Resistance to bond degradation between dual-cure resin cements and pre-treated sintered CAD-CAM dental ceramics Effect of surface pre-treatments on the zirconia ceramic-resin cement microtensile bond strength. Silica-based nano-coating on zirconia surfaces using reactive magnetron sputtering: effect on chemical adhesion of resin cements. Effects of different surface treatments on bond strength between resin cements and zirconia ceramics. Evaluation of four surface coating treatments for resin to zirconia bonding. The Effect of Laser Treatment on Bonding Between Zirconia Ceramic Surface and Resin Cement Effect of static and cyclic loading on ceramic laminate veneers adhered to teeth with and without aged composite restorations. Surface Characterization and Short-term Adhesion to Zirconia after Ultra-short Pulsed Laser Irradiation. The effect of silica coating on the resin bond to the intaglio surface of Procera AllCeram restorations. Comparison of resin cement adhesion to Y-TZP ceramic following manufacturers’ instructions of the cements only Effect of an experimental zirconia-silica coating technique on micro tensile bond strength of zirconia in different priming conditions. Effect of chemical etching solutions versus air abrasion on the adhesion of self-adhesive resin cement  to IPS e.max ZirCAD with and  without aging. Improved bonding of zirconia substructures to resin using a "glaze-on" technique. Influence of surface treatment and simulated aging on bond strengths of luting agents to zirconia. Pilot evaluation of resin composite cement adhesion to zirconia using a novel silane system Evaluation of a commercial primer for bonding of zirconia to two different resin composite cements. Bond strength of resin cement to zirconia ceramic with different surface treatments Effect of different surface treatments on adhesion of In-Ceram Zirconia to enamel and dentin substrates. Effect of silica coating combined to a MDP-based primer on the resin bond to Y-TZP ceramic. Effects of some chemical surface modifications on resin zirconia adhesion. Association of different primers and resin cements for adhesive bonding to zirconia ceramics. Durable bonding to mechanically and/or chemically pre-treated dental zirconia. New zirconia primer improves bond strength of resin-based cements.
Objective : To evaluate the bond stability of resin cements when luted to glass-reinforced alumina and zirconia CAD/CAM dental ceramics . Study design : Eighteen glass-infiltrated alumina and eighteen densely sintered zirconia blocks were r and omly conditioned as follows : Group 1 : No treatment ; Group 2 : S and blasting ( 125 µm Al2O3-particles ) ; and Group 3 : Silica-coating ( 50 µm silica-modified Al2O3-particles ) . Composite sample s were r and omly bonded to the pre-treated ceramic surfaces using different resin cements : Subgroup 1 : Clearfil Esthetic Cement ( CEC ) ; Subgroup 2 : RelyX Unicem ( RXU ) ; and Subgroup 3 : Calibra ( CAL ) . After 24 h , bonded specimens were cut into 1 ± 0.1 mm2 sticks . One-half of the beams were tested for microtensile bond strength ( MTBS ) . The remaining one-half was immersed in 10 % NaOCl aqueous solution ( NaOClaq ) for 5 h before testing . The fracture pattern and morphology of the debonded surfaces were assessed with a field emission gun scanning electron microscope ( FEG-SEM ) . A multiple ANOVA was conducted to analyze the contributions of ceramic composition , surface treatment , resin cement type , and chemical challenging to MTBS . The Tukey test was run for multiple comparisons ( p < 0.05 ) . Results : After 24 h , CEC luted to pre-treated zirconia achieved the highest MTBS . Using RXU , alumina and zirconia registered comparable MTBS . CAL failed prematurely , except when luted to s and blasted zirconia . After NaOClaq storage , CEC significantly lowered MTBS when luted to zirconia or alumina . RXU decreased MTBS only when bonded to silica-coated alumina . CAL recorded 100 % of pre-testing failures . Micromorphological alterations were evident after NaOClaq immersion . Conclusions : Resin-ceramic interfacial longevity depended on cement selection rather than on surface pre-treatments . The MDP-containing and the self-adhesive resin cements were both suitable for luting CAD/CAM ceramics . Despite both cements being prone to degradation , RXU luted to zirconia or untreated or s and blasted alumina showed the most stable interfaces . CAL experimented spontaneous debonding in all tested groups . Key words : CAD/CAM ceramic , alumina , zirconia , resin cement , surface pre-treatment , s and blasting , silica-coating , chemical aging , bond degradation , microtensile bond strength OBJECTIVE To evaluate the influence of different surface treatments on the microtensile bond strength of resin cement to zirconia ceramic . MATERIAL S AND METHODS Twelve cylinder-shaped ( ∅ 12 × 5.25 mm high ) blocks of a commercial zirconium-oxide ceramic ( Cercon ® Zirconia , DENTSPLY ) were r and omly divided into 4 groups ( n=3 ) , based on the surface treatment to be performed : ( 1 ) airborne particle abrasion with 125 μm Al₂O₃ particles ( S ) ; ( 2 ) selective infiltration etching ( SIE ) ; ( 3 ) experimental hot etching solution applied for 30 min ( ST ) and ( 4 ) no treatment ( C ) . Paradigm MZ100 blocks ( 3 M ESPE ) were cut into twelve cylinders of 4 mm in thickness . Composite cylinders were bonded to conditioned ceramics using a resin cement ( Calibra ® , DENTSPLY ) , in combination with the proprietary adhesive system . After 24h bonded specimens were cut into microtensile sticks and loaded in tension until failure . Bond strength data were analyzed with Kruskall-Wallis and Dunn 's Multiple Range test for multiple comparisons ( p < 0.05 ) . Failure mode distribution was recorded and the interfacial morphology of debonded specimens was analyzed using a scanning electron microscope ( SEM ) . RESULTS Bond strength values achieved after SIE and ST treatment were significantly higher than after S treatment and without any treatment ( p < 0.05 ) . Premature failures were mostly recorded in the S group . SIGNIFICANCE Conditioning the high-strength ceramic surface with SIE and ST treatments yielded higher bond strengths of the resin cement than when zirconia ceramic was treated with airborne particle abrasion or left untreated PURPOSE To compare the effect of silica (Si)-based nano-coating deposited by reactive magnetron sputtering ( RMP ) with that of conventional surface conditioning using metal/zirconia primer alone or after air-particle abrasion on the adhesion of resin cements to zirconia ceramic . MATERIAL S AND METHODS Two hundred forty zirconia ceramic blocks ( Cercon ) were sintered , finished with 1200- grit SiC paper under water cooling , and cleaned ultrasonically in distilled water for 10 min . The blocks ( 4.5 mm x 3.5 mm x 4.5 mm ) were r and omly divided into 24 groups ( n = 10 ) according to 3 testing parameters : a ) resin cements ( Multilink , Panavia F , RelyX U100 ) , b ) surface conditioning ( no conditioning as control group ; Metal/Zirconia Primer ; air abrasion + Metal/Zirconia Primer ; Si-based nanofilm + Monobond s ) ; c ) aging ( no aging vs thermocycling at 5 ° C to 55 ° C , 6000 cycles ) . The nanofilm was deposited by direct current using argon/oxygen plasma ( 8:1 in flux ) on the zirconia surface . Resin cements were bonded to zirconia surfaces using polyethylene molds . The shear bond strength ( SBS ) test was performed using a universal testing machine ( 1 mm/min ) , and after debonding , the substrate and adherent surfaces were analyzed using optical and scanning electron microscopes to categorize the failure types . The data were statistically evaluated using 3-way ANOVA and Tukey 's test ( 5 % ) . RESULTS Resin cement type ( p < 0.05 ) , surface conditioning method ( p < 0.05 ) , and aging condition ( p < 0.05 ) had a significant effect on the bond strength results . Interactions were also significant ( p < 0.05 ) . In the nonaged condition , while control groups presented the lowest results with all cements ( 0 to 5.2 MPa ) , the airabraded group in combination with RelyX U100 result ed in the highest SBS ( 21.8 ± 6.7 MPa ) . After aging , the SBS results decreased in the air-abraded groups for all cements ( 4.54 to 9.44 MPa ) and showed no statistical significance compared to the Si-based nanocoated groups ( 4.24 to 6.44 MPa ) . After air-abrasion and primer application , only Panavia F and RelyX U100 cements showed exclusively mixed failures , but after nanofilm coating and silanization , all cements showed exclusively mixed failures with and without aging . CONCLUSION Chemical adhesion of the resin cements tested to zirconia was similar after silica-based nanofilm deposition and air abrasion followed by primer application This study compares the bond strength of resin cement and yttrium-stabilized tetragonal zirconia polycrystalline ( Y-TZP ) ceramic with different surface conditioning methods . Two hundred presintered Y-TZP ceramic specimens were prepared , sintered ( 4 × 4 × 4 mm ) , and r and omly assigned to four equal groups as control ( C , no conditioning ) ; airborne particle abraded ( APA , air abrasion with 11 μm Al2O3 ) ; tribochemical silica coating/silane coupling system ( TSC , Rocatec , air abrasion with 110 μm Al2O3 , 30 μm silica-coated Al2O3 and silane ) ; and laser ( L , Er : YAG laser irradiation treated at a power setting of 200 mJ ) . After specimen preparation , composite resin cylinders were prepared and cemented with resin cements ( Clearfil Esthetic , Panavia F 2.0 , Rely X-U100 , Super Bond C&B , and Multilink Automix ) on the ceramic surfaces and kept in an incubator at 37 ° C for 60 days . All specimens were tested for shear bond strength with a universal testing machine , and fractured surfaces were evaluated by environmental scanning electron microscopy . Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-tests ( α=0.05 ) . The bond strengths for C and L groups were not significantly different according to adhesive resin cement . APA and TSC result ed in increased bond strength for Panavia F 2.0 and Rely X-U100 resin cements . Additionally , TSC presented higher bond strength with Multilink Automix . Adhesive fracture between the ceramic and resin cement was the most common failure . Complete cohesive fracture at the ceramic or composite cylinders was not observed . Regardless of the adhesive resin cement used , laser treatment did not improve resin bond strength OBJECTIVES To compare the effects of four surface coating methods on resin to zirconia  shear bond strength . MATERIAL AND METHODS Eighty pre-sintered zirconia discs were prepared and r and omly divided into five study groups according to the corresponding methods of surface treatments as follows : group C ( control group , fully sintered without any surface treatment ) , group S ( fully sintered and then s and blasted with silica coated alumina powder ) , group G ( fully sintered and then coated with glazing porcelain followed by acid etching ) , group Si ( pre-coated with silica slurry then fully sintered ) , and group Z ( coated with zirconia particles and then fully sintered ) . The observation of surface morphology and elemental composition analysis were conducted by SEM and EDX . Self-adhesive resin cement stubs ( diameter 3.6 mm and height 3 mm ) were then bonded on the zirconia discs with a cylindrical shape . Both initial and artificial aged ( including 30-day water storage , thermal cycling for 3000 and 6000 cycles ) shear bond strengths were then evaluated . RESULTS All the tested coating methods showed significantly higher shear bond strengths than the control group , in both dry and aged conditions . Group S produced the strongest initial zirconia/resin bonding ( 19.7MPa ) and the control group had the lowest value ( 8.8MPa ) . However , after thermal cycling , group Z exhibited the highest mean value . All the sample s in the control group failed in the thermal cycling . Both different coating methods ( p<0.001 ) and various aging treatments ( p<0.001 ) produced significant influence on resin-zirconia shear bond strength . CONCLUSIONS A reliable and durable resin zirconia bonding is vital for the longevity of dental restorations . Silica coating might be a reliable way in enhancing adhesion between resin and zirconia Abstract Objective . The purpose of this in-vitro study was to evaluate and compare the effects of different surface treatments and laser irradiation on the shear bond strength of resin cement to zirconia-based ceramic . Material and methods . Forty zirconia core specimens ( 10-mm diameter , 2-mm thickness ) were produced and embedded in the centers of autopolymerizing acrylic resin blocks . Subsequently , specimens were r and omly divided into four groups , each containing 10 specimens , for different surface treatment methods . The details of the groups are as follows : Group C , no treatment applied ( control ) ; Group SB , bonding surfaces of ceramic disks were airborne particle-abraded with 110-μm alumina oxide particles ; Group HF , bonding surfaces of ceramic disks were etched with 9.6 % hydrofluoric acid ; and Group L , bonding surfaces of ceramic disks were irradiated by a CO2 laser . A total of 40 composite resin disks were fabricated and cemented with an adhesive resin cement to the specimen surfaces . A universal test machine was used for the shear bond strength test at a crosshead speed of 1 mm/min . Results . The highest shear bond strength values were obtained with Group L ( 20.99 ± 3.77 MPa ) and the lowest values with Group C ( 13.39 ± 3.10 MPa ) . Although there was no significant difference between Groups C , HF and SB ( P > 0.05 ) , Group L showed a significant difference from all other groups ( p < 0.05 ) . Conclusion . All surface treatment methods improved the bond strength between resin cement and the zirconium oxide ceramic surface . CO2 laser etching may represent an effective method for conditioning zirconia surfaces , enhancing micromechanical retention and improving the bond strength of resin cement on zirconia ceramic PURPOSE Existing composite restorations on teeth are often remade prior to the cementation of fixed dental prostheses . The aim of this study was to evaluate the effect of static and cyclic loading on ceramic laminate veneers adhered to aged resin composite restorations . MATERIAL S AND METHODS Eighty sound maxillary incisors were collected and r and omly divided into four groups : group 1 : control group , no restorations ; group 2 : two Class III restorations ; group 3 : two Class IV restorations ; group 4 : complete composite substrate . St and ard composite restorations were made using a microhybrid resin composite ( Anterior Shine ) . Restored teeth were subjected to thermocycling ( 6000 cycles ) . Window preparations were made on the labial surface of the teeth for ceramic laminate fabrication ( Empress II ) . Teeth were conditioned using an etch- and -rinse system . Existing composite restorations representing the aged composites were silica coated ( CoJet ) and silanized ( ESPE-Sil ) . Ceramic laminates were cemented using a bis-GMA-based cement ( Variolink Veneer ) . The specimens were r and omly divided into two groups and were subjected to either static ( groups 1a , 2a , 3a , 4a ) or cyclic loading ( groups 1b , 2b , 3b , 4b ) . Failure type and location after loading were classified . Data were analyzed using one-way ANOVA and Tukey 's test . RESULTS Significantly higher fracture strength was obtained in group 4 ( 330 ± 81 N ) compared to the controls in group 1 ( 179 ± 120 N ) ( one-way ANOVA , p < 0.05 ) . Group 1b survived a lower mean number of cyclic loads ( 672,820 cycles ) than teeth of groups 2b to 4b ( 846x103 to 873x103 cycles ) . Failure type evaluation after the fracture test showed predominantly adhesive failures between dentin and cement , but after cyclic loading , more cohesive fractures in the ceramic were seen . CONCLUSION Ceramic laminate veneers bonded to conditioned aged composite restorations provided favorable results . Surface conditioning of existing restorations may eliminate the necessity of removing aged composite restorations PURPOSE To evaluate the suitability of an ultra-short pulsed laser ( USPL ) to treat zirconia ceramic surfaces and increase their adhesion to dual-curing resin cement . MATERIAL S AND METHODS Twenty 10 × 10 × 5 mm³ blocks were prepared from a zirconia ceramic ( Y-TZP ) . The specimens were polished and r and omly assigned to four groups ( n = 5 ) which received the following surface treatments : s and blasting ( SB ) with Al₂O₃ particles and silica coating ( SC ) with SiO₂ particles as positive controls ; two groups received USPL irradiation , one with 10 scan repetitions ( L10 ) and the other with 20 ( L20 ) . Laser irradiation was performed at 1030 nm , 2.3 J/cm² , 6 ps pulse duration . The ceramic blocks were duplicated in composite resin and cemented with a dual-curing resin cement . Half of the blocks were then stored in water ( 37 ° C ) for 24 h and the other half for 1 month . At each time , 40 to 60 sticks per group were subjected to microtensile bond strength testing . Data were analyzed statistically using the Kruskal-Wallis test ( α = 0.05 ) . RESULTS Laser-treated zirconia presented statistically significantly higher roughness than did SB and SC . After 24 h , the highest bond strength means ( MPa ) were achieved by L10 ( 42.3 ± 10.8 ) and L20 ( 37.9 ± 14.4 ) , and both of them were statistically significantly higher than SB ( 22.0 ± 5.3 ) and SC ( 20.8 ± 7.1 ) ( p < 0.05 ) . After 1 month of storage , L10- and L20-treated zirconia still showed significantly higher bond strengths than did SB- and SC-treated zirconia ( p < 0.05 ) . CONCLUSION USPL irradiation significantly increases bond strength of zirconia ceramic to dual-curing resin cement and might be an alternative for improving adhesion to this material OBJECTIVES This study investigated the influence of a silica-coating method on the resin bond of two different resin composite cements to the intaglio surface of Procera AllCeram densely sintered , high-purity , alumina ceramic restorations after long-term storage and thermocycling . METHOD AND MATERIAL S Densely sintered alumina ceramic specimens were fabricated with the intaglio surface of the Procera AlICeram coping and r and omly divided into five adhesive groups ( 100 total specimens ) . Resin composite cylinders were bonded either to the untreated or to the tribochemical silica/silane-coated ceramic surface with either a conventional Bis-GMA resin cement or a resin composite containing an adhesive phosphate monomer ( Panavia 21 ) in combination with their corresponding bonding/silane coupling agents . Panavia was also used without silanization to the untreated ceramic surface ( control ) . Subgroups of 10 specimens were stored in distilled water for either 3 ( baseline ) or 180 days prior to shear bond strength testing . The 180-day sample s were subjected to repeated thermocycling for a total of 12,000 cycles . Data were analyzed with one-way analysis of variance and Tukey 's multiple comparison . RESULTS Silica coating significantly increased overall bond strength to Procera AllCeram . RelyX ARC and silica coating revealed the highest bond strength at baseline . Long-term storage and thermocycling significantly decreased overall bond strength . Two groups revealed the significantly highest bond strength values after artificial aging : Panavia 21 with its silane/bonding agent to the original ceramic surface and Panavia 21 to the silica-coated ceramic surface . CONCLUSION The use of a resin composite containing an adhesive phosphate monomer either in combination with a silane coupling/bonding agent or after tribochemical silica/silane coating revealed the highest long-term shear bond strength to the intaglio surface of Procera AllCeram restorations The objectives of this study were ( 1 ) to evaluate the bond strength of four resin material s with various chemical compositions following the manufacturers ’ instructions only and ( 2 ) to test their durability in dry and thermal aged conditions when they were bonded to zirconia ceramic . Four types of resin material s namely , Panavia F 2.0 , Multilink , SuperBond and Quadrant Posterior Dense , were attached to the disc-shaped zirconia ceramics ( LAVA , 3 M ESPE ) using polyethylene molds and polymerized accordingly after the ceramics were wet ground finished and ultrasonically cleaned . The specimens were r and omly divided into two groups for ageing conditions . While the dry groups were tested immediately after attachment of the resin cement , the other specimens were subjected to thermocycling ( ×6,000 , 5–55 ° C ) . Bond strength results were significantly affected by the storage condition ( p < 0.001 ) and type of resin ( p < 0.001 ; analysis of variance ) . Panavia F 2.0 showed the highest bond strength results under dry conditions ( 9.6 ± 4.1 MPa ) . When manufacturers ’ instructions of the resin cements were followed , no adhesion ( 0 MPa ) was achieved on the zirconia after 6,000 thermal cyclings including Panavia F 2.0 OBJECTIVES This study aim ed to evaluate the adhesive properties of a MDP-containing resin cement to a colored zirconia ceramic , using an experimental zirconia-silica coating technique with different priming conditions . METHODS 18 zirconia ceramic discs ( Cercon base colored ) were divided into two groups : the control group and the experimental zirconia-silica coating group . Specimens in each group were further divided into 3 subgroups ( n = 3 ) according to the priming conditions : no primer , a MDP-containing primer ( ED Primer II ) or a silane coupling primer ( RelyX ™ Ceramic Primer ) . Then resin-composite discs ( Filtek ™ Z250 ) were bonded to the treated surface using a MDP-containing resin cement ( Panavia F 2.0 ) . The bi-layered specimens were cut into microbars and 20 microbars were r and omly selected from each specimen , half of which were stored in 37 ° C water bath for 24h , and the other half were stored for 30 days . After water storage , the sample s were exposed to a micro tensile bond strength test ( MTBS ) . The results were analyzed by ANOVA , while the fracture surfaces were examined by SEM . RESULTS After 24h water storage , zirconia-silica coating followed by silanization showed a significantly ( P<0.001 ) higher MTBS value 45.0 (10.9)MPa . Water storage affected ( P<0.05 ) MTBS in the control group ( 24.1 - 30.3 MPa to 2.8 - 3.1 MPa ) , but only partially in the zirconia-silica coating group ( 20.0 - 45.1 MPa to 17.4 - 25.9 MPa ) . SEM analysis revealed a failure mode change after water storage . SIGNIFICANCE The combination of zirconia-silica coating with silane coupling can improve the bonding of resin cement to this colored zirconia OBJECTIVES This study evaluated the adhesion of self-adhesive resin cement to zirconia after various surface conditioning methods in non-aged and aged conditions . METHODS Zirconia ( IPS e.max ZirCAD , Ivoclar Vivadent ) and resin composite blocks were obtained and r and omly divided into four groups according to one of the following surface conditioning methods : C : No surface treatment ( Control ) ; AS : Air abrasion ( 50 µm Al2O3 ) at low pressure ( 0.2 MPa ) plus silane ( Monobond Plus , Ivoclar Vivadent ) ; MC : Methylene chloride for 60 min ; CE : Chemical etching solution at 100 ° C for 60  min . Surface roughness ( Ra ) measurements were performed on the control and conditioned zirconia specimens using a profilometer . Each conditioned zirconia block was bonded to its corresponding resin composite block using self-adhesive resin cement ( RelyX Unicem Aplicap , 3 M ESPE ) under a load of 300 g. Half of the groups were tested without aging ; the other half were tested after x6000 thermocycling . Sticks were obtained from bonded specimens and subjected to microtensile bond strength ( MTBS ) testing in a universal testing machine ( 0.5 mm/min ) . Failure types were classified after debonding . Data ( MPa ) were analyzed using two-way ANOVA and Tukey 's tests ( α = 0.05 ) . RESULTS The highest mean Ra value was obtained in Group CE ( 0.52 µm ) , and the lowest in Group C ( 0.25 µm ) . Significantly lower MTBS test results were obtained in Group C , both in non-aged ( 17.4 ± 1.1 MPa ) and aged ( 5.11 ± 0.5 MPa ) conditions than in the other groups ( 34.6 ± 1.5 to 51.2 ± 1.1 MPa ; 28.0 ± 0.9 to 49.5 ± 1.0 MPa in non-aged and aged conditions , respectively ) ( P < 0.05 ) . Group CE presented the highest MTBS test results in both non-aged and aged conditions ( 51.2 ± 1.1 MPa and 49.5 ± 1 MPa , respectively ) ( P < 0.05 ) . Failure types were predominantly adhesive in all groups before and after aging . After aging , less adhesive and more mixed and cohesive failures in cement were observed in Groups AS and CE than in the other groups . CONCLUSION Chemical etching of zirconia may have potential use as a substitute for air abrasion as a surface conditioning method for zirconia OBJECTIVE To investigate the influence of applying thin intermediary coatings of acid-etchable glasses on the shear bond strength between a methacrylate resin based cement and an yttria-stabilized zirconia dental ceramic substrate . METHODS The upper and lower surfaces of 110 sintered yttria-stabilised tetragonal zirconia polycrystalline disc-shaped specimens were polished using sequential grade s of Silicon Carbide , then air-abraded with 25 μm diameter alumina particles . Specimens were r and omly allocated to 11 groups ( A-K ) ( n=10 ) , group A acting as control . The upper surface of Group A specimens was subjected to a tribochemical coating regime ( CoJet , 3 M ESPE ) . Five glazing ceramics were applied and fired according to the manufacturer 's recommended firing regime . The glaze was etched with 10 % HF acid and all specimens coated with a silane primer . Two differing storage regimes were employed ( wet storage vs thermocycling ) . Shear bond strength testing specimens were created by cementing resin-based composite cylinders to the centre of the prepared ceramic surface using Rely-X Unicem ( 3 M ESPE ) resin based cement . Shear bond strength testing was performed and load at failure recorded . RESULTS A factorial analysis of variance at a 95 % significance level demonstrated that all glazing techniques result ed in a significant increase in the shear bond strength compared with using the resin based cement alone ( P<0.01 ) , with the different glazing ceramics result ing in significant differences in mean shear bond strength ( P=0.008 ) . The differences were a function of the storage state ( wet storage vs thermocycling ( P=0.013 ) ) . CONCLUSION The glazing techniques used in the current investigation result ed in a significantly enhanced shear bond stress to the resin based cement when compared with the current ' gold st and ard ' - tribochemical coating OBJECTIVE To evaluate short- and long-term shear bond strengths of 4 luting agents to zirconia following different surface treatments . METHOD AND MATERIAL S A total of 320 ceramic specimens fabricated from a commercial zirconium oxide ceramic ( Lava ) were r and omly divided into 4 groups : left untreated ( NOT ) , airborne-particle abraded ( SND ) , Rocatec tribochemical silica/silane coated ( ROC ) , or ground and polished ( GRD ) . Resin composite cylinders were bonded to the zirconia specimens with resin composite luting agent RelyX ARC ( ARC ) , universal adhesive resin composite RelyX Unicem ( UNI ) , adhesive-phosphate-monomer-containing resin composite Panavia F ( PAN ) , or the hybrid glass-ionomer cement RelyX Luting ( LUT ) .  Subgroups of 10 specimens were stored in distilled water ( 37 degrees C ) for 3 days ( ST ) or stored for 180 days and thermocycled for 12,000 cycles ( LT/TC ) before shear bond strength was tested . Statistical analyses included Kruskal-Wallis and Wilcoxon 2- sample rank sum test ( alpha = .01 ) . RESULTS Short-term shear bond strengths were higher with ROC than with SND , which were both greater than GRD or NOT . UNI revealed higher shear bond strengths than PAN , ARC , and LUT . LT/TC significantly decreased shear bond strength values . GRD and NOT produced the lowest shear bond strengths . SND and ROC significantly increased bond strength . ROC generally yielded the highest long-term shear bond strength , especially with UNI , PAN , or ARC . These were similar to SND and PAN , which revealed the highest long-term shear bond strengths . CONCLUSIONS Surface treatment , luting agent , and storage conditions significantly influence shear bond strengths to zirconia . Artificial aging significantly reduces shear bond strengths . Airborne-particle abrasion combined with a resin composite containing adhesive phosphate monomers or tribochemical silica/silane coating combined with any of the tested resin composite luting agents provides superior long-term shear bond strength values Objective . In this study , we evaluated the effect of two silane coupling agents and their blends with a cross-linker silane on the bond strength of a dimethacrylate-based resin composite cement to surface-conditioned zirconia . Material and Methods . A total of 40 planar zirconia specimens were used for 8 test groups . After alumina particle abrasion , followed by tribochemical silica-coating , the specimens were r and omly assigned to four silanizations : with 1.0 vol% 3-methacryloyloxypropyltrimethoxysilane or 1.0 vol% 3-mercaptopropyltrimethoxysilane or their blends with 1.0 vol% 1,2-bis-(triethoxysilyl)ethane ( all in ethanol/water ) . The resin composite ( RelyX ™ ARC , 3 M ESPE ) stubs ( n=10/group ) were light-polymerized onto zirconia specimens . Four test groups were tested without water storage and 4 thermo-cycled at 6000 cycles ( 5±1 ° C to 55±1 ° C ) , with a dwelling time of 30 s. The shear bond strength of the cement stubs to zirconia was measured using a universal testing machine at a constant cross-head speed of 1 mm/min . Scanning electron microscopy was employed for imaging the zirconia surface after conditioning and testing . Failure mode was evaluated visually . A surface chemical analysis was carried out with the EDXA system . Results . The highest shear bond strength was 21.9±8.7 MPa , obtained with a blend of 3-mercaptopropyltrimethoxysilane and 1,2-bis-(triethoxysilyl)ethane ( dry storage ) , and 16.0±1.5 MPa , with 3-methacryloyloxypropyltrimethoxysilane ( thermo-cycled ) . Thermo-cycling decreased the bond strengths significantly ( ANOVA , p<0.01 ) , and the silanes differed significantly ( p<0.005 ) . Some specimens suffered from spontaneous debonding during thermo-cycling . Conclusions . The luting cement adhesion might be promoted to silica-coated zirconia with 1.0 vol% 3-methacryloyloxypropyltrimethoxysilane and with a blend of 1.0 vol% 3-mercaptopropyltrimethoxysilane and 1.0 vol% 1,2-bis-(triethoxysilyl)ethane PURPOSE To evaluate the effects of a commercial zirconia primer ( Choice or RelyX Unicem ) on shear bond strength ( SBS ) of two different resin composite cements - Choice ( a conventional bis-GMA-based resin cement ) and RelyX Unicem ( self-adhesive resin cement ) - to zirconia . MATERIAL S AND METHODS Zirconia blocks were manufactured and r and omly divided into 5 main groups ( n = 20 ) that received surface treatments and cements as follows : no surface treatment , Choice and RelyX Unicem ( groups C and U , resp . ) ; tribochemical silica coating followed by silanization , Choice ( group SSC ) ; application of a zirconia primer , Choice and RelyX Unicem ( groups ZC and ZU , resp . ) . Light-curing composite resin cylinders were prepared and bonded on the prepared zirconia blocks using the two different resin cements . Half of the specimens in each group were stored in water for 24 h , and half were aged by 50 days of water storage followed by thermocycling ( 12,000 cycles between 5 ° C and 55 ° C ) . Thereafter , all of them were su bmi tted to the SBS test . Fourier transmission infrared ( FT-IR ) spectrum analysis and gas mass spectrometry ( MS ) analysis were adopted for characterization of the zirconia primer . RESULTS Statistical analysis of the SBS test showed that group C presented the lowest SBS values and group SSC the highest ( p < 0.01 ) . Artificial aging exerted no influence on the SBS of groups U , SSC , ZC , or ZU . FT-IR analysis suggested that benzene rings and carboxylic groups exist in the zirconia primer . MS analysis detected that 2-hydroxyethyl methacrylate , triethylamine , ethyl-4-dimethylaminobenzoate , ethanol , and water are contained in the primer . CONCLUSION The zirconia primer and self-adhesive resin cement increased the SBS of zirconia Zirconia-based ceramics offer strong restorations in dentistry , but the adhesive bond strength of resin cements to such ceramics is not optimal . This study evaluated the influence of surface treatments on the bond strength of resin cement to yttrium-stabilized tetragonal zirconia ( Y-TZP ) ceramic . Seventy-five plates of Y-TZP ceramic were r and omly assigned to five groups ( n = 15 ) according to the surface treatments [ airborne particle abrasion , neodymium-doped yttrium aluminum garnet ( Nd : YAG ) laser irradiation ( Fidelis Plus 3 , Fotona ; 2 W , 200 mJ , 10 Hz , with two different pulse duration s 180 or 320 μs ) , glaze applied , and then 9.5 % hydrofluoric acid gel conditioned , control ] . One specimen from each group was r and omly selected , and specimens were evaluated with x-ray diffraction and SEM analysis . The resin cement ( Clearfil Esthetic Cement , Kuraray ) was adhered onto the zirconia surfaces with its corresponding adhesive components . Shear bond strength of each sample was measured using a universal testing machine at a crosshead speed of 1 mm/min . Bond strengths were analyzed through one-way ANOVA/Tukey tests . Surface treatments significantly modified the topography of the Y-TZP ceramic . The Nd : YAG laser-irradiated specimens result ed in both increased surface roughness and bond strength of the resin cement . The highest surface roughness and bond strength values were achieved with short pulse duration . Nd : YAG laser irradiation increased both surface roughness of Y-TZP surfaces and bond strength of resin cement to the zirconia surface PURPOSE Resin bonding of In-Ceram Zirconia ( ICZ ) ceramics is still a challenge , especially for minimally invasive applications . This study evaluated the adhesion of ICZ to enamel and dentin after different surface treatments of the ceramic . MATERIAL S AND METHODS ICZ ceramic specimens ( diameter : 6 mm ; thickness : 2 mm ) ( N = 100 ) were fabricated following the manufacturer 's instructions and r and omly assigned to 5 groups ( n = 20 ) , according to the surface treatment methods applied . The groups were as follows : group C : no treatment ; group SB : s and blasting ; group SCS-S : CoJet+silane ; group SCS-P : CoJet+Alloy Primer ; group GE-S : glaze+ hydrofluoric acid etching ( 9.6 % ) for 60 s+silane . Each group was r and omly divided into two subgroups to be bonded to either enamel or dentin ( n = 10 per group ) using MDP-based resin cement ( Panavia F2.0 ) . All the specimens were subjected to thermocycling ( 5000x , 5 ° C-55 ° C ) . The specimens were mounted in a universal testing machine and tensile force was applied to the ceramic/cement interface until failure occurred ( 1 mm/min ) . After evaluating all the debonded specimens under SEM , the failure types were defined as either " adhesive " with no cement left on the ceramic surface ( score 0 ) or " mixed " with less than 1/2 of the cement left adhered to the surface with no cohesive failure of the substrate ( score 1 ) . The data were statistically evaluated using 2-way ANOVA and Tukey 's tests ( α = 0.05 ) . RESULTS The highest tensile bond strength for the enamel surfaces was obtained in group GE-S ( 18.1 ± 2 MPa ) and the lowest in group SB ( 7.1 ± 1.4 MPa ) . Regarding dentin , group CSC-P showed the highest ( 12 ± 1.3 MPa ) and SB the lowest tensile bond strength ( 5.7 ± 0.4 MPa ) . Groups SB , CSC-S , CSC-P , and GE-S did not show significant differences between the different surface treatments on either enamel or dentin surfaces ( p < 0.05 , p < 0.001 , respectively ) . Groups CSC-P and GE-S presented similar bond strength for both the enamel and dentin substrates ( p < 0.8 and p < 0.9 ) , respectively . While on enamel substrates , exclusively adhesive failures from ICZ ( score 0 ) were found , on dentin exclusively mixed failures were observed ( score 1 ) . CONCLUSION Adhesion of ICZ to both enamel and dentin can be improved when ceramics are glazed , etched , and silanized , or s and blasted , primed , and cemented with an MDP-based cement The aim of this study was to evaluate the influence of silica coating and 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based primer applications upon the bonding durability of a MDP-based resin cement to a yttrium stabilized tetragonal zirconia ( Y-TZP ) ceramic . Ninety-six Y-TZP tabs were embedded in an acrylic resin ( free surface for adhesion : 5 × 5 mm(2 ) ) , ground finished and r and omly divided into four groups ( N = 24 ) according to the ceramic surface conditioning : ( 1 ) cleaning with isopropanol ( ALC ) ; ( 2 ) ALC + phosphoric acid etching + MDP-based primer application ( MDP-primer ) ; ( 3 ) silica coating + 3-methacryloyloxypropyl trimethoxysilane (MPS)-based coupling agent application ( SiO2 + MPS-Sil ) ; and ( 4 ) SiO2 + MDP-primer . The MDP-based resin cement was applied on the treated surface using a cylindrical mold ( diameter= 3 mm ) . Half of the specimens from each surface conditioning were stored in distilled water ( 37 ° C , 24 h ) before testing . Another half of the specimens were stored ( 90 days ) and thermo-cycled ( 12,000 x ) during this period ( 90 d/TC ) before testing . A shear bond strength ( SBS ) test was performed at a crosshead speed of 0.5 mm/min . Two factors composed the experimental design : ceramic conditioning strategy ( in four levels ) and storage condition ( in two levels ) , totaling eight groups . After 90 d/TC ( Tukey ; p < 0.05 ) , SiO2 + MDP-primer ( 24.40 MPa ) promoted the highest SBS . The ALC and MDP-primer groups debonded spontaneously during 90 d/TC . Bonding values were higher and more stable in the SiO2 groups . The use of MDP-primer after silica coating increased the bond strength OBJECTIVES To evaluate the effects of various chemical surface modifications on adhesion between zirconia and resin adhesive . MATERIAL AND METHODS Pre-sintered zirconia discs were sectioned from commercial cylindrical blocks and polished with abrasive papers under running tap water . All the discs were r and omly divided into five study groups according to the methods of surface treatment , including : the  control group ( fully sintered , without any modification ) , group S ( fully sintered and s and blasted with silica coated alumina particles ) , group HN ( fully sintered and etched with a blend of mineral acid solution at 100 ° C for 25 min ) , group HF ( fully sintered and etched with 48 % hydrofluoric acid solution at 100 ° C for 25 min )  , and group Si ( coated with silica particles and then fully sintered ) .  The mean value of surface roughness was evaluated before further treatment . Resin stubs ( 3.6 mm in diameter and 3 mm in height ) were adhered and light cured on each zirconia disc after the application of a silane coupling agent . In each group , all the sample s were further divided into three subgroups with each n=12 , one for the measurement of initial adhesion strength ( shear bond ) value and the other two were tested after thermal cycling for 10,000 and 20,000 cycles , respectively . The results were analyzed with two-way ANOVA and Turkey HSD ( p<0.05 ) . XRD technique was utilized in the examination of zirconia surface crystallinity . The morphological appearance of zirconia surface after surface treatment was observed with SEM . RESULTS The control group showed the lowest initial shear bond strength ( SBS ) value ( 16.8 ± 2.4 MPa ) and did not survive the aging treatments . All the investigated surface treatments improved resin zirconia bond strength significantly , the group S displaying the highest initial value of 25.1 ± 2.7 MPa . However , the highest resistance to the aging effects of thermal cycling was found in group Si . It was further shown in the XRD examination that only the grit-blasting caused the crystalline transformation from tetragonal phase to monoclinic phase ( T → M ) . On the other h and , such a phase transformation could not be detected in all the other four groups . SIGNIFICANCE Resin zirconia adhesion could be effectively improved by both HF etching and silica coating on zirconia surface , without leading to a T → M crystalline phase transformation PURPOSE To evaluate the shear bond strength ( SBS ) to zirconia ceramics using different associations of primers and resin cements . MATERIAL S AND METHODS Two blocks of LAVA zirconia ( 3Y-TZP ) were r and omly su bmi tted to an application of three different commercially available primers : Alloy Primer ( AP ) , Z-Prime Plus ( ZP ) , and Signum Zirconia Bond ( SZB ) . Nonprimed specimens were considered controls . After treatment , the 80 specimens ( 5 mm × 5 mm × 2 mm ) were r and omly cemented with one of the resin cements : Panavia F , Multilink , seT , and NX3 . For cementation , cylinders of resin cement were built on the ceramic surfaces using the SDI SBS apparatus . The specimens were su bmi tted to the SBS test . Fractured surfaces were observed under stereomicroscopy to determine the failure mode , and mean bond strength values were analyzed using the Kruskal-Wallis and Mann-Whitney tests ( α = 0.05 ) . RESULTS Signum Zirconia Bond had the highest SBS compared to all other primers and the control group , regardless of the resin cement used . The highest values were obtained when associating Panavia F with Signum Zirconia Bond . Alloy Primer increased bonding values when associated with seT cement only . When no primer was used , no statistical difference was observed among resin cements . All specimens fractured due to adhesive failure . CONCLUSION Signum Zirconia Bond is capable of increasing bonding values of resin cements to zirconia ceramics . Its association with Panavia F shows enhanced results when considering short-term adhesion to zirconia OBJECTIVES To evaluate the effect of mechanical and chemical surface pre-treatment on the bond durability of two composite cements to dental zirconia . METHODS Fully sintered IPS e.max ZirCAD ( Ivoclar-Vivadent ) blocks were either subjected to tribochemical silica s and blasting ( CoJet , 3 M ESPE ) or not mechanically pre-treated . Next , the zirconia sample s were either additionally pre-treated using one of two silane/MDP-combined ceramic primers ( Clearfil Ceramic Primer , Kuraray ; Monobond Plus , Ivoclar-Vivadent ) , or not further chemically pre-treated . Finally , two identically pre-treated zirconia blocks were bonded together using either a conventional BisGMA-based ( Clearfil Esthetic Cement , Kuraray ) or an MDP-based ( Panavia F2.0 , Kuraray ) ' self-etch ' dual-cure composite cement . The specimens were trimmed at the interface to a cylindrical hour-glass shape and stored for 7 days in distilled water ( 37 ° C ) , after which they were r and omly exposed to one of three ageing protocol s : ( 1 ) immersed in 37 ° C water for 10 days ( 10d ) ; ( 2 ) subjected to 10,000 thermo-cycles ( TC ) ; or ( 3 ) immersed in 37 ° C water for 6 months ( 6 m ) . After storage , the micro-tensile bond strength ( μTBS ) was determined in MPa ( n=15 - 21/group ) . Fractographic analysis was performed using SEM . RESULTS Weibull analysis revealed the highest Weibull scale and shape parameters for the ' CoJet/Clearfil Ceramic Primer/Panavia F2.0/10d ' combination . While the BisGMA-based composite cement Clearfil Esthetic Cement ( Kuraray ) bonded equally well to zirconia using either tribochemical silica s and blasting ( CoJet , 3 M ESPE ) or not , s and blasting appeared indispensable for the MDP-based and more hydrophilic composite cement Panavia F2.0 ( Kuraray ) . CONCLUSIONS Combined mechanical and chemical pre-treatment can best be recommended to durably bond to zirconia . CLINICAL SIGNIFICANCE As a st and ard procedure to durable bond zirconia to tooth tissue , both mechanical ( tribochemical silica coating ) and chemical ( silane/MDP-combined ceramic primers ) is clinical ly highly recommended OBJECTIVE Various chemical interactions can be used to develop ceramic-resin bonding and specific approaches are available for zirconia ceramics . This study evaluated the effect of a new experimental primer , a mixture of organophosphate and carboxylic acid monomers , on the  zirconia-to-resin shear bond strength ( SBS ) . METHODS Forty Y-TZP blocks ( 15x4x2 mm ) were embedded in an acrylic resin base , polished , Al(2)O(3)-s and blasted and r and omly divided into eight groups .  Three different resin-based luting agents ( BisCem , Duo-Link , Panavia F ) were used to build 2.4mm-diameter cylinders ( n=15 ) onto the zirconia surface with and without the new experimental zirconia primer . The new primer was also tested with Z100 restorative composite resin cylinders . In addition , Panavia was used with its own primer ( Clearfil Ceramic Primer ) . SBS testing was carried out after 24h of storage in water . Scanning electron microscopy ( SEM ) was used to evaluate the zirconia surface topography and failure mode . RESULTS According to ANOVA and Tukey test ( alpha=0.05 ) , the association of the experimental primer with the restorative composite resin Z100 yielded the highest SBS ( 29.35MPa ) followed by DuoLink with the new primer ( 26.68MPa ) . The groups that did not receive the experimental primer presented the lowest SBS values ( from 5.95 to 9.79MPa ) . The failure mode was adhesive for the non-primed specimens and predominantly mixed in the primed groups . SIGNIFICANCE The use of the new zirconia experimental primer based on organophosphate/carboxylic acid monomers increased the bond strength of different resin-based luting agents including Z100 restorative material
Conclusions .
Airborne-particle abrasion and tribo-chemical silica coating are the pre-treatment methods with more evidence in the literature .
Increased adhesion could be expected after physico-chemical conditioning of zirconia .
Surface contamination has a negative effect on adhesion .
There is no evidence to support a universal adhesion protocol
Background .
Reliable bonding between resin composite cements and high strength ceramics is difficult to achieve because of their chemical inertness and lack of silica content that makes etching impossible .
The purpose of this review is to classify and analyze the existing methods and material s suggested to improve the adhesion of zirconia to dental substrate by using composite resins , in order to explore current trends in surface conditioning methods with predictable results .
Methods .