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: To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results Objective : The aim of this study was to evaluate the performance of a new glass ionomer filling material ( ChemFlex ™ ) using the atraumatic restorative treatment ( ART ) approach in class I cavities in the permanent dentition of Latvian schoolchildren . Methods : A total of 63 fillings ( 40 test and 23 control ) were placed using the ART technique in 41 schoolchildren in Riga at the Stomatology Institute of the Medical Academy of Latvia . These fillings were then blindly assessed after 2 years . Results : The complete success rate for both the test and the control material fillings were 92.5 and 94.9 % , respectively . Conclusion : The new glass ionomer filling has shown a good performance in terms of retention , marginal failure and fractures in class I cavities The present r and omised clinical trial was aim ed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material . The treatment approaches tested in parallel groups were : conventional in a university setting , modified-conventional and ultraconservative ( Atraumatic Restorative Treatment , ART ) approaches in a field setting . A split-mouth design was used in which the two restorative material s were r and omly placed in 430 matched contralateral pairs of permanent molar teeth . A total of 152 children from five primary schools were recruited and treated by a dental therapist . The restorations were evaluated after 6 years by 2 calibrated independent examiners . The 6-year successes for all occlusal amalgam and glass-ionomer restorations were 72.6 and 72.3 % , respectively . There were no statistically significant differences observed between the successes for both amalgam and glass-ionomer restorations placed either by the ART ( 68.6 % , with 95 % CI = 61–76 % ) approach or by the conventional ( 74.5 % , with 95 % CI = 65–82 % ) and the modified-conventional ( 75.8 % , with 95 % CI = 67–83 % ) approaches after 6 years . There was also no statistically significant difference observed between the successes of occlusal ART restorations  with glass-ionomer ( 67.1 % , with 95 % CI = 56–77 % ) and occlusal conventional restorations with amalgam ( 74 % , with 95 % CI = 61–85 % ) after 6 years . ‘ Restoration fracture/marginal defects ’ and ‘ loss of material ’ were the most common causes for failure . The former was more often recorded in amalgam restorations and the latter in glass-ionomer restorations .  Secondary caries was observed for 2 % of glass-ionomer and for 10 % of amalgam restorations . This difference was statistically significant ( p = 0.001 ) . The ART approach using glass-ionomer performed equally well as conventional restorative approaches using electrically driven equipment and amalgam for treating dentinal lesions in occlusal surfaces after 6 years OBJECTIVE To compare the survival of  glass ionomer cement ( GIC ) restorations placed in a dental clinic setting using both the atraumatic restorative treatment ( ART ) approach with h and instruments , and conventional cavity preparation with rotary instruments . METHOD AND MATERIAL S Two encapsulated high-strength conventional GICs ( Fuji IX GP , Ketac-Molar Aplicap ) were placed in 82 Class I and 53 Class II preparations and one encapsulated non-gamma 2 amalgam alloy ( GK-amalgam ) was placed in 32 Class I preparations , in the primary molars of 60 Chinese children with a mean age of 7.40 + /- 1.24 ( SD ) years . Thus , 9 treatment groups were formed . RESULTS After two years , there were no significant survival differences found among 7 of the 9 treatment groups ( p = 0.99 ) . However , two groups comprising Fuji IX GP and Ketac-Molar Aplicap placed in Class II cavities prepared using the ART approach showed significantly lower restoration survivals ( p < 0.001 ) . Only 3 of the 72 initially sealed fissures adjacent to the restorations appeared to retain any GIC material . CONCLUSIONS In a clinic setting , both the ART h and instrument and conventional rotary instrument methods were equally suitable for high Class I restoration survival , but not for Class II restoration survival where the conventional cavity preparation method was preferable AIM The aim of this study was to assess the clinical performance of two adhesive restorative systems ( Single Bond/Filtek P-60 and Single Bond/Filtek Z-250 ) in posterior teeth using a modified United States Public Health Service ( USPHS ) system . METHODS AND MATERIAL S A total of 70 restorations were placed in molars and premolars in 30 patients ( 14 females and 16 males ; 18 - 40 years ) by one operator . All restorations were directly evaluated by two examiners at baseline , six months , and 12 months using the following modified USPHS rating criteria : marginal integrity , marginal discoloration , surface texture , contour , postoperative sensitivity , and recurrent caries . RESULTS At six and 12 months all restorations were available for evaluation of marginal discoloration , surface texture , contour , postoperative sensitivity , and recurrent caries that remained with 100 % Alpha-ratings at recalls for both restorative systems . Marginal integrity for P-60 was scored as 94.3 % and 91.4 % Alpha at six and 12 months , respectively , and rates for Z-250 were 100 % and 97.1 % Alpha at six and 12 months , respectively . Statistical analysis was completed with Fisher 's exact and McNemar Chi-square tests at a significance level of 5 % ( P<0.05 ) . CONCLUSION All restorations were clinical ly satisfactory and no significant differences were found among them . CLINICAL SIGNIFICANCE Posterior resin composite restorations placed under appropriate conditions provide a satisfactory clinical performance BACKGROUND In response to concern that inadequate dental school training may create a barrier to access to care for children , the authors conducted a survey concerning general practitioners ' practice patterns involving child patients . METHODS The authors requested a list of 4,970 r and omly chosen general practitioners from the American Dental Association Survey Center . They then sent those dentists a written survey asking whether and in what numbers they treat children ; the ages and caries levels of any children they do treat ; their perceptions of their educational experiences in pediatric dentistry , and their perceived needs for continuing education in pediatric dentistry . They analyzed data using chi2 . RESULTS Ninety-one percent of the general dentists surveyed treated children , but those younger than 4 years of age , with high levels of caries , and whose care is funded by Medicaid were represented in very low numbers . The types of patients treated and procedures performed by the respondents were significantly ( P < or = .05 ) associated with the intensity of the respondents ' educational experiences , except for the number and types of Medicaid patients they treated . CONCLUSIONS These data indicate that the vast majority of general practitioners treat children in their practice s , but there still are groups of children for whom access to dental care is a problem . PRACTICE IMPLICATION S Very young children , children with high levels of caries and Medicaid-covered children have difficulty finding dental care in the general practice community BACKGROUND The authors undertook a study to evaluate the effect of two cavity preparation methods on the initial survival of two more-viscous glass ionomer cements , or GICs , placed in the occlusal surfaces of permanent molar teeth . METHODS Three dentists placed 149 restorations in 68 adult patients in a hospital clinic . They used either atraumatic restorative treatment , or ART , or conventional cavity preparation methods to place two encapsulated esthetic conventional GICs : Fuji IX GP ( GC International Corp. , Tokyo ) and Ketac-Molar Aplicap ( 3 M ESPE , Seefeld , Germany ) . For comparison , they used high-copper-content GK Amalgam Alloy ( Advanced Technology & Material s Co. Ltd. , Beijing ) in conventional preparations . They evaluated the restorations using both direct and indirect observation methods . RESULTS Cavity preparations for which the authors used ART h and instruments took approximately twice as long to complete as did those for which they used conventional rotary instruments . After 12 months , no restorations had failed , but restorations comprising both GICs showed early losses of adjacent sealant material . Both GICs also showed relatively high restoration wear . At 12 months , the mean cumulative net occlusal wear for Fuji IX GP was 77 + /- 47 micrometers , and for Ketac-Molar 83 + /- 51 microm , without statistical significance ( P > .05 ) . Color matching improved significantly with time ( P < .001 ) , without significant differences in color between the two GICs by 12 months ( P = .09 ) . The amalgam alloy had minor surface tarnishing and marginal discrepancies increased with time ( P < .00 1 ) . CONCLUSIONS All of the occlusal restorations were rated as satisfactory after 12 months . The method of cavity preparation did not affect the restoration performance of the GICs . However , their deterioration requires long-term monitoring . Clinical Implication s. The more viscous GICs appear initially suitable for restricted use in clinical practice when placed using either of two cavity preparation methods in the occlusal surfaces of permanent molar teeth in adults OBJECTIVE The purpose of this study was to evaluate two glass-ionomer cements placed in the occlusal surfaces of permanent molar teeth , using two cavity preparation methods . METHOD AND MATERIAL S Three dentists placed 149 restorations for 68 patients in a hospital clinic .  Atraumatic restorative treatment or conventional cavity preparation methods were used for two encapsulated , high-strength conventional glass-ionomer cements : Fuji IX GP and Ketac-Molar . Non-gamma 2 amalgam alloy was used in conventional preparations for comparison . RESULTS The restorative procedures were uneventful , but cavity preparations made with atraumatic restorative treatment h and instruments took approximately twice as long as did conventional rotary instrumentation . After 30 months , only one glass-ionomer cement restoration had failed . Both glass-ionomer cements showed high early losses of sealant material , but caries was not detected in the exposed fissures . Both glass-ionomer cements also showed relatively high restoration wear . At 30 months , the mean cumulative net occlusal wear was 119 + /- 12 mm for Fuji IX GP and 96 + /- 13 mm for Ketac-Molar ; the difference was not statistically significant . Color matching improved significantly by 6 months ; there was no significant difference in color match between the two glass-ionomer cements by 12 months . Minor surface tarnishing and marginal discrepancies were present in the amalgam restorations and increased with time . CONCLUSION The occlusal restorations performed satisfactorily over periods of up to 30 months . However , the continued deterioration of the cements requires longer-term studies to be undertaken Since the last comprehensive review of anticoagulation in acute myocardial infa rct ion four additional r and omized control trials have been reported . The overwhelming majority of all trials favored anticoagulation .  Rates of thromboembolism were higher in the control , and hemorrhagic complications in the anticoagulated group . Pooling of all r and omized control trials gives mean case fatality rates of 19.6 % for the control and 15.4 % for the anticoagulated group , a relative reduction of 21 % ( P less than 0.05 or less than 0.001 , depending on the analytic method ) . Five of six r and omized control trials reported " no effect " because the difference favoring anticoagulation was not statistically significant . However , sample sizes in these " negative " papers were too small to protect against missing a 21 % reduction in true case fatality rate due to anticoagulation ( beta greater than 0.10 ) . All patients who present no specific contraindication should receive  anticoagulants  during hospitalization for infa rct ion Previous reports have shown a release of fluoride from glass-ionomer cement ( GIC ) restorations into the oral fluids . Fluoride in the ambient fluids has a caries-preventive effect by enhancing remineralization and inhibiting demineralization of the dent 
    Output:
    
agent
Studies investigating restorations placed in the primary dentition showed no significant differences between the groups after 12 and 24 months .
In the permanent dentition , the longevity of ART restorations is equal to or greater than that of equivalent amalgam restorations for up to 6.3 years and is site-dependent .
No difference was observed in primary teeth .
***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: To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results Objective : The aim of this study was to evaluate the performance of a new glass ionomer filling material ( ChemFlex ™ ) using the atraumatic restorative treatment ( ART ) approach in class I cavities in the permanent dentition of Latvian schoolchildren . Methods : A total of 63 fillings ( 40 test and 23 control ) were placed using the ART technique in 41 schoolchildren in Riga at the Stomatology Institute of the Medical Academy of Latvia . These fillings were then blindly assessed after 2 years . Results : The complete success rate for both the test and the control material fillings were 92.5 and 94.9 % , respectively . Conclusion : The new glass ionomer filling has shown a good performance in terms of retention , marginal failure and fractures in class I cavities The present r and omised clinical trial was aim ed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material . The treatment approaches tested in parallel groups were : conventional in a university setting , modified-conventional and ultraconservative ( Atraumatic Restorative Treatment , ART ) approaches in a field setting . A split-mouth design was used in which the two restorative material s were r and omly placed in 430 matched contralateral pairs of permanent molar teeth . A total of 152 children from five primary schools were recruited and treated by a dental therapist . The restorations were evaluated after 6 years by 2 calibrated independent examiners . The 6-year successes for all occlusal amalgam and glass-ionomer restorations were 72.6 and 72.3 % , respectively . There were no statistically significant differences observed between the successes for both amalgam and glass-ionomer restorations placed either by the ART ( 68.6 % , with 95 % CI = 61–76 % ) approach or by the conventional ( 74.5 % , with 95 % CI = 65–82 % ) and the modified-conventional ( 75.8 % , with 95 % CI = 67–83 % ) approaches after 6 years . There was also no statistically significant difference observed between the successes of occlusal ART restorations  with glass-ionomer ( 67.1 % , with 95 % CI = 56–77 % ) and occlusal conventional restorations with amalgam ( 74 % , with 95 % CI = 61–85 % ) after 6 years . ‘ Restoration fracture/marginal defects ’ and ‘ loss of material ’ were the most common causes for failure . The former was more often recorded in amalgam restorations and the latter in glass-ionomer restorations .  Secondary caries was observed for 2 % of glass-ionomer and for 10 % of amalgam restorations . This difference was statistically significant ( p = 0.001 ) . The ART approach using glass-ionomer performed equally well as conventional restorative approaches using electrically driven equipment and amalgam for treating dentinal lesions in occlusal surfaces after 6 years OBJECTIVE To compare the survival of  glass ionomer cement ( GIC ) restorations placed in a dental clinic setting using both the atraumatic restorative treatment ( ART ) approach with h and instruments , and conventional cavity preparation with rotary instruments . METHOD AND MATERIAL S Two encapsulated high-strength conventional GICs ( Fuji IX GP , Ketac-Molar Aplicap ) were placed in 82 Class I and 53 Class II preparations and one encapsulated non-gamma 2 amalgam alloy ( GK-amalgam ) was placed in 32 Class I preparations , in the primary molars of 60 Chinese children with a mean age of 7.40 + /- 1.24 ( SD ) years . Thus , 9 treatment groups were formed . RESULTS After two years , there were no significant survival differences found among 7 of the 9 treatment groups ( p = 0.99 ) . However , two groups comprising Fuji IX GP and Ketac-Molar Aplicap placed in Class II cavities prepared using the ART approach showed significantly lower restoration survivals ( p < 0.001 ) . Only 3 of the 72 initially sealed fissures adjacent to the restorations appeared to retain any GIC material . CONCLUSIONS In a clinic setting , both the ART h and instrument and conventional rotary instrument methods were equally suitable for high Class I restoration survival , but not for Class II restoration survival where the conventional cavity preparation method was preferable AIM The aim of this study was to assess the clinical performance of two adhesive restorative systems ( Single Bond/Filtek P-60 and Single Bond/Filtek Z-250 ) in posterior teeth using a modified United States Public Health Service ( USPHS ) system . METHODS AND MATERIAL S A total of 70 restorations were placed in molars and premolars in 30 patients ( 14 females and 16 males ; 18 - 40 years ) by one operator . All restorations were directly evaluated by two examiners at baseline , six months , and 12 months using the following modified USPHS rating criteria : marginal integrity , marginal discoloration , surface texture , contour , postoperative sensitivity , and recurrent caries . RESULTS At six and 12 months all restorations were available for evaluation of marginal discoloration , surface texture , contour , postoperative sensitivity , and recurrent caries that remained with 100 % Alpha-ratings at recalls for both restorative systems . Marginal integrity for P-60 was scored as 94.3 % and 91.4 % Alpha at six and 12 months , respectively , and rates for Z-250 were 100 % and 97.1 % Alpha at six and 12 months , respectively . Statistical analysis was completed with Fisher 's exact and McNemar Chi-square tests at a significance level of 5 % ( P<0.05 ) . CONCLUSION All restorations were clinical ly satisfactory and no significant differences were found among them . CLINICAL SIGNIFICANCE Posterior resin composite restorations placed under appropriate conditions provide a satisfactory clinical performance BACKGROUND In response to concern that inadequate dental school training may create a barrier to access to care for children , the authors conducted a survey concerning general practitioners ' practice patterns involving child patients . METHODS The authors requested a list of 4,970 r and omly chosen general practitioners from the American Dental Association Survey Center . They then sent those dentists a written survey asking whether and in what numbers they treat children ; the ages and caries levels of any children they do treat ; their perceptions of their educational experiences in pediatric dentistry , and their perceived needs for continuing education in pediatric dentistry . They analyzed data using chi2 . RESULTS Ninety-one percent of the general dentists surveyed treated children , but those younger than 4 years of age , with high levels of caries , and whose care is funded by Medicaid were represented in very low numbers . The types of patients treated and procedures performed by the respondents were significantly ( P < or = .05 ) associated with the intensity of the respondents ' educational experiences , except for the number and types of Medicaid patients they treated . CONCLUSIONS These data indicate that the vast majority of general practitioners treat children in their practice s , but there still are groups of children for whom access to dental care is a problem . PRACTICE IMPLICATION S Very young children , children with high levels of caries and Medicaid-covered children have difficulty finding dental care in the general practice community BACKGROUND The authors undertook a study to evaluate the effect of two cavity preparation methods on the initial survival of two more-viscous glass ionomer cements , or GICs , placed in the occlusal surfaces of permanent molar teeth . METHODS Three dentists placed 149 restorations in 68 adult patients in a hospital clinic . They used either atraumatic restorative treatment , or ART , or conventional cavity preparation methods to place two encapsulated esthetic conventional GICs : Fuji IX GP ( GC International Corp. , Tokyo ) and Ketac-Molar Aplicap ( 3 M ESPE , Seefeld , Germany ) . For comparison , they used high-copper-content GK Amalgam Alloy ( Advanced Technology & Material s Co. Ltd. , Beijing ) in conventional preparations . They evaluated the restorations using both direct and indirect observation methods . RESULTS Cavity preparations for which the authors used ART h and instruments took approximately twice as long to complete as did those for which they used conventional rotary instruments . After 12 months , no restorations had failed , but restorations comprising both GICs showed early losses of adjacent sealant material . Both GICs also showed relatively high restoration wear . At 12 months , the mean cumulative net occlusal wear for Fuji IX GP was 77 + /- 47 micrometers , and for Ketac-Molar 83 + /- 51 microm , without statistical significance ( P > .05 ) . Color matching improved significantly with time ( P < .001 ) , without significant differences in color between the two GICs by 12 months ( P = .09 ) . The amalgam alloy had minor surface tarnishing and marginal discrepancies increased with time ( P < .00 1 ) . CONCLUSIONS All of the occlusal restorations were rated as satisfactory after 12 months . The method of cavity preparation did not affect the restoration performance of the GICs . However , their deterioration requires long-term monitoring . Clinical Implication s. The more viscous GICs appear initially suitable for restricted use in clinical practice when placed using either of two cavity preparation methods in the occlusal surfaces of permanent molar teeth in adults OBJECTIVE The purpose of this study was to evaluate two glass-ionomer cements placed in the occlusal surfaces of permanent molar teeth , using two cavity preparation methods . METHOD AND MATERIAL S Three dentists placed 149 restorations for 68 patients in a hospital clinic .  Atraumatic restorative treatment or conventional cavity preparation methods were used for two encapsulated , high-strength conventional glass-ionomer cements : Fuji IX GP and Ketac-Molar . Non-gamma 2 amalgam alloy was used in conventional preparations for comparison . RESULTS The restorative procedures were uneventful , but cavity preparations made with atraumatic restorative treatment h and instruments took approximately twice as long as did conventional rotary instrumentation . After 30 months , only one glass-ionomer cement restoration had failed . Both glass-ionomer cements showed high early losses of sealant material , but caries was not detected in the exposed fissures . Both glass-ionomer cements also showed relatively high restoration wear . At 30 months , the mean cumulative net occlusal wear was 119 + /- 12 mm for Fuji IX GP and 96 + /- 13 mm for Ketac-Molar ; the difference was not statistically significant . Color matching improved significantly by 6 months ; there was no significant difference in color match between the two glass-ionomer cements by 12 months . Minor surface tarnishing and marginal discrepancies were present in the amalgam restorations and increased with time . CONCLUSION The occlusal restorations performed satisfactorily over periods of up to 30 months . However , the continued deterioration of the cements requires longer-term studies to be undertaken Since the last comprehensive review of anticoagulation in acute myocardial infa rct ion four additional r and omized control trials have been reported . The overwhelming majority of all trials favored anticoagulation .  Rates of thromboembolism were higher in the control , and hemorrhagic complications in the anticoagulated group . Pooling of all r and omized control trials gives mean case fatality rates of 19.6 % for the control and 15.4 % for the anticoagulated group , a relative reduction of 21 % ( P less than 0.05 or less than 0.001 , depending on the analytic method ) . Five of six r and omized control trials reported " no effect " because the difference favoring anticoagulation was not statistically significant . However , sample sizes in these " negative " papers were too small to protect against missing a 21 % reduction in true case fatality rate due to anticoagulation ( beta greater than 0.10 ) . All patients who present no specific contraindication should receive  anticoagulants  during hospitalization for infa rct ion Previous reports have shown a release of fluoride from glass-ionomer cement ( GIC ) restorations into the oral fluids . Fluoride in the ambient fluids has a caries-preventive effect by enhancing remineralization and inhibiting demineralization of the dent 
    Output:
    