***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: In this study the clinical usefulness of a light-curing ( Heliosit ) and a chemically-curing composite ( Concise ) for orthodontic bracket bonding were compared . A sample of 37 patients to be treated with full Edgewise ( FE ) appliance in one or both arches ( in total 52 dental arches ) were r and omly selected to have brackets on the left or right side of the dental arch bonded either with Concise or with Heliosit . In 12 patients , two teeth were extracted before orthodontic treatment and 25 patients were treated non- extraction . Impressions ( Impregum ) of the tooth surface and the bracket were made immediately after bracket loss . Frequency scores of bracket loss were noted for both composites and scanning microscopic evaluation of the tooth/composite surface was performed . Significant differences in bracket loss could be demonstrated between the two composites as a whole , and between the anterior and posterior parts of the dentition . For Heliosit bracket loss was observed predominantly in the posterior region , while for Concise it was distributed more equally over the dental arches . It was , however , demonstrated that in the clinical situation of bracket bonding the chemically-cured Concise failed significantly less than Heliosit in the overall frequency score A clinical trial was carried out to compare the failure rates of a visible light-cured fluoride-releasing material with a chemically cured adhesive .  Fifty patients were used for the trial and 762 brackets were bonded in a split-mouth experimental design . Bracket failures were reported over the full period of orthodontic treatment . Statistical data analysis was carried out by means of chi 2 tests . The results of this study indicate that brackets , bonded with a chemically cured material ( Lee Insta-bond , Lee Pharmaceuticals , EI Monte , Calif. ) , showed significantly fewer failures than brackets bonded with the light-cured material ( Orthon , Orthon Dental Inc. , Victoria , Canada ) . When the site of bond failure was evaluated in an overall manner , there were significantly more lower than upper , and more posterior than anterior bond failures Decalcification during orthodontic treatment is a serious problem . A glass ionomer agent is now available to bond orthodontic brackets as an alternative to composite resins . This prospect i ve study was a clinical trial to determine if a glass ionomer bonding system ( Fuji Ortho LC ) decreases the incidence of decalcification without increasing the amount of bonding failures . A prospect i ve clinical trial with 16 patients encompassing a total of 298 teeth was conducted . The 149 control teeth were bonded with a light-cured composite resin ( Reliance Light Bond ) whereas the 149 experimental teeth were bonded with the light-cured glass ionomer agent .  Patients were followed for a period of 12 to 14 months . All teeth were evaluated for breakage ( bonding failure rate ) , and all maxillary anterior teeth ( 96 ) were evaluated for decalcification on a grade d scale . The glass ionomer failure rate was 24.8 % , and was higher than the composite resin failure rate of 7.4 % ( P < .001 ) . There were more glass ionomer bond failures in 12 of 16 patients ( P < .001 ) . Enamel decalcification was similar in the 2 bonding systems The purpose s of this investigation were to compare the clinical performance of a resin-reinforced self-cured glass ionomer cement to a st and ard composite resin in the direct bonding of orthodontic brackets when bonded onto : a ) dry teeth and b ) teeth soaked with saliva . The two bonding agents were compared using a split-mouth design . In that , both systems were used for direct bonding of stainless steel brackets in every patient . Thirty-eight consecutive patients with fixed appliances were followed for a period of 12 months . The patients were r and omly divided into two groups : group A ( 11 patients ) and group B ( 27 patients ) . In group A , the performance of 220 stainless steel brackets was evaluated : 110 brackets were bonded with GC Fuji Ortho glass ionomer cement ( GC Industrial Co. , Tokyo , Japan ) onto dry teeth , and 110 bonded with System 1 + composite resin ( Ormco Corp. , Glendora , CA ) . In group B , the performance of 540 stainless steel brackets was evaluated : 270 brackets were bonded with GC Fuji Ortho onto teeth soaked with saliva , and 270 bonded with System 1 + . In group A , GC Fuji Ortho recorded an overall failure rate ( 34.5 % ) significantly higher ( p < 0.05 ) than System 1 + ( 9 % ) when applied onto completely dry teeth . Conversely , in group B , no statistically significant differences ( p > 0.05 ) between the failure rates of the two bonding agents were found when GC Fuji Ortho was used on teeth soaked with saliva . It was concluded , therefore , that GC Fuji Ortho shows clinical ly acceptable bond strengths when bonded onto moist teeth , but not when used on dry enamel . Both bonding agents failed mostly at the enamel/adhesive interface , without causing any enamel damage The aim of the study was to evaluate and compare the clinical performance of adhesive precoated brackets ( APC ) with that of two types of uncoated bracket bases , Straight-Wire and Dyna-Lock , bonded using two types of orthodontic adhesives , Transbond XT , and Right-On .  Forty consecutive orthodontic patients entered the trial and 607 brackets were bonded . The incidence and site of first time bond failures were recorded over a period of 1 year . The time required for bonding was also recorded . The overall bond failure rate was 6.6 per cent . There were no significant differences between the failure rates of the five groups , or between the upper and lower arch . However , significantly more brackets failed on the left side than on the right . Premolar brackets were lost most often , whilst incisor brackets failed least . No association was found between bond failure and time elapsed since bonding . Bonding time was least with Right-On adhesive . There were no significant differences between bonding times using APC or Transbond . Results of the present study conflict with those of a previous ex vivo study by the authors , using the same material s and bonding technique . Suggested reasons for this are discussed A clinical trial was carried out to evaluate and compare the clinical performance of a visible light-cured material with a chemically cured adhesive . This was used in combination with two types of bracket base .  Fifty-two patients entered the trial and 542 bracket bases were placed . The incidence and site of bond failure were recorded . The overall failure rate for the light-cured material in combination with both types of bracket was 4.7 % and 6 % for the chemical-cured adhesive . There were no significant differences detected between the failure rates for both types of adhesive in combination with either bracket base , and no bracket base/adhesive combination proved superior ( p greater than 0.05 ) . When the data were examined in an overall manner , a significantly higher posterior tooth failure rate was detected for all adhesive/base combinations ( p less than 0.001 ) The clinical performance of a glass ionomer cement for direct bonding of orthodontic brackets was compared with a composite resin routinely used in this procedure . Brackets were bonded , using both material s , in alternate quadrants of 16 patients of the Orthodontic Clinic of the State University of Rio de Janeiro . A total of 225 teeth , 112 in the glass ionomer cement group and 113 in the composite group , were tested .  Bond failure frequencies were recorded for 12 months , and chi-square statistical test was carried out comparing the failure rates of the material s. The composite showed a statistically significant lower failure rate ( 7.96 % ) than the glass ionomer cement ( 50.89 % ) , regardless of the dental arch tested . Although the glass ionomer cement presents important properties not observed in the composite , it is necessary to increase its cohesive strength to permit its clinical use for direct bonding of orthodontic brackets A clinical trial comparing a conventional adhesive , Concise ® , with a new fluoride-containing composite cement  is described . The bond failure rate , plaque score , gingival health , and enamel decalcification were assessed for each material after a minimum period of 1 year . The preliminary results show no significant difference between the two material s for each of the variables examined , although there was a reduction in the number of white spot lesions using the fluoride-containing composite . The level of fluoride ion concentration required to inhibit the growth of oral micro-organisms is discussed Glass polyalkenoate cements have the unique properties of physicochemically bonding to enamel and base metals and to leach fluoride over prolonged periods . These cements have been modified to provide a dual setting with both light activation and chemical cure to produce a more rapid set . This article reports a 12-month clinical trial of a light-activated glass polyalkenoate cement for the direct bonding of orthodontic brackets , compared with a st and ard composite bonding adhesive . There was no significant difference in failure rates of direct bonded orthodontic brackets cemented with Fuji II LC light-activated glass polyalkenoate cement ( GC Industrial Co. , Tokyo , Japan ) ( 3.3 % ) compared with System I+ composite bonding resin ( Ormco Corp. , Glendora , Calif. ) ( 1.6 % ) The adhesive pre-coated bracket system along with the application of light curing for orthodontic bracket placement were compared with a conventional adhesive system , in a prospect i ve r and omized study . Of 38 consecutive patients requiring fixed orthodontic appliances , half were treated with adhesive pre-coated brackets and half with a no-mix adhesive . The timings for the clinical stages involved in bracket placement , were recorded . This also included the time and reliability of bracket identification and orientation . The peri-bracket flash distribution , time taken for clean up at the subsequent visit , the site , and number of bracket failures at the time of bracket placement and during the first 3 months , were recorded . The study showed that althought the time taken to place and care the adhesive pre-coated system was longer than for the no-mix system , this difference was not statistically significant . However , this difference in time was compensated for in the time taken for bracket orientation in the control group and subsequent clean up at the second visit . Both the bracket failure rate and peri-bracket flash scores were reduced in the adhesive pre-coated group as compared with the control and these differences were statistically significantly . Other advantages of the adhesive pre-coated system are reported Glass  polyalkenoate ( ionomer ) cements have the unique properties to physicochemically bond to enamel and base metals , and to leach fluoride over prolonged periods . These cements are hybrids of silicate and polycarboxylate cements and , like the silicate cements , retain a cariostatic action on adjacent enamel . This article reports on a 12-month clinical trial of a  glass ionomer cement  for the direct bonding of orthodontic brackets compared with a st and ard composite bonding adhesive . This study shows a significant difference in failure rates of direct-bonded orthodontic brackets cemented with a thick mix of Fuji I glass polyalkenoate cement ( 20 % ) compared with System I+ composite bonding resin ( 5 % ) Heliosit-orthodontic , a visible light cured adhesive , has been compared with Right-on , a chemically activated adhesive , on 122 patients for a mean period of 12 months with a range 3–18 months . The overall bond failure rate was 20 per cent . Heliosit-orthodontic had a 23 per cent failure rate compared with a 16 per cent failure rate for Right-on . Heliosit-orthodontic  performed less well on the posterior teeth particularly lower second premolars ( P < 0.01 ) . Both material s performed equally well in the labial segment A clinical trial was undertaken to assess the value of incorporating fluoride released from a commercially available bonding adhesive ( Rely-a-Bond ) to determine the extent of any protection provided against enamel decalcification . Fifty patients undergoing fixed appliance therapy were included in the trial . Contralateral quadrants were used as controls where no fluoride was present in the adhesive . Enamel decalcification after treatment and bond failure rates during treatment were investigated . A total of 366 experimental and 371 control teeth were included in the study . The results showed that 50 per cent of patients and 13.5 per cent of teeth exhibited post-treatment decalcification . The addition of fluoride to the adhesive did not significantly reduce the incidence of enamel decalcification . Bond failure rates were satisfactory for both experimental and control teeth ( all under 5 per cent ) A longitudinal clinical trial was made in forty-two children to compare some commonly used techniques for  orthodontic bracket bonding .  A particular study design ( Figs. 1 and 5 ) allowed blind quadrantwise comparisons in the same patient of six different variables , including direct versus indirect bonding , adhesives of the filled diacrylate resin type with small versus large filler particles , and metal brackets with mesh-backed versus perforated bases . The same person bonded all brackets within one week and performed the orthodontic treatment by a friction-free edgewise light-wire technique . Efforts were made to minimize gingival irritation by using eccentrically placed brackets on small bases , by careful trimming of excess adhesives flash around the bases , and by directing much emphasis on oral hygiene measures . The plaque situation around the brackets and along the gingival margins and the gingival condition were assessed according to the criteria of the plaque and gingival index systems by a dental hygienist at each monthly visit during a test period of 6 months . The study demonstrated that both direct and indirect bonding with the different adhesives and bracket types could give clinical ly satisfactory results . Still , there were statistically significant differences in plaque retention , gingival inflammation , and bond strength . The bonding adhesive with small filler particles was more hygienic than and about as strong as two adhesives with larger , coarser filler particles . The mesh-backed brackets retained less plaque and gave stronger bonds than the brackets with perforated pads . Adv 
    Output:
    
There is no clear evidence on which to make a clinical decision of the type of orthodontic adhesive to use