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: Objectives This study was conducted to evaluate a self-adhesive resin luting cement [ RelyX Unicem 3MESPE – RXU ] for  luting partial ceramic crowns ( PCCs )  with and without selective enamel etching in a prospect i ve , r and omized clinical trial . Material s and methods Thirty-four patients had received the intended treatment . Two PCCs ( Vita Mark II ; Cerec 3D ; Sirona ) had been placed in a split-mouth design : one with RXU without enamel etching ( RXU ) , the other with RXU with selective enamel etching ( RXU + E ) . Restorations were evaluated at baseline ( BL ) and after 12 , 24 , and 36 months ( USPHS criteria ) . For statistical analysis , the Chi-square test was applied ( α = 0.05 ) . Clinical survival of all restorations ( n = 68 ) after 3 years was determined using Kaplan – Meier analysis . Results Twenty three patients ( 12 male/11 female ) were available for clinical evaluation after 3 years . 19 RXU-PCCs were placed in molars , four in premolars , 18 RXU + E – PCCs in molars , five in premolars . Concerning clinical changes , no significant differences were found between luting strategies RXU/RXU + E at all recalls . Statistically significant changes over time were observed for marginal adaptation and marginal discoloration between BL and 36 m for RXU and RXU + E. For RXU + E , postoperative hypersensitivities decreased significantly from BL ( n = 6 ) to 36 m ( n = 0 ) . Of the 68 restorations originally included , eight RXU and four RXU + E restorations failed . At 3 years , Kaplan – Meier survival  of RXU was 72.9 % , that of RXU + E 87.6 % . Survival rates were not statistically significant different . Conclusions Although clinical survival of RXU + E is slightly better at 3 years , restorations of both groups perform similar with respect to clinical changes over time as evaluated by modified USPHS criteria . Clinical relevance The self-adhesive resin cement RXU can be used in conjunction with selective enamel etching , because survival rates of PCCs in the RXU + E group were not lower but , as a trend , even better than without enamel etching INTRODUCTION The aim of this study was to investigate the effects of pretreatment of gel chlorhexidine ( CHX ) and ethanol ( EtOH ) on the bond strength and durability of the adhesion of the fiber post relined with resin composite to the root dentin using a total etch adhesive system . METHODS Forty bovine incisor roots were divided into four groups after phosphoric acid etching : irrigation with physiologic solution ( control ) , 5 minutes with CHX , 1 minute with EtOH , and 5 minutes with chlorhexidine followed by 1 minute with EtOH . Fiber posts relined with resin composite were cemented with either RelyX ARC ( 3 M ESPE , St Paul , MN ) and a total etch adhesive system Scotchbond Multi- Purpose ( 3 M ESPE ) . Each group was r and omly divided into two subgroups : 24 hours of storage and 12 months of storage . All roots were sectioned transversely , and the push-out test was performed . Failure modes were observed , and the bond strength means were analyzed by analysis of variance and the Tukey test ( α = 0.05 ) . RESULTS CHX irrigation result ed in homogeneous bond strength values at 24 hours and 12 months of storage ( P < .05 ) . A significant bond strength decrease was noticed after 12 months of storage when irrigations were performed with physiologic solution and EtOH application only or associated with CHX ( P < .05 ) . CONCLUSIONS The use of CHX pretreatment could preserve the bond strength of the fiber post relined with resin composite to root dentin for 12 months . The use of EtOH and CHX followed by EtOH did not preserve the bond strength of the total etch adhesive system Scotchbond Multi- Purpose OBJECTIVES To evaluate the push-out bond strength and the sealing ability of five adhesive cements routinely used for fiber-post bonding . METHODS Fifty extracted single-rooted teeth were r and omly divided in five groups and restored using Parapost FiberLux and the following luting agents : Panavia 21 ( PAN ) , Clearfil Esthetic Cement ( CLF ) , Variolink II ( VAR ) , RelyX Unicem ( UNI ) and experimental GC self-adhesive cement ( EGC ) . After 1 week of water storage at 37 degrees C , three sections ( coronal , middle and apical ) of 2 mm thickness were prepared from each specimen . Sealing ability was quantified with a fluid-filtration system ( Flodec ) during 10 min , after which the push-out bond strength was immediately measured . Data were analyzed with ANOVA ( push-out ) and Kruskal-Wallis ( sealing ability ) . RESULTS The push-out bond strength and sealing ability were not significantly different among the coronal , middle and apical sections for each luting agent . The highest push-out bond strength was measured for CLF ( 14.60+/-3.63 MPa ) , which was not significantly different from PAN ( 12.57+/-2.45 MPa ) , but significantly higher than VAR ( 11.09+/-4.09 MPa ) , UNI ( 11.29+/-4.31 MPa ) and EGC ( 7.65+/-4.79 MPa ) . When evaluating the sealing ability , significant differences were not found among PAN , CLF and VAR , and between UNI and EGC . The latter luting agents scored significantly lower than the former ones . The push-out bond strength was correlated to the sealing ability ( p<0.001 ) . SIGNIFICANCE The self-etching MDP-based cements presented the highest push-out bond strength . Although the bonding effectiveness of self-adhesive cements appears promising , their interaction with root dentin might be too weak to minimize microleakage at the post-cement-dentin interface STATEMENT OF PROBLEM Since the introduction of glass fiber posts , irreversible vertical root fractures have become a rare occurrence ; however , adhesive failure has become the primary failure mode . PURPOSE The purpose of this study was to evaluate the push-out bond strength of glass fiber posts cemented with different luting agents on 3 segments of the root . MATERIAL AND METHODS Eighty human maxillary canines with similar root lengths were r and omly divided into 8 groups ( n=10 ) according to the cement assessed ( Rely X luting , Luting and Lining , Ketac Cem , Rely X ARC , Biscem , Duo-link , Rely X U100 , and Variolink II ) . After st and ardized post space preparation , the root dentin was pretreated for dual-polymerizing resin cements and untreated for the other cements . The mixed luting cement paste was inserted into post spaces with a spiral file and applied to the post surface that was seated into the canal . After 7 days , the teeth were sectioned perpendicular to their long axis into 1-mm-thick sections . The push-out test was performed at a speed of 0.5 mm/min until extrusion of the post occurred . The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures ( Tukey test ) ( α=.05 ) . RESULTS ANOVA showed that the type of interaction between cement and root location significantly influenced the push-out strength ( P<.05 ) . The highest push-out strength results with root location were obtained with Luting and Lining ( S3 ) ( 19.5 ±4.9 MPa ) , Ketac Cem ( S2 ) ( 18.6 ±5.5 MPa ) , and Luting and Lining ( S1 ) ( 18.0 ±7.6 MPa ) . The lowest mean values were recorded with Variolink II ( S1 ) ( 4.6 ±4.0 MPa ) , Variolink II ( S2 ) ( 1.6 ±1.5 MPa ) , and Rely X ARC ( S3 ) ( 0.9 ±1.1 MPa ) . CONCLUSIONS Self-adhesive cements and glass ionomer cements showed significantly higher values compared to dual-polymerizing resin cements . In all root segments , dual-polymerizing resin cements provided significantly lower bond strength . Significant differences among root segments were found only for Duo-link cement Abstract Objective . To compare push-out bond strength of fiber-posts luted with different adhesive approaches to root canal dentin . Material s and methods . Forty maxillary first incisors were decoronated and endodontically treated . Specimens were r and omly distributed into five groups ( n = 8) and fiber-posts ( DentinPost coated , Komet ) were inserted using five different luting material s : etch- and -rinse adhesive systems and corresponding core- and -post material in groups 1 ( DentinBond/DentinBuild , Komet ) and 2 ( XP Bond + SCA/Core-X flow , Densply ) , self-adhesive resin cements in groups 3 ( RelyX Unicem , 3 M Espe ) and 4 ( SmartCem 2 , Dentsply ) and a self-etch adhesive/resin cement in group 5 ( ED-Primer II/Panavia F 2.0 , Kuraray ) . The roots were sectioned into eight 1 mm thick serial slices and within 48 h push-out bond strength was investigated . Statistical analyses were performed using non-parametrical Kruskal-Wallis H-test and Mann-Whitney U-test for differences between experimental groups at p < 0.05 . The failure modes were analyzed using Chi square test . Results . The bond strength [ MPa ] ( mean/min – max ) for groups 3 ( 12.35/3.60–32.44 ) , 4 ( 13.52/4.48–30.69 ) and 2 ( 11.15/5.23–35.58 ) were significantly higher ( p < 0.001 ) compared to groups 1 ( 6.66/2.34–24.89 ) and 5 ( 7.41/0.28–34.18 ) . Adhesive failure between dentin and luting agent was the most frequent failure mode . Conclusions . Bond strength of fiber-posts adhesively luted to root canal dentin was significantly higher when self-adhesive resin cements were used . One ( group 2 ) of the tested core- and -post material s/etch- and -rinse adhesive achieved comparable bond strength values OBJECTIVES The objective of this r and omized controlled clinical trial was to evaluate the 8-year clinical performance of a mild 2-step self-etch adhesive in non-carious Class-V lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins . METHODS A total of 100 non-carious Class-V lesions in 29 patients were restored with Clearfil AP-X ( Kuraray ) .  The composite restorations were bonded following two different approaches : ( 1 ) application of Clearfil SE ( Kuraray ) following a self-etch approach ( control group ; C-SE non-etch ) , ( 2 ) selective phosphoric acid-etching of the enamel cavity margins before application of Clearfil SE ( experimental group ; C-SE etch ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 and 8 years of clinical service regarding their retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality and post-operative sensitivity . RESULTS The recall rate at 8 years was 76 % . Only two restorations , one of the C-SE non-etch group and one of the C-SE etch group , were clinical ly unacceptable due to loss of retention leading to a retention rate and a clinical success rate of 97 % in both groups . Aging of the restorations was characterized by an increase in the percentage of restorations with a small but clinical ly acceptable marginal defect ( C-SE non-etch : 92 % ; C-SE etch : 84 % ) and /or a superficial marginal discoloration ( C-SE non-etch : 44 % ; C-SE etch : 28 % ) . At the enamel side , the presence of small marginal defects ( C-SE non-etch : 86 % ; C-SE etch : 65 % ) and superficial marginal discoloration ( C-SE non-etch : 11 % ; C-SE etch% ) was more frequently noticed in the control group than in the experimental group . The difference , however , was only statistically significant for the presence of superficial marginal discoloration ( McNemar , p=0.01 ) . SIGNIFICANCE After 8 years of clinical functioning , the clinical effectiveness of Clearfil SE 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 at enamel This study examined the contribution of testing time on the interfacial strengths of  fiber posts to radicular dentin . Twenty-five fiber posts were luted to root segments  with resin cements and a zinc phosphate cement . Immediately upon setting of the material s , the roots were sectioned into slices and r and omly divided into two subgroups , depending on testing time ( immediate vs. 24-hours ) , for push-out test . The results showed an improvement on the interfacial strength after 24 hours of storage . When data were pooled for each cement , the interfacial strengths ( MPa ) were : Optibond Solo 
    Output:
    
agent
Endodontic treatment , method of cement application , and post pretreatment are factors that might significantly affect the retention of glass-fiber posts  into root canals mainly when cemented with regular resin cement .
Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements
***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: Objectives This study was conducted to evaluate a self-adhesive resin luting cement [ RelyX Unicem 3MESPE – RXU ] for  luting partial ceramic crowns ( PCCs )  with and without selective enamel etching in a prospect i ve , r and omized clinical trial . Material s and methods Thirty-four patients had received the intended treatment . Two PCCs ( Vita Mark II ; Cerec 3D ; Sirona ) had been placed in a split-mouth design : one with RXU without enamel etching ( RXU ) , the other with RXU with selective enamel etching ( RXU + E ) . Restorations were evaluated at baseline ( BL ) and after 12 , 24 , and 36 months ( USPHS criteria ) . For statistical analysis , the Chi-square test was applied ( α = 0.05 ) . Clinical survival of all restorations ( n = 68 ) after 3 years was determined using Kaplan – Meier analysis . Results Twenty three patients ( 12 male/11 female ) were available for clinical evaluation after 3 years . 19 RXU-PCCs were placed in molars , four in premolars , 18 RXU + E – PCCs in molars , five in premolars . Concerning clinical changes , no significant differences were found between luting strategies RXU/RXU + E at all recalls . Statistically significant changes over time were observed for marginal adaptation and marginal discoloration between BL and 36 m for RXU and RXU + E. For RXU + E , postoperative hypersensitivities decreased significantly from BL ( n = 6 ) to 36 m ( n = 0 ) . Of the 68 restorations originally included , eight RXU and four RXU + E restorations failed . At 3 years , Kaplan – Meier survival  of RXU was 72.9 % , that of RXU + E 87.6 % . Survival rates were not statistically significant different . Conclusions Although clinical survival of RXU + E is slightly better at 3 years , restorations of both groups perform similar with respect to clinical changes over time as evaluated by modified USPHS criteria . Clinical relevance The self-adhesive resin cement RXU can be used in conjunction with selective enamel etching , because survival rates of PCCs in the RXU + E group were not lower but , as a trend , even better than without enamel etching INTRODUCTION The aim of this study was to investigate the effects of pretreatment of gel chlorhexidine ( CHX ) and ethanol ( EtOH ) on the bond strength and durability of the adhesion of the fiber post relined with resin composite to the root dentin using a total etch adhesive system . METHODS Forty bovine incisor roots were divided into four groups after phosphoric acid etching : irrigation with physiologic solution ( control ) , 5 minutes with CHX , 1 minute with EtOH , and 5 minutes with chlorhexidine followed by 1 minute with EtOH . Fiber posts relined with resin composite were cemented with either RelyX ARC ( 3 M ESPE , St Paul , MN ) and a total etch adhesive system Scotchbond Multi- Purpose ( 3 M ESPE ) . Each group was r and omly divided into two subgroups : 24 hours of storage and 12 months of storage . All roots were sectioned transversely , and the push-out test was performed . Failure modes were observed , and the bond strength means were analyzed by analysis of variance and the Tukey test ( α = 0.05 ) . RESULTS CHX irrigation result ed in homogeneous bond strength values at 24 hours and 12 months of storage ( P < .05 ) . A significant bond strength decrease was noticed after 12 months of storage when irrigations were performed with physiologic solution and EtOH application only or associated with CHX ( P < .05 ) . CONCLUSIONS The use of CHX pretreatment could preserve the bond strength of the fiber post relined with resin composite to root dentin for 12 months . The use of EtOH and CHX followed by EtOH did not preserve the bond strength of the total etch adhesive system Scotchbond Multi- Purpose OBJECTIVES To evaluate the push-out bond strength and the sealing ability of five adhesive cements routinely used for fiber-post bonding . METHODS Fifty extracted single-rooted teeth were r and omly divided in five groups and restored using Parapost FiberLux and the following luting agents : Panavia 21 ( PAN ) , Clearfil Esthetic Cement ( CLF ) , Variolink II ( VAR ) , RelyX Unicem ( UNI ) and experimental GC self-adhesive cement ( EGC ) . After 1 week of water storage at 37 degrees C , three sections ( coronal , middle and apical ) of 2 mm thickness were prepared from each specimen . Sealing ability was quantified with a fluid-filtration system ( Flodec ) during 10 min , after which the push-out bond strength was immediately measured . Data were analyzed with ANOVA ( push-out ) and Kruskal-Wallis ( sealing ability ) . RESULTS The push-out bond strength and sealing ability were not significantly different among the coronal , middle and apical sections for each luting agent . The highest push-out bond strength was measured for CLF ( 14.60+/-3.63 MPa ) , which was not significantly different from PAN ( 12.57+/-2.45 MPa ) , but significantly higher than VAR ( 11.09+/-4.09 MPa ) , UNI ( 11.29+/-4.31 MPa ) and EGC ( 7.65+/-4.79 MPa ) . When evaluating the sealing ability , significant differences were not found among PAN , CLF and VAR , and between UNI and EGC . The latter luting agents scored significantly lower than the former ones . The push-out bond strength was correlated to the sealing ability ( p<0.001 ) . SIGNIFICANCE The self-etching MDP-based cements presented the highest push-out bond strength . Although the bonding effectiveness of self-adhesive cements appears promising , their interaction with root dentin might be too weak to minimize microleakage at the post-cement-dentin interface STATEMENT OF PROBLEM Since the introduction of glass fiber posts , irreversible vertical root fractures have become a rare occurrence ; however , adhesive failure has become the primary failure mode . PURPOSE The purpose of this study was to evaluate the push-out bond strength of glass fiber posts cemented with different luting agents on 3 segments of the root . MATERIAL AND METHODS Eighty human maxillary canines with similar root lengths were r and omly divided into 8 groups ( n=10 ) according to the cement assessed ( Rely X luting , Luting and Lining , Ketac Cem , Rely X ARC , Biscem , Duo-link , Rely X U100 , and Variolink II ) . After st and ardized post space preparation , the root dentin was pretreated for dual-polymerizing resin cements and untreated for the other cements . The mixed luting cement paste was inserted into post spaces with a spiral file and applied to the post surface that was seated into the canal . After 7 days , the teeth were sectioned perpendicular to their long axis into 1-mm-thick sections . The push-out test was performed at a speed of 0.5 mm/min until extrusion of the post occurred . The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures ( Tukey test ) ( α=.05 ) . RESULTS ANOVA showed that the type of interaction between cement and root location significantly influenced the push-out strength ( P<.05 ) . The highest push-out strength results with root location were obtained with Luting and Lining ( S3 ) ( 19.5 ±4.9 MPa ) , Ketac Cem ( S2 ) ( 18.6 ±5.5 MPa ) , and Luting and Lining ( S1 ) ( 18.0 ±7.6 MPa ) . The lowest mean values were recorded with Variolink II ( S1 ) ( 4.6 ±4.0 MPa ) , Variolink II ( S2 ) ( 1.6 ±1.5 MPa ) , and Rely X ARC ( S3 ) ( 0.9 ±1.1 MPa ) . CONCLUSIONS Self-adhesive cements and glass ionomer cements showed significantly higher values compared to dual-polymerizing resin cements . In all root segments , dual-polymerizing resin cements provided significantly lower bond strength . Significant differences among root segments were found only for Duo-link cement Abstract Objective . To compare push-out bond strength of fiber-posts luted with different adhesive approaches to root canal dentin . Material s and methods . Forty maxillary first incisors were decoronated and endodontically treated . Specimens were r and omly distributed into five groups ( n = 8) and fiber-posts ( DentinPost coated , Komet ) were inserted using five different luting material s : etch- and -rinse adhesive systems and corresponding core- and -post material in groups 1 ( DentinBond/DentinBuild , Komet ) and 2 ( XP Bond + SCA/Core-X flow , Densply ) , self-adhesive resin cements in groups 3 ( RelyX Unicem , 3 M Espe ) and 4 ( SmartCem 2 , Dentsply ) and a self-etch adhesive/resin cement in group 5 ( ED-Primer II/Panavia F 2.0 , Kuraray ) . The roots were sectioned into eight 1 mm thick serial slices and within 48 h push-out bond strength was investigated . Statistical analyses were performed using non-parametrical Kruskal-Wallis H-test and Mann-Whitney U-test for differences between experimental groups at p < 0.05 . The failure modes were analyzed using Chi square test . Results . The bond strength [ MPa ] ( mean/min – max ) for groups 3 ( 12.35/3.60–32.44 ) , 4 ( 13.52/4.48–30.69 ) and 2 ( 11.15/5.23–35.58 ) were significantly higher ( p < 0.001 ) compared to groups 1 ( 6.66/2.34–24.89 ) and 5 ( 7.41/0.28–34.18 ) . Adhesive failure between dentin and luting agent was the most frequent failure mode . Conclusions . Bond strength of fiber-posts adhesively luted to root canal dentin was significantly higher when self-adhesive resin cements were used . One ( group 2 ) of the tested core- and -post material s/etch- and -rinse adhesive achieved comparable bond strength values OBJECTIVES The objective of this r and omized controlled clinical trial was to evaluate the 8-year clinical performance of a mild 2-step self-etch adhesive in non-carious Class-V lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins . METHODS A total of 100 non-carious Class-V lesions in 29 patients were restored with Clearfil AP-X ( Kuraray ) .  The composite restorations were bonded following two different approaches : ( 1 ) application of Clearfil SE ( Kuraray ) following a self-etch approach ( control group ; C-SE non-etch ) , ( 2 ) selective phosphoric acid-etching of the enamel cavity margins before application of Clearfil SE ( experimental group ; C-SE etch ) . The restorations were evaluated after 6 months , 1 , 2 , 3 , 5 and 8 years of clinical service regarding their retention , marginal integrity and discoloration , caries occurrence , preservation of tooth vitality and post-operative sensitivity . RESULTS The recall rate at 8 years was 76 % . Only two restorations , one of the C-SE non-etch group and one of the C-SE etch group , were clinical ly unacceptable due to loss of retention leading to a retention rate and a clinical success rate of 97 % in both groups . Aging of the restorations was characterized by an increase in the percentage of restorations with a small but clinical ly acceptable marginal defect ( C-SE non-etch : 92 % ; C-SE etch : 84 % ) and /or a superficial marginal discoloration ( C-SE non-etch : 44 % ; C-SE etch : 28 % ) . At the enamel side , the presence of small marginal defects ( C-SE non-etch : 86 % ; C-SE etch : 65 % ) and superficial marginal discoloration ( C-SE non-etch : 11 % ; C-SE etch% ) was more frequently noticed in the control group than in the experimental group . The difference , however , was only statistically significant for the presence of superficial marginal discoloration ( McNemar , p=0.01 ) . SIGNIFICANCE After 8 years of clinical functioning , the clinical effectiveness of Clearfil SE 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 at enamel This study examined the contribution of testing time on the interfacial strengths of  fiber posts to radicular dentin . Twenty-five fiber posts were luted to root segments  with resin cements and a zinc phosphate cement . Immediately upon setting of the material s , the roots were sectioned into slices and r and omly divided into two subgroups , depending on testing time ( immediate vs. 24-hours ) , for push-out test . The results showed an improvement on the interfacial strength after 24 hours of storage . When data were pooled for each cement , the interfacial strengths ( MPa ) were : Optibond Solo 
    Output:
    