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 .
Different Strategies to Bond Bis-GMA-based Resin Cement to Zirconia.
PURPOSE To evaluate the effect of different bonding strategies on short- and long-term bis-GMA-based resin cement bond strengths to zirconia . MATERIAL S AND METHODS One hundred twenty sample s of fully-sintered zirconia ( Prettau Zirconia ) were s and blasted and r and omly distributed into 5 groups ( n = 24 ) : UA : Scotchbond Universal Adhesive ; SZP : Signum Zirconia Bond I + II ; ZPP : Z-Prime Plus ; EXP : MZ experimental primer ; CO : no primer application ( control ) . After performing these surface treatments , translucent tubes ( 0.8 mm diameter and 1.0 mm height ) were placed on the zirconia specimens , and bis-GMA-based cement ( Duo-Link ) was injected into them and light cured . Specimens were tested for microshear bond strength either 24 h or 6 months ( m ) after water storage ( 37 ° C ) and surfaces were characterized by SEM and EDX . Two-way ANOVA and Tukey 's post-hoc test ( p < 0.05 ) were used to evaluate bond strength results . RESULTS The mean bond strengths ( MPa ± SD ) were : UA=14.6 ± 4.7a ( 24 h ) ; 16.0 ± 4.8a ( 6 m ) ; SZP = 14.0 ± 5.4ab ( 24 h ) ; 11.9 ± 2.6ab ( 6 m ) ; ZPP=8.0 ± 1.8b ( 24 h ) ; 8.6 ± 3.3b ( 6 m ) ; EXP = 1.2 ± 0.5c ( 24 h ) ; 0.6 ± 0.7c ( 6 m ) ; CO=1.0 ± 1.2c ( 24 h ) ; 1.3 ± 1.2c ( 6 m ) . Bonding strategy significantly influenced bond strength ( p = 0.0001 ) , but storage time did not ( p = 0.841 ) . Groups UA and SZP showed a homogeneous layer covering the zirconia surface . In these groups , EDX demonstrated the presence of phosphorus . Group ZPP result ed in a nonhomogeneous layer , exposing the zirconia substrate underneath . EXP application result ed in an undetectable layer . CONCLUSION Water storage did not affect resin cement bond strengths to zirconia irrespective of the surface treatment . Bis-GMA-based resin cement bond strengths to zirconia are affected by specific bonding strategies
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 .