Ormocer: An aesthetic direct restorative material; An in vitro study comparing the marginal sealing ability of organically modified ceramics and a hybrid composite using an ormocer-based bonding agent and a conventional fifth-generation bonding agent Clinical performance of ormocer, nanofilled, and nanoceramic resin composites in Class I and Class II restorations: a three-year evaluation. Surface Roughness of Nanofill and Nanohybrid Composite Resin and Ormocer-based Tooth-colored Restorative Materials after Several Finishing and Polishing Procedures Two-year clinical evaluation of ormocer, nanohybrid and nanofill composite restorative systems in posterior teeth. A prospective randomized clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: Five-year results. A prospective randomised clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: three-year results. The use of Ormocer as an alternative material for bonding orthodontic brackets. One-year evaluation of two hybrid composites placed in a randomized-controlled clinical trial. Four-year clinical evaluation of Class II nano-hybrid resin composite restorations bonded with a one-step self-etch and a two-step etch-and-rinse adhesive. Color stability of nanohybrid resin-based composites, ormocers and compomers A Comparative Evaluation of Marginal Leakage of Different Restorative Materials in Deciduous Molars: An in vitro Study Eight-year randomized clinical evaluation of Class II nanohybrid resin composite restorations bonded with a one-step self-etch or a two-step etch-and-rinse adhesive Monomer elution from nanohybrid and ormocer-based composites cured with different light sources. Randomized 3-year clinical evaluation of Class I and II posterior resin restorations placed with a bulk-fill resin composite and a one-step self-etching adhesive. Restorations in abrasion/erosion cervical lesions: 8-year results of a triple blind randomized controlled trial. Silorane, ormocer, methacrylate and compomer long-term staining susceptibility using ΔE and ΔE00 colour-difference formulas Influence of proximal box elevation on the marginal quality and fracture behavior of root-filled molars restored with CAD/CAM ceramic or composite onlays The influence of different cements on the fracture resistance and marginal adaptation of all-ceramic and fiber-reinforced crowns. Clinical performance of large, all-ceramic CAD/CAM-generated restorations after three years: a pilot study. Clinical performance of the posterior composite QuiXfil after 3, 6, and 18 months in Class 1 and 2 cavities. Computer-aided designed/computer-assisted manufactured composite resin versus ceramic single-tooth restorations: a 3-year clinical study. Three-year results of a randomized controlled clinical trial of the posterior composite QuiXfil in class I and II cavities Clinical evaluation of ceramic inlays compared to composite restorations.
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 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 The purpose of this study was to evaluate the effect of several finishing and polishing procedures on the surface roughness of nanofill and nanohybrid composites and ormocer-based dental restorative material s. The material s included a nanofill composite ( Supreme ) ; a nanohybrid composite ( Gr and io ) ; and an ormocer ( organically modified ceramic ) ( Admira ) . Forty specimens of each material were prepared using a Mylar strip ( polyester strip ) and r and omly divided into four finishing and polishing groups ( n 1/4 10 ) : ( I ) Diamondbur/Super-snapRainbowTechniqueKit(Al2O2-coated , grade d abrasive discs ) ; ( II ) Diamond bur/Astropol and Astrobrush system ( silicone abrasive polishers and brush system ) ; ( III ) Tungsten carbide bur/Super-snap Rainbow Technique Kit ; and ( IV ) Tungsten carbide bur/Astropol and Astro-brush system . The average surface roughness ( Ra ) in micrometers was measured using a “ Mahr Perthometer S4P ” Surface Roughness Tester and the data were compared using ANOVA at P 0.05 . The results of this study indicated that the Mylar strip produced the smoothest surface on all material s and among the finishing-polishing methods the first and the third methods performed significantly smoother surfaces than the second and the fourth methods for the three restoratives . Ormocer ( Admira ) performed the lowest variability in initial surface roughness among the tested material s . This study has shown that Super-snap abrasive discs produced a smoother surface than the Astropol and Astrobrush silicone polishers for composite and ormocer-based restorative material s , but the results would be valid clinical ly for readily accessible and flat surfaces i.e. , not for all areas in the mouth . Therefore silicone polishers are necessary for posterior areas and for concave and convex surfaces PURPOSE To evaluate and compare the 2-year clinical performance of an ormocer , a nanohybrid , and a nanofill resin composite with that of a microhybrid composite in restorations of small occlusal cavities made in posterior teeth . MATERIAL S AND METHODS Thirty-five patients , each with 4 occlusal restorations under occlusion , were enrolled in this study . A total of 140 restorations  was placed , 25 % for each material : an ormocer-based composite , Admira ; a nanohybrid resin composite , Tetric EvoCeram ; a nanofill resin composite , Filtek Supreme ; and a microhybrid resin composite , Tetric Ceram . Two operators placed all restorations according to the manufacturers ' instructions . One week after placement , the restorations were finished/polished and patients were advised to return for follow-up at 6 months , 1 year , and 2 years . All patients attended the 2-year visit where the clinical performance of all restorations was evaluated . Two independent examiners made all evaluations according to the USPHS modified Ryge criteria immediately after placement of restorations and at subsequent recall visits . The changes in the USPHS parameters during the 2-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 2 years . Only one  ormocer and one  microhybrid composite restoration had failed after 2 years . No failure was detected in nanohybrid and nanofill composite restorations . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p > 0.05 ) . CONCLUSION After 2 years , the ormocer , nanohybrid , and nanofill composites showed acceptable clinical performance similar to that of the microhybrid resin composite OBJECTIVES Ormocer composites , consisting of a silicon-based polymer , have been developed recently as a tooth-colored restorative material . The purpose of this prospect i ve r and omized clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems ( AD , Admira/Admira Bond , VOCO ; DE , Definite/Etch & Prime 3.0 , Dentsply ) and one small-particle hybrid bis-GMA-based composite restorative system ( TC , Tetric-Ceram/Syntac , Ivoclar-Vivadent ) in class II cavities . METHODS From 128 occlusal-proximal restorations ( 44 AD , 43 DE and 41 TC ) placed in 32 adult patients , eventually 77 ( 22 AD , 29 DE and 26 TC ) remained available for evaluation after 5 years . Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs . RESULTS After 5 years , eight AD , six DE and seven TC restorations had failed ( p=0.10 , log-rank test ) . The main reason was fracture or marginal gap formation , while secondary caries accounted for four failures . In all restorations the quality of surface , margins and contact point decreased significantly compared to baseline . DE had a significant poorer color match ( p<0.01 ) . Statistical evaluation using the KW test showed that failures were concentrated on specific patients . CONCLUSIONS In a group of class II restorations , there was no significant difference in failures after 5 years between ormocer-based and bis-GMA-based restorative systems OBJECTIVES Ormocer composites , consisting of a silicon-based polymer , have been developed recently as a tooth-coloured restorative material . The purpose of this prospect i ve r and omised clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems ( AD , Admira/Admira Bond , VOCO ; DE , Definite/Etch & Prime 3.0 , Dentsply ) and one small-particle hybrid bis-GMA-based composite restorative system ( TC , Tetric-Ceram/Syntac , Ivoclar-Vivadent ) in occlusal stress-bearing restorations . METHODS One hundred and twenty-eight occlusal-proximal restorations ( 44 AD , 43 DE and 41 TC ) were placed according to the manufacturer 's instructions in thirty-two adult patients . Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs . RESULTS After 3 years , four AD , five DE and four TC restorations had failed due to fracture or marginal gap formation . Surface roughness improved significantly when compared to the baseline in AD and TC ( Friedman test , p<0.05 ) during the first year but returned to baseline values after 3 years . DE had a significant tendency towards discolouration ( p<0.05 ) . Bite-wing radiographs showed two AD and one TC restorations with internal porosities . ANOVA showed that larger restorations ( > or = 3 surfaces ) showed significantly more degradation than smaller ones . CONCLUSIONS In a group of class II restorations , there was no significant difference in failures after 3 years between ormocer-based and bis-GMA-based restorative systems As new adhesives , composite resins , and bonding techniques were introduced , orthodontists adopted some of these innovations and added them to their armamentarium . The purpose of this study was to compare the shear bond strength ( SBS ) of two adhesive material s ; one with an organically modified ceramic matrix , Admira ( Voco , Cuxhaven , Germany ) and another that contains the traditional Bis GMA matrix namely Transbond XT ( 3 M Unitek , Monrovia , Calif ) . The new material s have a lower wear rate and are more biocompatible than traditional composites . Forty molar teeth were r and omly divided into two groups : 20 teeth bonded with the Transbond adhesive system  and the other 20 teeth with the Admira bonding system .  Student 's t-test was used to compare the SBS of the two adhesives . Significance was predetermined at P < or = .05 . The results of the t-test comparisons ( t = 0.489 ) of the SBS indicated that there was no significant ( P = .628 ) difference between the two adhesives tested . The mean SBS for Admira was 5.1 + /- 3.3 MPa and that for Transbond XT was 4.6 + /- 3.2 MPa . It was concluded that the new material , Ormocer , which is an organically modified ceramic restorative material can potentially have orthodontic applications if available in a more flowable paste . These new material s are more biocompatible and have lower wear rate including bonding orthodontic brackets to teeth OBJECTIVE The aim of this prospect i ve r and omized-controlled clinical trial is to assess the long-term performance of two direct composite resins in posterior teeth . This study provides a survey of the one-year results . MATERIAL S AND METHODS A total of 1805 restorations were placed by students in stress-bearing Class I/II cavities ( including cuspal-coverage ) in molars and premolars in 456 patients . Clinical evaluation was performed at baseline and after one year using modified USPHS criteria . The restorations in each patient were performed either with Ceram X/Prime&Bond NT or Tetric Ceram/Optibond Solo Plus . RESULTS After one year 528 fillings with Ceram X and 580 with Tetric Ceram were available for evaluation of substance loss , contact point , color match , marginal staining , marginal adaptation , secondary caries and radiographic examination ( if necessary ) . This represents a recall rate of 61.18 % ( 279 patients ) . The failure rate per material was 5.3 % in the Ceram X group and 6.1 % in the Tetric Ceram group . Most of the failures were associated with marginal adaptation/integrity of the filling . A significant influence on the occurrence of a failure was observed for the number of treated teeth per patient , the age of the patient , the mesio-distal extension of the restoration and the tooth position . Gender , material , a previous root canal treatment , the bucco-lingual extension of the filling or cuspal-coverage did not significantly influence the failure rate . Patients attending the first recall were significantly older and had more fillings than patients not attending . CONCLUSIONS In a group of Class I/II restorations ( including cuspal-coverage ) , there was no significant difference in failure rates between ormocer-based and bis-GMA-based restorative systems after one year . A previous root canal treatment had no negative influence on the failure rate . A longer observation period is indicated to get clear evidence of the long-term performance of these composite resin systems OBJECTIVE The objective of this prospect i ve clinical trial was to evaluate the 4-year clinical performance of an ormocer-based nano-hybrid resin composite ( Ceram X ; Dentsply/DeTrey ) in Class II restorations placed with a one-step self-etch ( Xeno III ; Dentsply/DeTrey ) and two-step etch- and -rinse adhesive ( Ivoclar Vivadent ) . METHODS Seventy-eight participants received at r and om at least two , as similar as possible , Class II restorations of the nano-hybrid resin composite bonded with either a single step self-etch adhesive or a control 2-step etch- and -rinse adhesive . The 165 restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 4 years . RESULTS 162 restorations were evaluated at 4 years . Postoperative sensitivity was observed in 6 patients ( 3 Xeno III , 3 Exite ) between 1 and 3 weeks . Eleven failed restorations ( 6.8 % ) were observed during the follow up . Seven in the one-step self-etch adhesive group ( 7.7 % ) and four in the 2-step etch- and -rinse group ( 5.6 % ) . This result ed in non-significant different annual failure rates of 1.9 % and 1.4 % , respectively . Fracture of restoration was the main reason for failure . CONCLUSION The ormocer-based nano-hybrid resin composite showed a good clinical performance in Class II cavities during the 4 year evaluation . No significant difference was seen in overall clinical effectiveness between the two adhesives 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 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 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 clinical performance was shown during the 8-year evaluation and no significant difference in overall clinical performance between the two adhesives . Fracture was the main reason for failure . Clinical relevance The one-step self-etch adhesive showed a good long-term clinical effectiveness in combination with the nanohybrid resin composite in Class II restorations 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 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 PURPOSE An equivalence r and omized controlled trial within the subject was organized to evaluate the clinical long-term success of a new 2-step etch & rinse adhesive and a new nano-filled ormocer . METHODS 50 subjects , 21 males and 29 females aged between 21 and 65 , were r and omized to receive 150 restorations , 100 with the new restorative material , 50 with the composite as control , placed in non-carious cervical lesions with the same bonding system . The main outcome measure was the cause of failure at 8 years . R and omization was number table-generated , with allocation concealment by opaque sequentially numbered sealed and stapled envelopes . Subjects , examiner , and analyst were blinded to group assignment . Two interim analyses were performed . Data were analyzed by ANOVA and Cox test ( P < 0.05 ) . RESULTS After 8 years , 40 subjects and 120 teeth were included in the analysis of the primary outcome . There were eight failures in the experimental group and four failures in the control group . The cumulative loss rate was 7 % for both restorative material s , with the annual failure lower than 1 % , without any statistically significant difference . There were two key elements of failure : the presence of sclerotic dentin and the relationship between lesion and gingival margin The aim of this study was to evaluate the staining susceptibility of a silorane ( Filtek Silorane ) , an ormocer ( Ceram X Duo ) , a methacrylate ( Tetric EvoCeram ) and a compomer ( Dyract ) exposed on the long term to various staining agents by using ΔE and ΔE00 colour-difference formulas . Thirty-six disc-shaped specimens were made of each of the four chemically different material s , r and omly divided in six groups ( n = 6 ) and immersed in five staining solutions ( red wine , juice , coke , tea and coffee ) or stored dry ( control ) in an incubator at 37 ° C for 99 days . Spectrophotometric measurements by means of a spectrophotometer ( Spectroshade H and y Dental , MHT ) were repeated over a white ( L * = 92.6 , a * = −1.2 , b * = 2.9 ) and black ( L * = 1.6 , a * = 1.2 , b * = −1.0 ) background made of plasticized paper , in order to determine the colour changes according to ΔE , ΔE00 and translucency formulas . Statistical analysis was performed by means of factorial Anova , Fisher ’s LSD test ( post hoc ) and a Spearman rank correlation between ΔE and ΔE00 . When analysed over a white background , mean ΔE00 values were highly significantly different and varied from 0.8 ( Ceram X Duo/air ) to 20.9 ( Ceram X Duo/red wine ) . When analysed over a black background , mean ΔE00 values were highly significantly different and varied from 1.0 ( Ceram X Duo and Tetric/air ) to 25.2 ( Ceram X Duo/red wine ) . Differences in translucency varied from 0.3 ( Ceram X Duo/air ) to 21.1 ( Ceram X Duo/juice ) . The correlation between ΔE and ΔE00 over a white background was 0.9928 , while over a black background , it was 0.9886 Objectives This study investigated the influence of proximal box elevation ( PBE ) with composite resin when applied to deep proximal defects in root-filled molars with mesio-occluso-distal ( MOD ) cavities , which were subsequently restored with computer-aided design ed/computer-aided manufacturing ( CAD/CAM ) ceramic or composite restorations . Material s and method  Root canal treatment was performed on 48 human m and ibular molars . St and ardized MOD cavities were prepared with the distal box located 2 mm below the cemento-enamel junction ( CEJ ) . The teeth were r and omly assigned to one of four experimental groups ( n = 12 ) . In groups G1 and G2 , the distal proximal box was elevated up to the level of the CEJ with composite resin ( PBE ) . No elevation was performed in the remaining two groups ( G3 , G4 ) . CAD/CAM restorations were fabricated with feldspathic ceramic ( Vita Mark II , CER ) in groups G1 ( PBE-CER ) and G3 ( CER ) or with resin nano-ceramic blocks ( Lava Ultimate , LAV ) in groups G2 ( PBE-LAV ) and G4 ( LAV ) . Replicas were taken before and after thermomechanical loading ( TML ; 1.2 Mio cycles ; 49 N ; 3,000 thermocycles between 50 ° C and 5 ° C ) . Following TML , load was applied until failure . Fracture analysis was performed under a stereomicroscope ( ×16 ) . Marginal quality before and after TML ( tooth restoration , composite restoration ) was evaluated using scanning electron microscopy ( ×200 ) . Results After TML , lower percentages of continuous margins were observed in groups G1–G3 compared with pre-TML assessment s ; however , the differences were not statistically significant . For group G4-LAV , the marginal quality after TML was significantly better than in any other group . The highest mean fracture value was recorded for group G4 . No significant difference was found for this value between the groups with PBE compared with the groups without PBE , regardless of the material used . The specimens restored with ceramic onlays exhibited fractures that were mainly restricted to the restoration while , in teeth restored with composite onlays , the percentage of catastrophic failures ( fractures beyond bone level ) was increased . Conclusion PBE had no impact on either the marginal integrity or the fracture behavior of root canal-treated m and ibular molars restored with feldspathic ceramic onlays . CAD/CAM-fabricated composite onlays were more favorable than ceramic onlays in terms of both marginal quality and fracture resistance , particularly in specimens without PBE . Clinical relevance Composite onlays with or without PBE may be a viable approach for the restoration of root-filled molars with subgingival MOD cavities PURPOSE This in vitro study investigated the marginal adaptation and fracture resistance of heat-pressed glass-ceramic and fiber-reinforced composite molar crowns luted with resin , resin-modified glass-ionomer , or zinc-oxide-eugenol-free cements .  MATERIAL S AND METHODS A total of 24 heat-pressed all-ceramic and 24 glass fiber-reinforced composite crowns were constructed and cemented using the above-mentioned luting agents ( eight crowns per cement ) . The restorations were thermocycled and mechanically stressed , and fracture resistance was determined . Marginal adaptation was evaluated before and after stress application using semiquantitative analysis in a scanning electron microscope . RESULTS All-ceramic and fiber-reinforced composite crowns reached the highest fracture resistance after stress application in combination with the resin cement . When luted with resin-modified glass-ionomer or zinc-oxide-eugenol-free cements , the fracture resistance of all-ceramics decreased significantly , while the fiber-reinforced composite crowns maintained their fracture resistance level ; the lowest values were found for zinc-oxide-eugenol-free cements . The marginal adaptation remained unchanged after stress for all-ceramics and fiber-reinforced composite restorations if they were luted with resin cements . Luting with resin-modified glass-ionomers significantly deteriorated the marginal adaptation after stress application , with the exception of the crown-cement interface of all-ceramics . CONCLUSION The highest fracture resistance and marginal adaptation were found for all-ceramic and glass fiber-reinforced composite molar crowns if they were luted with resin cement BACKGROUND Adhesively luted all-ceramic restorations preserve and stabilize weakened tooth structure , but there is little published information about the clinical performance of large , all-ceramic restorations . METHODS In this pilot study , the authors placed 58 large , single-tooth , all-ceramic restorations in 26 patients using a computer-aided design /computer-aided manufacturing , or CAD/CAM , system ( CEREC 2 , Sirona Dental Systems GmbH , Bensheim , Germany ) . They documented the maximum height of the restoration and remaining cementoenamel junction , or CEJ . In 21 cases , rubber dam isolation was not possible during adhesive luting . They re-evaluated the restorations after three years according to the U.S. Public Health Service criteria . RESULTS After three years , the authors rated 56 ( 97 percent ) of the 58 restorations as Bravo or better in regard to marginal integrity , secondary caries ( four could not be rated ) , discoloration and anatomical form . One restoration was rated as Charlie because of poor marginal integrity , and one restoration had to be replaced owing to a bulk fracture . The authors rated the adequacy of proximal contact and occlusal relationships as acceptable-to-good for all restorations . Neither the extent of the remaining enamel at the cavity margin nor application of a rubber dam had any statistically significant influence ( chi2 test , P > .05 ) on the clinical performance of the restorations after three years . CONCLUSIONS At the three-year recall appointment , the authors found that the adhesively luted all-ceramic restorations had successfully repaired large coronal defects , irrespective of the cavity margin location ( that is , coronal or apical to the CEJ ) . CLINICAL IMPLICATION S Tooth-colored , all-ceramic CAD/CAM-generated restorations are an alternative to conventional restorations if large coronal defects need to be treated OBJECTIVE This longitudinal r and omized controlled clinical trial evaluated direct composite restorations for clinical acceptability of posterior restoratives in single- or multisurface cavities and provided a preliminary survey of the 3- , 6- , and 18-month results . METHOD AND MATERIAL S Three clinicians placed 46 QuiXfil ( Xeno III ; Dentsply DeTrey ) and 50 Tetric Ceram ( Syntac Classic ; Vivadent ) composite restorations in stress-bearing Class 1 and 2 cavities in first or second molars ( 43 adult patients ) . Clinical evaluation was performed at baseline and after 3 , 6 , and 18 months by 2 other clinicians using modified US Public Health Service criteria . At the final recall period , 45 QuiXfil and 49 Tetric Ceram restorations were assessed . RESULTS A total of 97.8 % of QuiXfil and 100 % of Tetric Ceram posterior composites were assessed to be clinical ly excellent or acceptable with predominating Alpha scores . At the 18-month recall , 1 QuiXfil restoration had failed because of bulk fracture . No significant differences between either composite could be detected at 18 months for all evaluated clinical criteria ( P > .05 ) . Small QuiXfil restorations exhibited significantly less marginal discoloration ( P = .003 ) and better restoration integrity ( P = .008 ) than large restorations . The comparison of restoration performance with time within both groups yielded a significant increase in marginal discoloration for QuiXfil ( P = .011 ) and significant deterioration for anatomic form at the marginal step for Tetric Ceram ( P = .011 ) . However , both changes were only effects of scoring shifts from Alpha to Bravo . CONCLUSION Clinical assessment of stress-bearing QuiXfil and Tetric Ceram posterior composite restorations exhibited for both material s good clinical results with predominating Alpha scores PURPOSE No clinical evidence has been provided to suggest that metal-free all-composite resin indirect restorations are a functional and esthetic alternative to all-ceramic restorations . The aim of this study was to evaluate the clinical performance of  single-tooth computer-aided design /computer-assisted manufacturing (CAD/CAM)-generated all-composite resin and all-ceramic crowns after 3 years of function . MATERIAL S AND METHODS In a prospect i ve trial , 200 all-composite resin and all-ceramic crowns were rated over a 3-year period . Restorations were evaluated at 3 weeks and 1 and 3 years after insertion by the California Dental Association quality evaluation index , the patient 's self- assessment , marginal fit , periodontal parameters , volume loss , and wear patterns of the veneering material . Statistical analysis was performed using t tests ( a = .05 ) . RESULTS Cumulative survival and success rates after 3 years were 87.9 % and 55.6 % for all-composite resin and 97.2 % and 81.2 % for all-ceramic crowns , respectively ( P < .05 for success rates ) . Restoration loosening occurred exclusively for all-composite resin crowns cemented on a cast post . All-ceramic restorations demonstrated satisfactory esthetic results .  All-composite resin crowns result ed in significantly more mean total volume loss and mean vertical wear at occlusal contact areas after 6 months and 3 years of function . The clinical performance of the CAD/CAM-generated all-ceramic crowns used in this study was similar to that of other all-ceramic CAD/CAM systems . CONCLUSION For up to 3 years of function , all-composite resin single-tooth restorations have inferior success rates compared to all-ceramic restorations . Due to the inferior esthetics and wear resistance of all-composite resin crowns , all-ceramic crowns remain the preferred treatment for CAD/CAM-generated metal-free single-tooth restorations This longitudinal r and omized controlled clinical trial evaluated direct composite restorations  for clinical acceptability as posterior restoratives in single- or multi-surface cavities and provides a survey of the 3-year results . Three dentists placed 46 QuiXfil ( Xeno III ) and 50 Tetric Ceram ( Syntac Classic ) composite restorations in stress-bearing class I and II cavities in first or second molars ( 43 adult patients ) . Clinical evaluation was performed at baseline and after 3 years by two other dentists using modified US Public Health Service criteria . At the last recall period , 40 QuiXfil and 46 Tetric Ceram restorations  were assessed . A total of 92.5 % of QuiXfil and 97.8 % of Tetric Ceram posterior composites were assessed to be clinical ly excellent or acceptable with predominating alpha scores . Up to the 3-year recall , three QuiXfil restorations failed because of bulk fracture , partial tooth fracture , and postoperative symptoms . One Tetric Ceram restoration was lost due to problems with tooth integrity . No significant differences between both composites could be detected at 3 years for all evaluated clinical criteria ( p > 0.05 ) . The comparison of restoration performance with time within both groups yielded a significant increase in marginal discoloration ( p = 0.007 ) and deterioration of marginal integrity ( p = 0.029 ) for QuiXfil and significant increase in marginal discoloration ( p = 0.009 ) for Tetric Ceram . However , both changes were mainly effects of scoring shifts from alpha to bravo . Clinical assessment of stress-bearing QuiXfil and Tetric Ceram posterior composite restorations exhibited for both material s good clinical results with predominating alpha scores This study compared the clinical performance of  indirectly manufactured ceramic Evopress inlays with those of directly placed , fine particle hybrid Filtek Z250 composite restorations in posterior teeth . From January 2000 to October 2003 , 109 patients received 264 Evopress ( Wegold ) ceramic inlays and 68 patients received 145 Filtek Z250 ( 3 M ESPE ) composite restorations in a dental office . Two-hundred and fifty ceramic inlays ( 95 % ) and 135 composite restorations ( 93 % ) were re-examined up to 57 months after placement . Modified USPHS criteria were used for the study . The worst finding of all the assessment s was the overall assessment of individual restorations . On the basis of these criteria , 220 ( 88 % ) Evopress ceramic inlays were assessed as Alpha at the time of clinical re-examination , 26 ( 10 % ) were judged Beta and four ceramic inlays ( 2 % ) were rated Delta in the re-examination interval and thus categorized as failures . At the time of re-examination , 91 of the 135 composite restorations ( 67 % ) were judged Alpha , 36 restorations ( 26 % ) were rated Beta and three restorations ( 2 % ) were judged Charlie . Five restorations ( 4 % ) were categorized as failures ( Delta ) . In two cases , there were marginal gap formations ; there were also two cases of secondary caries after 28 and 35 months , as well as a fracture after 13 months . According to Kaplan and Meier , the survival rate after 57 months was 94 % for ceramic inlays and 93 % for composite restorations . The log rank test showed no significant differences in the survival curves . The current study showed that indirectly manufactured Evopress ceramic inlays performed better than direct Filtek Z250 composite restorations in marginal adaptation , color match and anatomic form . However , with regard to survival probability , there was no significant difference
SIGNIFICANCE This study did not identify clear advantages of using the first generation of ormocer-based fillings rather than conventional composites .
OBJECTIVES In-vitro experiments on  ormocers ( ORganically MOdified CERamics )  have provided controversial results .
Consequently , the objectives of this meta- analysis were to ( 1 ) compare clinical performances of first generation ormocers versus conventional composite restorations  , ( 2 ) explore the influence of various clinical factors and the impact of the quality of studies on published results .