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 this study evaluated the effect of surface treatments ( Nd : YAG laser , CO2 laser , Al203 airborne-particle abrasion , and silica-coating ) on the  zirconia-to-resin shear bond strength ( SBS ) .  METHOD AND MATERIAL S eighty-one Lava ( 3 M ESPE ) blocks ( 13 x 4 x 2 mm ) were embedded in acrylic resin , polished , and r and omly divided into three groups , which received the following surface treatments : no abrasion , Al203 airborne-particle abrasion ( 50 Μm ) , or silica-coating ( Cojet , 3 M ESPE ) . Each group was divided into three subgroups that were treated with Nd : YAG laser , CO2 laser , or no laser irradiation . Following application of a monomer phosphate-containing primer , cylinders of resin cement ( Panavia F , Kuraray ) ( n = 18 ) were built on the surface . SBS testing was carried out after 24 hours of storage in water . Surface roughness and topography ( SEM ) after treatments were evaluated . RESULTS according to ANOVA and Tukey test ( α = 0.05 ) , mean SBS after Nd : YAG laser treatment ranged from 14.09 to 16.20 MPa and was statistically higher than CO2 laser ( 6.24 to 10.51 MPa ) and no laser treatment ( 4.65 to 8.79 MPa ) . The Nd : YAG laser created more roughness on zirconia when compared to the CO2 laser and abrasion treatments . Silica-coating increased the SBS of lased and nonlased zirconia . Significant microcracks were found on specimens treated with CO2 . CONCLUSION Nd : YAG laser pretreatment , whether associated with abrasion methods or not , created consistent roughness on the zirconia surface and significantly increased zirconia SBS to Panavia F. Silica-coating could potentially increase the SBS of lased and nonlased zirconia . Significant microcracks were found on specimens treated with the CO2 laser Objective : To evaluate the bond stability of resin cements when luted to glass-reinforced alumina and zirconia CAD/CAM dental ceramics . Study design : Eighteen glass-infiltrated alumina and eighteen densely sintered zirconia blocks were r and omly conditioned as follows : Group 1 : No treatment ; Group 2 : S and blasting ( 125 µm Al2O3-particles ) ; and Group 3 : Silica-coating ( 50 µm silica-modified Al2O3-particles ) . Composite sample s were r and omly bonded to the pre-treated ceramic surfaces using different resin cements : Subgroup 1 : Clearfil Esthetic Cement ( CEC ) ; Subgroup 2 : RelyX Unicem ( RXU ) ; and Subgroup 3 : Calibra ( CAL ) . After 24 h , bonded specimens were cut into 1 ± 0.1 mm2 sticks . One-half of the beams were tested for microtensile bond strength ( MTBS ) . The remaining one-half was immersed in 10 % NaOCl aqueous solution ( NaOClaq ) for 5 h before testing . The fracture pattern and morphology of the debonded surfaces were assessed with a field emission gun scanning electron microscope ( FEG-SEM ) . A multiple ANOVA was conducted to analyze the contributions of ceramic composition , surface treatment , resin cement type , and chemical challenging to MTBS . The Tukey test was run for multiple comparisons ( p < 0.05 ) . Results : After 24 h , CEC luted to pre-treated zirconia achieved the highest MTBS . Using RXU , alumina and zirconia registered comparable MTBS . CAL failed prematurely , except when luted to s and blasted zirconia . After NaOClaq storage , CEC significantly lowered MTBS when luted to zirconia or alumina . RXU decreased MTBS only when bonded to silica-coated alumina . CAL recorded 100 % of pre-testing failures . Micromorphological alterations were evident after NaOClaq immersion . Conclusions : Resin-ceramic interfacial longevity depended on cement selection rather than on surface pre-treatments . The MDP-containing and the self-adhesive resin cements were both suitable for luting CAD/CAM ceramics . Despite both cements being prone to degradation , RXU luted to zirconia or untreated or s and blasted alumina showed the most stable interfaces . CAL experimented spontaneous debonding in all tested groups . Key words : CAD/CAM ceramic , alumina , zirconia , resin cement , surface pre-treatment , s and blasting , silica-coating , chemical aging , bond degradation , microtensile bond strength This study compares the bond strength of resin cement and yttrium-stabilized tetragonal zirconia polycrystalline ( Y-TZP ) ceramic with different surface conditioning methods . Two hundred presintered Y-TZP ceramic specimens were prepared , sintered ( 4 × 4 × 4 mm ) , and r and omly assigned to four equal groups as control ( C , no conditioning ) ; airborne particle abraded ( APA , air abrasion with 11 μm Al2O3 ) ; tribochemical silica coating/silane coupling system ( TSC , Rocatec , air abrasion with 110 μm Al2O3 , 30 μm silica-coated Al2O3 and silane ) ; and laser ( L , Er : YAG laser irradiation treated at a power setting of 200 mJ ) . After specimen preparation , composite resin cylinders were prepared and cemented with resin cements ( Clearfil Esthetic , Panavia F 2.0 , Rely X-U100 , Super Bond C&B , and Multilink Automix ) on the ceramic surfaces and kept in an incubator at 37 ° C for 60 days . All specimens were tested for shear bond strength with a universal testing machine , and fractured surfaces were evaluated by environmental scanning electron microscopy . Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-tests ( α=0.05 ) . The bond strengths for C and L groups were not significantly different according to adhesive resin cement . APA and TSC result ed in increased bond strength for Panavia F 2.0 and Rely X-U100 resin cements . Additionally , TSC presented higher bond strength with Multilink Automix . Adhesive fracture between the ceramic and resin cement was the most common failure . Complete cohesive fracture at the ceramic or composite cylinders was not observed . Regardless of the adhesive resin cement used , laser treatment did not improve resin bond strength The present study evaluated the durability of bond strength between zirconia and 3 different resin cements . Thirty stabilized tetragonal zirconium-dioxide blocks were duplicated in dual-curing resin core build-up material specimens . Resin blocks were r and omly luted to zirconium surfaces using 1 ) Clearfil Esthetic Cement ( CLF ) , 2 ) RelyX Unicem Aplicap ( RELX ) , or 3 ) Multilink Automix ( MLA ) . After 24 h , half of the specimens from each of the 3 groups were loaded in tension until fracture ( 0.5 mm/min ) . The remaining half were tested after 6,000 thermal cycles ( 5 to 55 ° C ) . Data were analyzed using 2-way ANOVA and the Tukey test ( α = 0.05 ) . Fractographic analysis was performed using a stereomicroscope . Tensile bond strength values were significantly affected by the luting agent system employed and by thermal aging ( P < 0.001 ) . The highest tensile bond strength values in non-thermal-aged groups were observed for specimens from the RELX and CLF groups . In contrast , in the thermal-aged groups , the highest tensile bond strength values were for the MLA and RELX groups . Moreover , while thermocycling significantly affected bond strengths in the RELX and CLF groups , the mean strength of the MLA group did not significantly change after aging . There was little difference in the distribution of failure modes in any group Abstract Objective . The purpose of this in vitro study was to evaluate the influence of different power outputs of a carbon dioxide ( CO2 ) laser on shear bond strength of resin cement to zirconium dioxide-based ceramic . Material s and methods . Fifty zirconium dioxide core specimens ( 10 mm diameter and 2 mm thickness ) were produced and they were embedded in the centers of auto-polymerizing acrylic resin blocks . Ten specimens served as control and no surface treatment was applied . Subsequently specimens were r and omly divided into four groups , each containing 10 specimens for surface treatment with CO2 laser with different output power ; laser treated with 2 W ( Group 2 W ) , 3 W ( Group 3 W ) , 4 W ( Group 4 W ) and finally 5 W ( Group 5 W ) . Fifty composite resin discs were fabricated and cemented with adhesive resin cement to the specimen surfaces . A universal test machine was used for shear bond strength test at a crosshead speed 1 mm/min . Data were statistically analyzed by one-way analyses of variance ( ANOVA ) with Post-Hoc Tukey tests ( α = 0.05 ) . Results . It was found that the shear bond strength values were affected by power outputs of laser ( p < 0.05 ) . Highest shear bond strength values were obtained with group 2 W ( 21.0 ± 2.7 ) . Lowest values were obtained with group 5 W ( 14.4 ± 1.6 ) . Conclusion . The current study revealed that there was a relationship between laser output power and shear bond strength for zirconium dioxide ceramics . However , output power of the laser and the energy level is a critical factor on micromechanical retention The objective of this study was to evaluate the durability of bond strength between a resin cement and aluminous ceramic su bmi tted to various surface conditioning methods . Twenty-four blocks ( 5 x 5 x 4 mm(3 ) ) of a glass-infiltrated zirconia-alumina ceramic ( In-Ceram Zirconia Classic ) were r and omly divided into three surface treatment groups : ST1-Air-abrasion with 110-mum Al2O3 particles + silanization ; ST2-Laboratory tribochemical silica coating method ( 110-microm Al2O3 , 110-microm silica ) ( Rocatec ) + silanization ; ST3-Chairside tribochemical silica coating method ( 30-microm SiO(x ) ) ( CoJet ) + silanization . Each treated ceramic block was placed in its silicone mold with the treated surface exposed . The resin cement ( Panavia F ) was prepared and injected into the mold over the treated surface . Specimens were sectioned to achieve nontrimmed bar specimens ( 14 sp/block ) that were r and omly divided into two conditions : ( a ) Dry-microtensile test after sectioning ; ( b ) Thermocycling (TC)-(6,000x , 5 - 55 degrees C ) and water storage ( 150 days ) . Thus , six experimental groups were obtained ( n = 50 ) : Gr1-ST1 + dry ; Gr2-ST1 + TC ( ; ) Gr3-ST2 + dry ; Gr4-ST2 + TC ; Gr5-ST3 + dry ; Gr6-ST3 + TC . After microtensile testing , the failure types were noted . ST2 ( 25.1 + /- 11 ) and ST3 ( 24.1 + /- 7.4 ) presented statistically higher bond strength ( MPa ) than that of ST1 ( 17.5 + /- 8) regardless of aging conditions ( p < 0.0001 ) . While Gr2 revealed the lowest results ( 13.3 + /- 6.4 ) , the other groups ( 21.7 + /- 7.4 - 25 . 9 + /- 9.1 ) showed statistically no significant differences ( two-way ANOVA and Tukey 's test , alpha = 0.05 ) . The majority of the failures were mixed ( 82 % ) followed by adhesive failures ( 18 % ) . Gr2 presented significantly higher incidence of ADHESIVE failures ( 54 % ) than those of other groups ( p = 0.0001 ) . Both laboratory and chairside silica coating plus silanization showed durable bond strength . After aging , air-abrasion with 110-microm Al(2)O(3 ) + silanization showed the largest decrease indicating that aging is fundamental for bond strength testing for acid-resistant zirconia ceramics in order to estimate their long-term performance in the mouth PURPOSE To evaluate the shear bond strength ( SBS ) to zirconia ceramics using different associations of primers and resin cements . MATERIAL S AND METHODS Two blocks of LAVA zirconia ( 3Y-TZP ) were r and omly su bmi tted to an application of three different commercially available primers : Alloy Primer ( AP ) , Z-Prime Plus ( ZP ) , and Signum Zirconia Bond ( SZB ) . Nonprimed specimens were considered controls . After treatment , the 80 specimens ( 5 mm × 5 mm × 2 mm ) were r and omly cemented with one of the resin cements : Panavia F , Multil 
    Output:
    
agent
Airborne-particle abrasion and tribochemical silica coating are reference pretreatment methods .
***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 this study evaluated the effect of surface treatments ( Nd : YAG laser , CO2 laser , Al203 airborne-particle abrasion , and silica-coating ) on the  zirconia-to-resin shear bond strength ( SBS ) .  METHOD AND MATERIAL S eighty-one Lava ( 3 M ESPE ) blocks ( 13 x 4 x 2 mm ) were embedded in acrylic resin , polished , and r and omly divided into three groups , which received the following surface treatments : no abrasion , Al203 airborne-particle abrasion ( 50 Μm ) , or silica-coating ( Cojet , 3 M ESPE ) . Each group was divided into three subgroups that were treated with Nd : YAG laser , CO2 laser , or no laser irradiation . Following application of a monomer phosphate-containing primer , cylinders of resin cement ( Panavia F , Kuraray ) ( n = 18 ) were built on the surface . SBS testing was carried out after 24 hours of storage in water . Surface roughness and topography ( SEM ) after treatments were evaluated . RESULTS according to ANOVA and Tukey test ( α = 0.05 ) , mean SBS after Nd : YAG laser treatment ranged from 14.09 to 16.20 MPa and was statistically higher than CO2 laser ( 6.24 to 10.51 MPa ) and no laser treatment ( 4.65 to 8.79 MPa ) . The Nd : YAG laser created more roughness on zirconia when compared to the CO2 laser and abrasion treatments . Silica-coating increased the SBS of lased and nonlased zirconia . Significant microcracks were found on specimens treated with CO2 . CONCLUSION Nd : YAG laser pretreatment , whether associated with abrasion methods or not , created consistent roughness on the zirconia surface and significantly increased zirconia SBS to Panavia F. Silica-coating could potentially increase the SBS of lased and nonlased zirconia . Significant microcracks were found on specimens treated with the CO2 laser Objective : To evaluate the bond stability of resin cements when luted to glass-reinforced alumina and zirconia CAD/CAM dental ceramics . Study design : Eighteen glass-infiltrated alumina and eighteen densely sintered zirconia blocks were r and omly conditioned as follows : Group 1 : No treatment ; Group 2 : S and blasting ( 125 µm Al2O3-particles ) ; and Group 3 : Silica-coating ( 50 µm silica-modified Al2O3-particles ) . Composite sample s were r and omly bonded to the pre-treated ceramic surfaces using different resin cements : Subgroup 1 : Clearfil Esthetic Cement ( CEC ) ; Subgroup 2 : RelyX Unicem ( RXU ) ; and Subgroup 3 : Calibra ( CAL ) . After 24 h , bonded specimens were cut into 1 ± 0.1 mm2 sticks . One-half of the beams were tested for microtensile bond strength ( MTBS ) . The remaining one-half was immersed in 10 % NaOCl aqueous solution ( NaOClaq ) for 5 h before testing . The fracture pattern and morphology of the debonded surfaces were assessed with a field emission gun scanning electron microscope ( FEG-SEM ) . A multiple ANOVA was conducted to analyze the contributions of ceramic composition , surface treatment , resin cement type , and chemical challenging to MTBS . The Tukey test was run for multiple comparisons ( p < 0.05 ) . Results : After 24 h , CEC luted to pre-treated zirconia achieved the highest MTBS . Using RXU , alumina and zirconia registered comparable MTBS . CAL failed prematurely , except when luted to s and blasted zirconia . After NaOClaq storage , CEC significantly lowered MTBS when luted to zirconia or alumina . RXU decreased MTBS only when bonded to silica-coated alumina . CAL recorded 100 % of pre-testing failures . Micromorphological alterations were evident after NaOClaq immersion . Conclusions : Resin-ceramic interfacial longevity depended on cement selection rather than on surface pre-treatments . The MDP-containing and the self-adhesive resin cements were both suitable for luting CAD/CAM ceramics . Despite both cements being prone to degradation , RXU luted to zirconia or untreated or s and blasted alumina showed the most stable interfaces . CAL experimented spontaneous debonding in all tested groups . Key words : CAD/CAM ceramic , alumina , zirconia , resin cement , surface pre-treatment , s and blasting , silica-coating , chemical aging , bond degradation , microtensile bond strength This study compares the bond strength of resin cement and yttrium-stabilized tetragonal zirconia polycrystalline ( Y-TZP ) ceramic with different surface conditioning methods . Two hundred presintered Y-TZP ceramic specimens were prepared , sintered ( 4 × 4 × 4 mm ) , and r and omly assigned to four equal groups as control ( C , no conditioning ) ; airborne particle abraded ( APA , air abrasion with 11 μm Al2O3 ) ; tribochemical silica coating/silane coupling system ( TSC , Rocatec , air abrasion with 110 μm Al2O3 , 30 μm silica-coated Al2O3 and silane ) ; and laser ( L , Er : YAG laser irradiation treated at a power setting of 200 mJ ) . After specimen preparation , composite resin cylinders were prepared and cemented with resin cements ( Clearfil Esthetic , Panavia F 2.0 , Rely X-U100 , Super Bond C&B , and Multilink Automix ) on the ceramic surfaces and kept in an incubator at 37 ° C for 60 days . All specimens were tested for shear bond strength with a universal testing machine , and fractured surfaces were evaluated by environmental scanning electron microscopy . Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-tests ( α=0.05 ) . The bond strengths for C and L groups were not significantly different according to adhesive resin cement . APA and TSC result ed in increased bond strength for Panavia F 2.0 and Rely X-U100 resin cements . Additionally , TSC presented higher bond strength with Multilink Automix . Adhesive fracture between the ceramic and resin cement was the most common failure . Complete cohesive fracture at the ceramic or composite cylinders was not observed . Regardless of the adhesive resin cement used , laser treatment did not improve resin bond strength The present study evaluated the durability of bond strength between zirconia and 3 different resin cements . Thirty stabilized tetragonal zirconium-dioxide blocks were duplicated in dual-curing resin core build-up material specimens . Resin blocks were r and omly luted to zirconium surfaces using 1 ) Clearfil Esthetic Cement ( CLF ) , 2 ) RelyX Unicem Aplicap ( RELX ) , or 3 ) Multilink Automix ( MLA ) . After 24 h , half of the specimens from each of the 3 groups were loaded in tension until fracture ( 0.5 mm/min ) . The remaining half were tested after 6,000 thermal cycles ( 5 to 55 ° C ) . Data were analyzed using 2-way ANOVA and the Tukey test ( α = 0.05 ) . Fractographic analysis was performed using a stereomicroscope . Tensile bond strength values were significantly affected by the luting agent system employed and by thermal aging ( P < 0.001 ) . The highest tensile bond strength values in non-thermal-aged groups were observed for specimens from the RELX and CLF groups . In contrast , in the thermal-aged groups , the highest tensile bond strength values were for the MLA and RELX groups . Moreover , while thermocycling significantly affected bond strengths in the RELX and CLF groups , the mean strength of the MLA group did not significantly change after aging . There was little difference in the distribution of failure modes in any group Abstract Objective . The purpose of this in vitro study was to evaluate the influence of different power outputs of a carbon dioxide ( CO2 ) laser on shear bond strength of resin cement to zirconium dioxide-based ceramic . Material s and methods . Fifty zirconium dioxide core specimens ( 10 mm diameter and 2 mm thickness ) were produced and they were embedded in the centers of auto-polymerizing acrylic resin blocks . Ten specimens served as control and no surface treatment was applied . Subsequently specimens were r and omly divided into four groups , each containing 10 specimens for surface treatment with CO2 laser with different output power ; laser treated with 2 W ( Group 2 W ) , 3 W ( Group 3 W ) , 4 W ( Group 4 W ) and finally 5 W ( Group 5 W ) . Fifty composite resin discs were fabricated and cemented with adhesive resin cement to the specimen surfaces . A universal test machine was used for shear bond strength test at a crosshead speed 1 mm/min . Data were statistically analyzed by one-way analyses of variance ( ANOVA ) with Post-Hoc Tukey tests ( α = 0.05 ) . Results . It was found that the shear bond strength values were affected by power outputs of laser ( p < 0.05 ) . Highest shear bond strength values were obtained with group 2 W ( 21.0 ± 2.7 ) . Lowest values were obtained with group 5 W ( 14.4 ± 1.6 ) . Conclusion . The current study revealed that there was a relationship between laser output power and shear bond strength for zirconium dioxide ceramics . However , output power of the laser and the energy level is a critical factor on micromechanical retention The objective of this study was to evaluate the durability of bond strength between a resin cement and aluminous ceramic su bmi tted to various surface conditioning methods . Twenty-four blocks ( 5 x 5 x 4 mm(3 ) ) of a glass-infiltrated zirconia-alumina ceramic ( In-Ceram Zirconia Classic ) were r and omly divided into three surface treatment groups : ST1-Air-abrasion with 110-mum Al2O3 particles + silanization ; ST2-Laboratory tribochemical silica coating method ( 110-microm Al2O3 , 110-microm silica ) ( Rocatec ) + silanization ; ST3-Chairside tribochemical silica coating method ( 30-microm SiO(x ) ) ( CoJet ) + silanization . Each treated ceramic block was placed in its silicone mold with the treated surface exposed . The resin cement ( Panavia F ) was prepared and injected into the mold over the treated surface . Specimens were sectioned to achieve nontrimmed bar specimens ( 14 sp/block ) that were r and omly divided into two conditions : ( a ) Dry-microtensile test after sectioning ; ( b ) Thermocycling (TC)-(6,000x , 5 - 55 degrees C ) and water storage ( 150 days ) . Thus , six experimental groups were obtained ( n = 50 ) : Gr1-ST1 + dry ; Gr2-ST1 + TC ( ; ) Gr3-ST2 + dry ; Gr4-ST2 + TC ; Gr5-ST3 + dry ; Gr6-ST3 + TC . After microtensile testing , the failure types were noted . ST2 ( 25.1 + /- 11 ) and ST3 ( 24.1 + /- 7.4 ) presented statistically higher bond strength ( MPa ) than that of ST1 ( 17.5 + /- 8) regardless of aging conditions ( p < 0.0001 ) . While Gr2 revealed the lowest results ( 13.3 + /- 6.4 ) , the other groups ( 21.7 + /- 7.4 - 25 . 9 + /- 9.1 ) showed statistically no significant differences ( two-way ANOVA and Tukey 's test , alpha = 0.05 ) . The majority of the failures were mixed ( 82 % ) followed by adhesive failures ( 18 % ) . Gr2 presented significantly higher incidence of ADHESIVE failures ( 54 % ) than those of other groups ( p = 0.0001 ) . Both laboratory and chairside silica coating plus silanization showed durable bond strength . After aging , air-abrasion with 110-microm Al(2)O(3 ) + silanization showed the largest decrease indicating that aging is fundamental for bond strength testing for acid-resistant zirconia ceramics in order to estimate their long-term performance in the mouth PURPOSE To evaluate the shear bond strength ( SBS ) to zirconia ceramics using different associations of primers and resin cements . MATERIAL S AND METHODS Two blocks of LAVA zirconia ( 3Y-TZP ) were r and omly su bmi tted to an application of three different commercially available primers : Alloy Primer ( AP ) , Z-Prime Plus ( ZP ) , and Signum Zirconia Bond ( SZB ) . Nonprimed specimens were considered controls . After treatment , the 80 specimens ( 5 mm × 5 mm × 2 mm ) were r and omly cemented with one of the resin cements : Panavia F , Multil 
    Output:
    