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 This study evaluated the adhesion of 10-MDP containing self-etch and self-adhesive resin cements to dentin with and without the use of etch- and -rinse technique . MATERIAL S AND METHODS Human third molars ( N=180 ) were r and omly divided into 6 groups ( n=30 per group ) . Conventional ( Panavia F2.0 , Kuraray-PAN ) and self-adhesive resin cements ( Clearfil SA , Kuraray-CSA ) were bonded to dentin surfaces either after application of 3-step etch- and -rinse ( 35 % H3PO4 + ED Primer ) or two-step self-etch adhesive resin ( Clearfil SE Bond ) . Specimens were subjected to shear bond strength test using the universal testing machine ( 0.5 mm/min ) . The failure types were analyzed using a stereomicroscope and quality of hybrid layer was observed under a scanning electron microscope . The data ( MPa ) were analyzed using two-way ANOVA and Tukey 's tests ( α=.05 ) . RESULTS Overall , PAN adhesive cement showed significantly higher mean bond strength ( 12.5 ± 2.3 - 14.1 ± 2.4 MPa ) than CSA cement ( 9.3 ± 1.4 - 13.9 ± 1.9 MPa ) ( P<.001 ) . Adhesive failures were more frequent in CSA cement groups when used in conjunction with two-step self-adhesive ( 68 % ) or no adhesive at all ( 66 % ) . Hybrid layer quality was inferior in CSA compared to PAN cement in all conditions . CONCLUSION In clinical situations where bonding to dentin substrate is crucial , both conventional and self-adhesive resin cements based on 10-MDP can benefit from etch- and -rinse technique to achieve better quality of adhesion in the early clinical period OBJECTIVE To evaluate the microtensile bond strengths ( μTBS ) and nanoleakage ( NL ) of three universal or multi-mode adhesives , applied with increasing solvent evaporation times . METHODS One-hundred and forty caries-free extracted third molars were divided into 20 groups for bond strength testing , according to three factors : ( 1 ) Adhesive - All-Bond Universal ( ABU , Bisco , Inc. ) , Prime&Bond Elect ( PBE , Dentsply ) , and Scotchbond Universal Adhesive ( SBU , 3 M ESPE ) ; ( 2 ) Bonding strategy - self-etch ( SE ) or etch- and -rinse ( ER ) ; and ( 3 ) Adhesive solvent evaporation time - 5s , 15s , and 25s . Two extra groups were prepared with ABU because the respective manufacturer recommends a solvent evaporation time of 10s . After restorations were constructed , specimens were stored in water ( 37 ° C/24h ) . Resin-dentin beams ( 0.8mm(2 ) ) were tested at 0.5mm/min ( μTBS ) . For NL , forty extracted molars were r and omly assigned to each of the 20 groups . Dentin disks were restored , immersed in ammoniacal silver nitrate , sectioned and processed for evaluation under a FESEM in backscattered mode . Data from μTBS were analyzed using two-way ANOVA ( adhesive vs. drying time ) for each strategy , and Tukey 's test ( α=0.05 ) . NL data were computed with non-parametric tests ( Kruskal-Wallis and Mann-Whitney tests , α=0.05 ) . RESULTS Increasing solvent evaporation time from 5s to 25s result ed in statistically higher mean μTBS for all adhesives when used in ER mode . Regarding NL , ER result ed in greater NL than SE for each of the evaporation times regardless of the adhesive used . A solvent evaporation time of 25s result ed in the lowest NL for SBU-ER . SIGNIFICANCE Residual water and /or solvent may compromise the performance of universal adhesives , which may be improved with extended evaporation times BACKGROUND The durability of restorations bonded with one-step self-etching ( OSSE ) adhesive systems is inferior compared with that of restorations bonded with conventional adhesives . The authors conducted an 18-month r and omized clinical study to evaluate the clinical performance of two OSSE systems in noncarious cervical lesions applied as recommended or with an extra layer of hydrophobic adhesive layer after 18 months of clinical service . METHODS Thirty participants , each of whom had at least two pairs of similar-sized noncarious cervical lesions , took part in this study . The authors placed 120 restorations  , 30 in each of four groups : Clearfil S3 Bond ( Kuraray , Osaka , Japan ) ( CS ) and iBond Gluma inside ( Heraeus Kulzer , Hanau , Germany ) ( IB ) , and Clearfil S3 Bond ( CSB ) and iBond Gluma inside ( IBB ) with an extra layer of hydrophobic adhesive applied on top of them . They placed the restorations incrementally , using a resin-based composite . The authors evaluated the restorations at baseline and at 18 months following modified U.S. Public Health Service criteria . RESULTS At 18 months , the retention rate for the IB group was statistically lower than those for the CS , IBB and CSB groups . Marginal discoloration occurred in all groups and was statistically worse in the IB group . CONCLUSIONS The conversion of the iBond Gluma inside and Clearfil S3 Bond adhesive systems into two-step systems by means of applying an extra hydrophobic adhesive layer improved the clinical performance of these material s after 18 months of clinical service . CLINICAL IMPLICATION S The application of an extra hydrophobic adhesive layer over OSSE adhesive systems , layers improved the OSSE systems clinical performance , mainly in terms of retention rate Abstract Objective . The aim of this study was to evaluate the efficacy of the microtensile , microshear and shear bond strength test methods to assess the bond strength of two self-etch adhesives and one etch&rinse adhesive on dentin . Material s and methods : Seventy-five extracted human molars were ground to expose their flat dentin surfaces and r and omly assigned to one of three groups according to the type of test method ( 15 for microtensile , 15 for microshear , 45 for shear ) . Each of these groups was then assigned to three sub-groups according to the bonding systems ( Clearfil SE Bond , Kuraray ; G Bond , GC ; Prime&Bond NT , Dentsply ) used . Then , 15 specimens were prepared for each sub-group according to the test method employed ( n = 15 ) . After being stored in distilled water at 37 ° C for 24 h , the specimens were placed in a universal testing machine for three test methods and stressed at a crosshead speed of 0.5 mm/min . Mean bond strengths were analyzed using Kruskall-Wallis and Mann-Whitney U-tests at a significance level of p < 0.05 . Results . The microtensile test had the highest bond strength ( p = 0.046 ) . Clearfil SE Bond and Prime&Bond NT produced significantly higher values than the G Bond in the microtensile bond test ( p < 0.05 ) , whereas no significant differences were found among the adhesives in the microshear bond test ( p > 0.05 ) . For the shear test , Clearfil SE Bond showed higher bond strength than Prime&Bond NT and G Bond ( p < 0.05 ) . Conclusion : Bond strength to dentin depends on the material and the test method used OBJECTIVE The objective of this r and omized controlled clinical trial was to evaluate the 13-year clinical performance of a mild two-step self-etch adhesive in non-carious cervical lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins . METHODS A total of 100 non-carious cervical lesions in 29 patients were restored with Clearfil AP-X ( Kuraray Noritake ) . The composite restorations were bonded following two different approaches : ( 1 ) application of Clearfil SE Bond ( Kuraray Noritake ) following a self-etch approach ( CSE-NE ) ; ( 2 ) selective phosphoric acid-etching of enamel cavity margins before application of Clearfil SE Bond ( CSE-E ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 , 8 and 13 years of clinical service regarding retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality and post-operative sensitivity . RESULTS The patient recall rate at 13 years was 62 % . Six restorations , 4 of the CSE-NE group and 2 of the CSE-E group , were clinical ly unacceptable due to loss of retention ( 1 CSE-NE , 1 CSE-E ) , a severe marginal defect ( 2 CSE-NE , 1 CSE-E ) and caries occurrence in combination with a severe marginal defect ( 1 CSE-NE ) leading to a clinical success rate of 86 % ( CSE-NE ) and 93 % ( CSE-E ) . Ageing of the restorations was characterized by a further increase in the percentage of restorations with a clinical ly acceptable small marginal defect ( CSE-NE : 87 % ; CSE-E : 83 % ) and /or superficial marginal discoloration ( CSE-NE : 53 % ; CSE-E : 56 % ) . The presence of small marginal defects ( CSE-NE : 86 % ; CSE-E : 68 % ) and superficial marginal discoloration ( CSE-NE : 41 % ; CSE-E : 20 % ) at the incisal enamel side was more frequently noticed in the CSE-NE group than in the CSE-E group . The difference , however , was not statistically significant ( McNemar , p>0.05 ) . SIGNIFICANCE After 13 years , the clinical effectiveness of Clearfil SE Bond in non-carious Class-V lesions remained excellent , with selective acid-etching of the enamel cavity margins only having some minor positive effect on marginal integrity and absence of marginal discoloration 
    Output:
    
agent
Conclusions Multi-mode ' universal ' adhesives can achieve substantial bonding to dentin , regardless of the used modes ( either etch- and -rinse or self-etch )
***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 This study evaluated the adhesion of 10-MDP containing self-etch and self-adhesive resin cements to dentin with and without the use of etch- and -rinse technique . MATERIAL S AND METHODS Human third molars ( N=180 ) were r and omly divided into 6 groups ( n=30 per group ) . Conventional ( Panavia F2.0 , Kuraray-PAN ) and self-adhesive resin cements ( Clearfil SA , Kuraray-CSA ) were bonded to dentin surfaces either after application of 3-step etch- and -rinse ( 35 % H3PO4 + ED Primer ) or two-step self-etch adhesive resin ( Clearfil SE Bond ) . Specimens were subjected to shear bond strength test using the universal testing machine ( 0.5 mm/min ) . The failure types were analyzed using a stereomicroscope and quality of hybrid layer was observed under a scanning electron microscope . The data ( MPa ) were analyzed using two-way ANOVA and Tukey 's tests ( α=.05 ) . RESULTS Overall , PAN adhesive cement showed significantly higher mean bond strength ( 12.5 ± 2.3 - 14.1 ± 2.4 MPa ) than CSA cement ( 9.3 ± 1.4 - 13.9 ± 1.9 MPa ) ( P<.001 ) . Adhesive failures were more frequent in CSA cement groups when used in conjunction with two-step self-adhesive ( 68 % ) or no adhesive at all ( 66 % ) . Hybrid layer quality was inferior in CSA compared to PAN cement in all conditions . CONCLUSION In clinical situations where bonding to dentin substrate is crucial , both conventional and self-adhesive resin cements based on 10-MDP can benefit from etch- and -rinse technique to achieve better quality of adhesion in the early clinical period OBJECTIVE To evaluate the microtensile bond strengths ( μTBS ) and nanoleakage ( NL ) of three universal or multi-mode adhesives , applied with increasing solvent evaporation times . METHODS One-hundred and forty caries-free extracted third molars were divided into 20 groups for bond strength testing , according to three factors : ( 1 ) Adhesive - All-Bond Universal ( ABU , Bisco , Inc. ) , Prime&Bond Elect ( PBE , Dentsply ) , and Scotchbond Universal Adhesive ( SBU , 3 M ESPE ) ; ( 2 ) Bonding strategy - self-etch ( SE ) or etch- and -rinse ( ER ) ; and ( 3 ) Adhesive solvent evaporation time - 5s , 15s , and 25s . Two extra groups were prepared with ABU because the respective manufacturer recommends a solvent evaporation time of 10s . After restorations were constructed , specimens were stored in water ( 37 ° C/24h ) . Resin-dentin beams ( 0.8mm(2 ) ) were tested at 0.5mm/min ( μTBS ) . For NL , forty extracted molars were r and omly assigned to each of the 20 groups . Dentin disks were restored , immersed in ammoniacal silver nitrate , sectioned and processed for evaluation under a FESEM in backscattered mode . Data from μTBS were analyzed using two-way ANOVA ( adhesive vs. drying time ) for each strategy , and Tukey 's test ( α=0.05 ) . NL data were computed with non-parametric tests ( Kruskal-Wallis and Mann-Whitney tests , α=0.05 ) . RESULTS Increasing solvent evaporation time from 5s to 25s result ed in statistically higher mean μTBS for all adhesives when used in ER mode . Regarding NL , ER result ed in greater NL than SE for each of the evaporation times regardless of the adhesive used . A solvent evaporation time of 25s result ed in the lowest NL for SBU-ER . SIGNIFICANCE Residual water and /or solvent may compromise the performance of universal adhesives , which may be improved with extended evaporation times BACKGROUND The durability of restorations bonded with one-step self-etching ( OSSE ) adhesive systems is inferior compared with that of restorations bonded with conventional adhesives . The authors conducted an 18-month r and omized clinical study to evaluate the clinical performance of two OSSE systems in noncarious cervical lesions applied as recommended or with an extra layer of hydrophobic adhesive layer after 18 months of clinical service . METHODS Thirty participants , each of whom had at least two pairs of similar-sized noncarious cervical lesions , took part in this study . The authors placed 120 restorations  , 30 in each of four groups : Clearfil S3 Bond ( Kuraray , Osaka , Japan ) ( CS ) and iBond Gluma inside ( Heraeus Kulzer , Hanau , Germany ) ( IB ) , and Clearfil S3 Bond ( CSB ) and iBond Gluma inside ( IBB ) with an extra layer of hydrophobic adhesive applied on top of them . They placed the restorations incrementally , using a resin-based composite . The authors evaluated the restorations at baseline and at 18 months following modified U.S. Public Health Service criteria . RESULTS At 18 months , the retention rate for the IB group was statistically lower than those for the CS , IBB and CSB groups . Marginal discoloration occurred in all groups and was statistically worse in the IB group . CONCLUSIONS The conversion of the iBond Gluma inside and Clearfil S3 Bond adhesive systems into two-step systems by means of applying an extra hydrophobic adhesive layer improved the clinical performance of these material s after 18 months of clinical service . CLINICAL IMPLICATION S The application of an extra hydrophobic adhesive layer over OSSE adhesive systems , layers improved the OSSE systems clinical performance , mainly in terms of retention rate Abstract Objective . The aim of this study was to evaluate the efficacy of the microtensile , microshear and shear bond strength test methods to assess the bond strength of two self-etch adhesives and one etch&rinse adhesive on dentin . Material s and methods : Seventy-five extracted human molars were ground to expose their flat dentin surfaces and r and omly assigned to one of three groups according to the type of test method ( 15 for microtensile , 15 for microshear , 45 for shear ) . Each of these groups was then assigned to three sub-groups according to the bonding systems ( Clearfil SE Bond , Kuraray ; G Bond , GC ; Prime&Bond NT , Dentsply ) used . Then , 15 specimens were prepared for each sub-group according to the test method employed ( n = 15 ) . After being stored in distilled water at 37 ° C for 24 h , the specimens were placed in a universal testing machine for three test methods and stressed at a crosshead speed of 0.5 mm/min . Mean bond strengths were analyzed using Kruskall-Wallis and Mann-Whitney U-tests at a significance level of p < 0.05 . Results . The microtensile test had the highest bond strength ( p = 0.046 ) . Clearfil SE Bond and Prime&Bond NT produced significantly higher values than the G Bond in the microtensile bond test ( p < 0.05 ) , whereas no significant differences were found among the adhesives in the microshear bond test ( p > 0.05 ) . For the shear test , Clearfil SE Bond showed higher bond strength than Prime&Bond NT and G Bond ( p < 0.05 ) . Conclusion : Bond strength to dentin depends on the material and the test method used OBJECTIVE The objective of this r and omized controlled clinical trial was to evaluate the 13-year clinical performance of a mild two-step self-etch adhesive in non-carious cervical lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins . METHODS A total of 100 non-carious cervical lesions in 29 patients were restored with Clearfil AP-X ( Kuraray Noritake ) . The composite restorations were bonded following two different approaches : ( 1 ) application of Clearfil SE Bond ( Kuraray Noritake ) following a self-etch approach ( CSE-NE ) ; ( 2 ) selective phosphoric acid-etching of enamel cavity margins before application of Clearfil SE Bond ( CSE-E ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 , 8 and 13 years of clinical service regarding retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality and post-operative sensitivity . RESULTS The patient recall rate at 13 years was 62 % . Six restorations , 4 of the CSE-NE group and 2 of the CSE-E group , were clinical ly unacceptable due to loss of retention ( 1 CSE-NE , 1 CSE-E ) , a severe marginal defect ( 2 CSE-NE , 1 CSE-E ) and caries occurrence in combination with a severe marginal defect ( 1 CSE-NE ) leading to a clinical success rate of 86 % ( CSE-NE ) and 93 % ( CSE-E ) . Ageing of the restorations was characterized by a further increase in the percentage of restorations with a clinical ly acceptable small marginal defect ( CSE-NE : 87 % ; CSE-E : 83 % ) and /or superficial marginal discoloration ( CSE-NE : 53 % ; CSE-E : 56 % ) . The presence of small marginal defects ( CSE-NE : 86 % ; CSE-E : 68 % ) and superficial marginal discoloration ( CSE-NE : 41 % ; CSE-E : 20 % ) at the incisal enamel side was more frequently noticed in the CSE-NE group than in the CSE-E group . The difference , however , was not statistically significant ( McNemar , p>0.05 ) . SIGNIFICANCE After 13 years , the clinical effectiveness of Clearfil SE Bond in non-carious Class-V lesions remained excellent , with selective acid-etching of the enamel cavity margins only having some minor positive effect on marginal integrity and absence of marginal discoloration 
    Output:
    