoration interface . Thus , a r and omized , double-blind , crossover study was carried out to evaluate in situ the effect of microleakage on caries around enamel-dentine restorations in the presence of F from dental material s or dentifrice , either alone or in combination . In 4 phases of 14 days each , 14 volunteers wore palatal devices containing dental slabs restored with composite resin ( CR ) or resin-modified glass ionomer cement ( GI ) . Restorations were made without leakage ( L– ) , following the recommended ad 
    Output:
    