title: 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 Color stability of nanohybrid resin-based composites, ormocers and compomers Clinical performance of ormocer, nanofilled, and nanoceramic resin composites in Class I and Class II restorations: a three-year evaluation. Clinical evaluation of packable composite resins in Class-II restorations Monomer elution from nanohybrid and ormocer-based composites cured with different light sources. A Comparative Evaluation of Marginal Leakage of Different Restorative Materials in Deciduous Molars: An in vitro Study 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. 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 Clinical evaluation of two "packable" posterior composite resins: two-year results 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 Four-year evaluation of a resin composite including nanofillers in posterior cavities. A prospective randomized clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: Five-year results. The use of Ormocer as an alternative material for bonding orthodontic brackets. Recommendations for conducting controlled clinical studies of dental restorative materials A prospective randomised clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: three-year results.
abstract: 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 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 The purpose of this study was to evaluate the clinical performance of two " packable " posterior composites : Prodigy Condensable/Optibond Solo — Kerr ( PC-OS ) and Definite/Etch & Prime — Degussa ( D-EP ) .  Thirty-six patients participated in this study . A total of 78 restorations ( 40 with D-EP  and 38 with  PC-OS ) were made . Each patient received at least two restorations ( one of each studied material ) . The material s were h and led according to the manufacturer 's instructions . The occlusal adjustments were made at the placement visit . The restorations were finished and polished after 1 week . They were evaluated at baseline , and after 1 year and 2 years by two independent evaluators using the USPHS criteria . Colored slides were made of all the restorations . After 2 years , 34 patients and 74 restorations ( 38 with D-EP and 36 with PC-OS ) were available for evaluation . A total of 50 % of PC-OS restorations received A criterion and 50 % received B criterion ( 2.8 % color , 11.1 % marginal staining , 27.8 % superficial staining , 2.8 % anatomic form and 5.6 % marginal adaptation ) . For D-EP , 60.5 % of restorations received A criterion and 39.5 % received B criterion ( 2.6 % color , 5.3 % marginal staining , 10.5 % superficial staining , 7.9 % anatomic form and 13.2 % marginal adaptation ) . The C criterion was observed only for marginal adaptation with D-EP ( 2 restorations—5.3 % ) . The obtained data were tabulated and statistically analyzed using the Fisher , Chi-square and McNemar tests . After 2 years , PC-OS showed a significant increase in superficial and marginal staining . For D-EP the marginal adaptation and superficial staining became significantly worse than baseline 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 PURPOSE The aim of this prospect i ve study was to evaluate the clinical performance of the restorative material Ceram . X in combination with an experimental one-bottle etch- and -rinse adhesive ( K-0127 ) . MATERIAL S AND METHODS A single operator placed two Class I or II restorations in molars of 43 patients . One molar was restored with Ceram . X/K-0127 ( Dentsply DeTrey ) , the other one with Tetric Ceram/Syntac Classic ( Ivoclar Vivadent ) . At baseline , after one , two , and four years the restorations were evaluated by a second dentist using modified Ryge 's criteria . After four years , 27 patients were examined . RESULTS In one patient , both restorations ( Class II ) had to be removed for root canal treatment due to pulpitis . Another Class II Ceram . X restoration ( 3.8 % ; 4.3 % [ 1 of 23 ] of Class II restorations ) showed score C with regard to wear/anatomical form . Thus , the cumulative failure rate was 7.4 % in the Ceram . X group ( 8.3 % of Class II restorations [ 2 of 24 ] ) and 3.7 % in the Tetric Ceram group ( 4.2 % of Class II restorations [ 1 of 24 ] ) . Furthermore , three restorations ( 11.5 % ) in each group showed score B for anatomical form and marginal integrity . Slight marginal discoloration ( score B ) was found at five Ceram . X restorations ( 19.2 % ) and four Tetric Ceram restorations ( 15.4 % ) . Two restorations ( 7.7 % ) in each group showed slight changes in color stability ( score B ) . No sensitivity , recurrent caries , or changes in surface texture were recorded after four years . No statistically significant differences were found between the two restorative material s ( p > 0.05 ) . CONCLUSION After four years of clinical service , 92.6 % of Ceram . X/K-0127 and 96.3 % of Tetric Ceram/Syntac Classic restorations performed clinical ly well 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 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 About 35 years ago , Ryge provided a practical approach to evaluation of clinical performance of restorative material s. This systematic approach was soon universally accepted . While that methodology has served us well , a large number of scientific method ologies and more detailed questions have arisen that require more rigor . Current restorative material s have vastly improved clinical performance and any changes over time are not easily detected by the limited sensitivity of the Ryge criteria in short term clinical investigations . However , the clinical evaluation of restorations not only involves the restorative material per se but also different operative techniques . For instance , a composite resin may show good longevity data when applied in conventional cavities but not in modified operative approaches . Insensitivity , combined with the continually evolving and non-st and ard investigator modifications of the categories , scales , and reporting methods , has created a body of literature that is extremely difficult to meaningfully interpret . In many cases , the insensitivity of the original Ryge methods is misinterpreted as good clinical performance . While there are many good features of the original system , it is now time to move to a more contemporary one . The current review approaches this challenge in two ways : ( 1 ) a proposal for a modern clinical testing protocol for controlled clinical trials , and ( 2 ) an in-depth discussion of relevant clinical evaluation parameters , providing 84 references that are primarily related to issues or problems for clinical research trials . Together , these two parts offer a st and ard for the clinical testing of restorative material s/ procedures and provide significant guidance for research teams in the design and conduct of contemporary clinical trials . Part 1 of the review considers the recruitment of subjects , restorations per subject , clinical events , validity versus bias , legal and regulatory aspects , rationale s for clinical trial design s , guidelines for design , r and omization , number of subjects , characteristics of participants , clinical assessment , st and ards and calibration , categories for assessment , criteria for evaluation , and supplemental documentation . Part 2 of the review considers categories of assessment for esthetic evaluation , functional assessment , biological responses to restorative material s , and statistical analysis of results . The overall review represents a considerable effort to include a range of clinical research interests over the past years . As part of the recognition of the importance of these suggestions , the review is being published simultaneously in identical form in both the “ Journal of Adhesive Dentistry ” and the “ Clinical Oral Investigations . ” Additionally an extended abstract will be published in the “ International Dental Journal ” giving a link to the web full version . This should help to introduce these considerations more quickly to the scientific community 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
target: SIGNIFICANCE This study did not identify clear advantages of using the first generation of ormocer-based fillings rather than conventional composites .
background: 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 .