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: Aims and Objectives : To compare the marginal sealing ability of ormocer with a hybrid composite using an ormocer based bonding agent and a conventional fifth generation bonding agent . Material s and Methods : Fifty four human premolars were r and omly distributed into four test groups of 12 teeth each and two control groups of 3 teeth each . Class I occlusal preparation of 1.5 mm depth were made in each tooth . These were restored using the adhesive and restorative material according to the group . The restorations were finished using a st and ard composite finishing and polishing kit . Thermocycling between 5 ° C and 55 ° C was carried out . Having blocked the root apex and the entire tooth surface except 1 mm around the restoration margin , the teeth were immersed in 2 % methylene blue for 48 hours , after which the dye penetration through the margins of each sample was studied under a stereomicroscope . Results and Discussion : Group IV ( Admira with Admira Bond ) showed the minimum marginal leakage with a mean of 0.200 mm . Four sample s in this group showed no microleakage at all and a maximum of 0.400 mm was seen in one sample . Group II ( Spectrum TPH with Admira Bond ) showed the maximum leakage with a mean of 0.433 mm . One sample showed as much as 1.00 mm of microleakage .  Admira when used with Admira Bond showed lesser microleakage than Spectrum TPH used with Prime & Bond NT , the difference being statistically insignificant Objective The aim of this study is to evaluate the color stability of two nanohybrid resin-based composites , two organic modified ceramic resin composites ( ormocers ) and a compomer , following their immersion during 4 weeks in four usual drinks . Material and methods Forty discs of each of the following material s were prepared : Gr and ioSO ( GR ) , Esthet X ( EX ) , Dyract EXTRA ( DY ) , Ceram X duo ( CX ) , and Admira Fusion ( AD ) . The discs were polished and stored in distilled water during 24 h at 37 ° C . Color according to the CIEL*a*b * scale was recoded . Ten r and omly selected sample s of each material were immersed in red wine ( RW ) , coffee ( CF ) , cola ( CK ) , and distilled water ( DW ) . The color was recorded after 1 , 7 , 21 and 28 days of immersion . The ΔE values between the baseline color and each of the study timepoints were calculated . The data were analyzed based on the Kruskal-Wallis test , Wilcoxon test , and Mann-Whitney U test . Results After 1 day of immersion , all the material s showed ΔE > 3.3 , except EX , CF , and CX in CK . RD was the most staining beverage ( ΔE 15.36 to 31.09 ) . EX and CX were significantly less stained than the rest of the material s ( p < 0.05 ) . Conclusions All the staining solutions produced darkening beyond clinical ly acceptable limits . EX and CX were the material s who experimented less staining , followed by GD . AD and DY were the material s more stained . RW was the drink that produced more staining , followed by CF and CK . Clinical relevance After 24 h of immersion in all the solutions , equivalent to 1 month of exposure in the mouth , the evaluated material s showed clinical ly unacceptable ΔE values PURPOSE This prospect i ve long-term clinical trial evaluated and compared the three-year clinical performance of an ormocer , a nanofilled , and a nanoceramic resin composite with that of a microhybrid composite placed in Class I and Class II cavities . METHODS Forty patients , each with four Class I and II restorations under occlusion , were enrolled in this study . A total of 160 restorations were placed , 25 % for each material , as follows : an ormocer-based composite , Admira ; a nanofilled resin composite , Filtek Supreme XT ; a nanoceramic resin composite , Ceram X ; and a microhybrid resin composite , Tetric Ceram . A single operator placed all restorations according to the manufacturers ' instructions . Immediately after placement the restorations were finished/polished . Clinical evaluation was performed at baseline and at yearly intervals after placement by two other independent examiners using modified US Public Health Service ( USPHS ) criteria . The changes in the USPHS parameters during the three-year period were analyzed with the Friedman test . Comparison of the baseline scores with those at the recall visits was made using the Wilcoxon signed rank test . The level of significance was set at p < 0.05 . RESULTS All material s showed only minor changes , and no differences were detected between their performance at baseline and after three years . Only two ormocer , one nanofilled , and one microhybrid restorations in molars failed because of loss of retention . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p>0.05 ) . CONCLUSIONS The ormocer , nanofilled , and nanoceramic composites provided acceptable clinical performance over a three-year period Abstract . This study investigated the clinical performance of two packable composite resins  in Class-II restorations . One hundred and four Class-II restorations were placed in 52 patients by five dentists ( four in dental practice s and one in a university clinic ) in a controlled prospect i ve multicentre clinical trial . Each patient received one Definite/Etch & Prime 3.0 ( D-EP ) and one Solitaire/Solid Bond ( S-SB ) restoration , which were examined clinical ly according to modified USPHS- criteria after 1 week ( baseline ) and after 1 year . Statistical analysis was performed using the Wilcoxon rank sum test and the error rates method . The significance level was set to 0.05 . At baseline both material s performed equally according to the evaluated criteria . After 1 year D-EP showed significantly worse marginal adaptation compared to S-SB . Both material s displayed significant deterioration for the criteria marginal adaptation , marginal discolouration , approximal contact , and fracture of restoration after 1 year compared to baseline . With a failure rate of 9.6 % after 1 year , D-EP did not fulfill ADA acceptance criteria for restorative material s. It is proposed that at least 1-year data of clinical testing should be available before a new material is broadly marketed OBJECTIVES To study monomer elution from four resin-based composites ( RBCs )  cured with different light sources . METHODS Twenty-eight premolars were r and omly allocated to four groups . St and ardized cavities were prepared and restored with a nanohybrid ( Filtek Supreme XT or Tetric EvoCeram ) , an ormocer ( Admira ) or a microhybrid RBC ( Filtek Z250 ) which served as control . Buccal restorations were cured with a halogen and oral restorations with an LED light-curing unit . Elution of diurethane dimethacrylate ( UDMA ) , Bisphenol A diglycidylether methacrylate ( BisGMA ) , triethylene glycol dimethacrylate ( TEGDMA ) and 2-hydroxyethyl methacrylate ( HEMA ) was analyzed using high-performance liquid chromatography ( HPLC ) 1h to 28 days post-immersion in 75 % ethanol . Data were analyzed using multivariate and repeated measures analysis of variance ( α = 0.05 ) . RESULTS The greatest elution of UDMA and BisGMA occurred from Tetric EvoCeram and the least from Filtek Z250 ( p < 0.05 ) . LED and halogen light-curing units gave similar results for all RBCs ( p > 0.05 ) except Tetric EvoCeram which showed greater elution for the LED unit ( p < 0.05 ) . TEGDMA was below the limit of quantification . HEMA eluted in similar concentrations from Filtek Supreme and Tetric EvoCeram ( p > 0.05 ) . SIGNIFICANCE The two nanohybrid RBCs eluted more cross-linking monomers than the ormocer and the control microhybrid RBC . Continuous elution over 28 days indicates that RBCs act as a chronic source of monomers in clinical conditions . Light source may affect monomer elution since differences were found for one out of four RBCs . Mathematical models for elution kinetics of UDMA and BisGMA indicated two elution mechanisms ABSTRACT Context : Microleakage around dental restorative material s is a major problem in clinical dentistry . Inspite of many new restorative material s available in the market very few actually bond to the tooth surface . Aims : The aims of this study were : ( 1 ) To evaluate and compare the marginal leakage of newer restorative material s viz colored compomer , ormocer , giomer and RMGIC in class I restoration of deciduous molars . ( 2 ) To compare the microleakage scores between the groups of : Colored compomer and ormocer , giomer and RMGIC , ormocer with giomer and RMGIC , giomer with RMGIC . Material s and methods : A total of 40 primary molars were r and omly divided into four groups of 10 each . Class I cavities were prepared and the cavities were restored with colored compomer ( Group A ) , Ormocer ( Group B ) , Giomer ( Group C ) and RMGIC ( Group D ) . The teeth were thermocycled and subjected to 0.5 % basic fuchsin dye penetration followed by sectioning . The cut sections were evaluated under a stereomicroscope and the data was subjected to statistical analysis . Statistical analysis used : Mann-Whitney U test and Student t-test . Results : No significant difference was observed when colored compomer was compared to ormocer , giomer and RMGIC . Ormocer showed significantly lower microleakage when compared to giomer . However , no significant difference was observed when ormocer was compared to RMGIC . No significant difference between giomer and RMGIC was found . Conclusion : Ormocer has proven to be an excellent restorative material as it showed least microleakage followed by colored compomer , giomer and RMGIC in increasing order . How to cite this article : Yadav G , Rehani U , Rana V. A Comparative Evaluation of Marginal Leakage of Different Restorative Material s in Deciduous Molars : An in vitro Study . Int J Clin Pediatr Dent 2012;5(2):101 - 107 PURPOSE To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations . MATERIAL S AND METHODS Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients ( mean age 52.4 years ) . Each patient received at least two extended Class I or Class II restorations that were as similar as possible . In all cavities , a one-step self-etching adhesive ( XenoV+ ) was applied . One of the cavities of each pair was r and omly assigned to receive the flowable bulk-fill resin composite SDR in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface . The occlusal part was completed with an ormocer-based nanohybrid resin composite ( Ceram X mono+ ) . In the other cavity , only the resin composite CeramX mono+ was placed in 2 mm increments . The restorations were evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years . Caries risk and bruxing habits of the participants were estimated . RESULTS No post-operative sensitivity was reported . At the 3-year follow-up , 196 restorations - 74 Class I and 122 Class II - were evaluated . Seven restorations failed ( 3.6 % ) , 4 SDR-CeramX mono+ and 3 CeramX mono+ only restorations , all of which were Class II . The main reason for failure was tooth fracture , followed by resin composite fracture . The annual failure rate ( AFR ) for all restorations ( Class I and II ) was 1.2 % for the bulkfilled restorations and 1.0 % for the resin composite-only restorations ( p > 0.05 ) . For the Class II restorations , the AFR was 2.2 % and 1.6 % , respectively . CONCLUSION The 4-mm bulk-fill technique showed good clinical effectiveness during the 3-year follow-up Objectives The aim of this study is to observe the durability of Class II nanohybrid resin composite restorations  , placed with two different adhesive systems , in an 8-year follow-up . Methods Seventy-eight participants received at r and om at least two Class II restorations of the ormocer-based nanohybrid resin composite ( Ceram X ) bonded with either a one-step self-etch adhesive ( Xeno III ) or a control two-step etch- and -rinse adhesive ( Excite ) . The 165 restorations were evaluated using slightly modified United States Public Health Services ( USPHS ) criteria at baseline and then yearly during 8 years . Results One hundred and fifty-eight restorations were evaluated after 8 years . Three participants with five restorations ( three Xeno III , two Excite ) were registered as dropouts . Twenty-one failed restorations ( 13.3 % ) were observed during the follow-up . Twelve in the one-step self-etch adhesive group ( 13.5 % ) and nine in the two-step etch- and -rinse group ( 13.0 % ) . This result ed in nonsignificant different annual failure rates of 1.69 and 1.63 % , respectively . Fracture of restoration was the main reason for failure . Conclusion Good clin 
    Output:
    
agent
SIGNIFICANCE This study did not identify clear advantages of using the first generation of ormocer-based fillings rather than conventional composites .
***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: Aims and Objectives : To compare the marginal sealing ability of ormocer with a hybrid composite using an ormocer based bonding agent and a conventional fifth generation bonding agent . Material s and Methods : Fifty four human premolars were r and omly distributed into four test groups of 12 teeth each and two control groups of 3 teeth each . Class I occlusal preparation of 1.5 mm depth were made in each tooth . These were restored using the adhesive and restorative material according to the group . The restorations were finished using a st and ard composite finishing and polishing kit . Thermocycling between 5 ° C and 55 ° C was carried out . Having blocked the root apex and the entire tooth surface except 1 mm around the restoration margin , the teeth were immersed in 2 % methylene blue for 48 hours , after which the dye penetration through the margins of each sample was studied under a stereomicroscope . Results and Discussion : Group IV ( Admira with Admira Bond ) showed the minimum marginal leakage with a mean of 0.200 mm . Four sample s in this group showed no microleakage at all and a maximum of 0.400 mm was seen in one sample . Group II ( Spectrum TPH with Admira Bond ) showed the maximum leakage with a mean of 0.433 mm . One sample showed as much as 1.00 mm of microleakage .  Admira when used with Admira Bond showed lesser microleakage than Spectrum TPH used with Prime & Bond NT , the difference being statistically insignificant Objective The aim of this study is to evaluate the color stability of two nanohybrid resin-based composites , two organic modified ceramic resin composites ( ormocers ) and a compomer , following their immersion during 4 weeks in four usual drinks . Material and methods Forty discs of each of the following material s were prepared : Gr and ioSO ( GR ) , Esthet X ( EX ) , Dyract EXTRA ( DY ) , Ceram X duo ( CX ) , and Admira Fusion ( AD ) . The discs were polished and stored in distilled water during 24 h at 37 ° C . Color according to the CIEL*a*b * scale was recoded . Ten r and omly selected sample s of each material were immersed in red wine ( RW ) , coffee ( CF ) , cola ( CK ) , and distilled water ( DW ) . The color was recorded after 1 , 7 , 21 and 28 days of immersion . The ΔE values between the baseline color and each of the study timepoints were calculated . The data were analyzed based on the Kruskal-Wallis test , Wilcoxon test , and Mann-Whitney U test . Results After 1 day of immersion , all the material s showed ΔE > 3.3 , except EX , CF , and CX in CK . RD was the most staining beverage ( ΔE 15.36 to 31.09 ) . EX and CX were significantly less stained than the rest of the material s ( p < 0.05 ) . Conclusions All the staining solutions produced darkening beyond clinical ly acceptable limits . EX and CX were the material s who experimented less staining , followed by GD . AD and DY were the material s more stained . RW was the drink that produced more staining , followed by CF and CK . Clinical relevance After 24 h of immersion in all the solutions , equivalent to 1 month of exposure in the mouth , the evaluated material s showed clinical ly unacceptable ΔE values PURPOSE This prospect i ve long-term clinical trial evaluated and compared the three-year clinical performance of an ormocer , a nanofilled , and a nanoceramic resin composite with that of a microhybrid composite placed in Class I and Class II cavities . METHODS Forty patients , each with four Class I and II restorations under occlusion , were enrolled in this study . A total of 160 restorations were placed , 25 % for each material , as follows : an ormocer-based composite , Admira ; a nanofilled resin composite , Filtek Supreme XT ; a nanoceramic resin composite , Ceram X ; and a microhybrid resin composite , Tetric Ceram . A single operator placed all restorations according to the manufacturers ' instructions . Immediately after placement the restorations were finished/polished . Clinical evaluation was performed at baseline and at yearly intervals after placement by two other independent examiners using modified US Public Health Service ( USPHS ) criteria . The changes in the USPHS parameters during the three-year period were analyzed with the Friedman test . Comparison of the baseline scores with those at the recall visits was made using the Wilcoxon signed rank test . The level of significance was set at p < 0.05 . RESULTS All material s showed only minor changes , and no differences were detected between their performance at baseline and after three years . Only two ormocer , one nanofilled , and one microhybrid restorations in molars failed because of loss of retention . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p>0.05 ) . CONCLUSIONS The ormocer , nanofilled , and nanoceramic composites provided acceptable clinical performance over a three-year period Abstract . This study investigated the clinical performance of two packable composite resins  in Class-II restorations . One hundred and four Class-II restorations were placed in 52 patients by five dentists ( four in dental practice s and one in a university clinic ) in a controlled prospect i ve multicentre clinical trial . Each patient received one Definite/Etch & Prime 3.0 ( D-EP ) and one Solitaire/Solid Bond ( S-SB ) restoration , which were examined clinical ly according to modified USPHS- criteria after 1 week ( baseline ) and after 1 year . Statistical analysis was performed using the Wilcoxon rank sum test and the error rates method . The significance level was set to 0.05 . At baseline both material s performed equally according to the evaluated criteria . After 1 year D-EP showed significantly worse marginal adaptation compared to S-SB . Both material s displayed significant deterioration for the criteria marginal adaptation , marginal discolouration , approximal contact , and fracture of restoration after 1 year compared to baseline . With a failure rate of 9.6 % after 1 year , D-EP did not fulfill ADA acceptance criteria for restorative material s. It is proposed that at least 1-year data of clinical testing should be available before a new material is broadly marketed OBJECTIVES To study monomer elution from four resin-based composites ( RBCs )  cured with different light sources . METHODS Twenty-eight premolars were r and omly allocated to four groups . St and ardized cavities were prepared and restored with a nanohybrid ( Filtek Supreme XT or Tetric EvoCeram ) , an ormocer ( Admira ) or a microhybrid RBC ( Filtek Z250 ) which served as control . Buccal restorations were cured with a halogen and oral restorations with an LED light-curing unit . Elution of diurethane dimethacrylate ( UDMA ) , Bisphenol A diglycidylether methacrylate ( BisGMA ) , triethylene glycol dimethacrylate ( TEGDMA ) and 2-hydroxyethyl methacrylate ( HEMA ) was analyzed using high-performance liquid chromatography ( HPLC ) 1h to 28 days post-immersion in 75 % ethanol . Data were analyzed using multivariate and repeated measures analysis of variance ( α = 0.05 ) . RESULTS The greatest elution of UDMA and BisGMA occurred from Tetric EvoCeram and the least from Filtek Z250 ( p < 0.05 ) . LED and halogen light-curing units gave similar results for all RBCs ( p > 0.05 ) except Tetric EvoCeram which showed greater elution for the LED unit ( p < 0.05 ) . TEGDMA was below the limit of quantification . HEMA eluted in similar concentrations from Filtek Supreme and Tetric EvoCeram ( p > 0.05 ) . SIGNIFICANCE The two nanohybrid RBCs eluted more cross-linking monomers than the ormocer and the control microhybrid RBC . Continuous elution over 28 days indicates that RBCs act as a chronic source of monomers in clinical conditions . Light source may affect monomer elution since differences were found for one out of four RBCs . Mathematical models for elution kinetics of UDMA and BisGMA indicated two elution mechanisms ABSTRACT Context : Microleakage around dental restorative material s is a major problem in clinical dentistry . Inspite of many new restorative material s available in the market very few actually bond to the tooth surface . Aims : The aims of this study were : ( 1 ) To evaluate and compare the marginal leakage of newer restorative material s viz colored compomer , ormocer , giomer and RMGIC in class I restoration of deciduous molars . ( 2 ) To compare the microleakage scores between the groups of : Colored compomer and ormocer , giomer and RMGIC , ormocer with giomer and RMGIC , giomer with RMGIC . Material s and methods : A total of 40 primary molars were r and omly divided into four groups of 10 each . Class I cavities were prepared and the cavities were restored with colored compomer ( Group A ) , Ormocer ( Group B ) , Giomer ( Group C ) and RMGIC ( Group D ) . The teeth were thermocycled and subjected to 0.5 % basic fuchsin dye penetration followed by sectioning . The cut sections were evaluated under a stereomicroscope and the data was subjected to statistical analysis . Statistical analysis used : Mann-Whitney U test and Student t-test . Results : No significant difference was observed when colored compomer was compared to ormocer , giomer and RMGIC . Ormocer showed significantly lower microleakage when compared to giomer . However , no significant difference was observed when ormocer was compared to RMGIC . No significant difference between giomer and RMGIC was found . Conclusion : Ormocer has proven to be an excellent restorative material as it showed least microleakage followed by colored compomer , giomer and RMGIC in increasing order . How to cite this article : Yadav G , Rehani U , Rana V. A Comparative Evaluation of Marginal Leakage of Different Restorative Material s in Deciduous Molars : An in vitro Study . Int J Clin Pediatr Dent 2012;5(2):101 - 107 PURPOSE To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations . MATERIAL S AND METHODS Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients ( mean age 52.4 years ) . Each patient received at least two extended Class I or Class II restorations that were as similar as possible . In all cavities , a one-step self-etching adhesive ( XenoV+ ) was applied . One of the cavities of each pair was r and omly assigned to receive the flowable bulk-fill resin composite SDR in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface . The occlusal part was completed with an ormocer-based nanohybrid resin composite ( Ceram X mono+ ) . In the other cavity , only the resin composite CeramX mono+ was placed in 2 mm increments . The restorations were evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years . Caries risk and bruxing habits of the participants were estimated . RESULTS No post-operative sensitivity was reported . At the 3-year follow-up , 196 restorations - 74 Class I and 122 Class II - were evaluated . Seven restorations failed ( 3.6 % ) , 4 SDR-CeramX mono+ and 3 CeramX mono+ only restorations , all of which were Class II . The main reason for failure was tooth fracture , followed by resin composite fracture . The annual failure rate ( AFR ) for all restorations ( Class I and II ) was 1.2 % for the bulkfilled restorations and 1.0 % for the resin composite-only restorations ( p > 0.05 ) . For the Class II restorations , the AFR was 2.2 % and 1.6 % , respectively . CONCLUSION The 4-mm bulk-fill technique showed good clinical effectiveness during the 3-year follow-up Objectives The aim of this study is to observe the durability of Class II nanohybrid resin composite restorations  , placed with two different adhesive systems , in an 8-year follow-up . Methods Seventy-eight participants received at r and om at least two Class II restorations of the ormocer-based nanohybrid resin composite ( Ceram X ) bonded with either a one-step self-etch adhesive ( Xeno III ) or a control two-step etch- and -rinse adhesive ( Excite ) . The 165 restorations were evaluated using slightly modified United States Public Health Services ( USPHS ) criteria at baseline and then yearly during 8 years . Results One hundred and fifty-eight restorations were evaluated after 8 years . Three participants with five restorations ( three Xeno III , two Excite ) were registered as dropouts . Twenty-one failed restorations ( 13.3 % ) were observed during the follow-up . Twelve in the one-step self-etch adhesive group ( 13.5 % ) and nine in the two-step etch- and -rinse group ( 13.0 % ) . This result ed in nonsignificant different annual failure rates of 1.69 and 1.63 % , respectively . Fracture of restoration was the main reason for failure . Conclusion Good clin 
    Output:
    