Airborne-particle abrasion and tribochemical silica coating are reference pretreatment methods .
STATEMENT OF PROBLEM With a number of  zirconia ceramic material s currently available for clinical use , an overview of the scientific literature on the adhesion methods and their potential influence is indicated .
PURPOSE The purpose of this systematic review was to classify and analyze the existing methods and material s proposed to improve adhesion to zirconia surfaces .
Adhesive monomers are necessary for chemical bonding .
Surface contamination and aging have negative effects on adhesion to zirconia .
Investigational study of the use of Er:YAG laser versus dental drill for caries removal and cavity preparation--phase I.
OBJECTIVE We determined that the Er : YAG pulsed 2.94 micron radiation was successful in the removal of caries , cavity preparation , and etching prior to acid etching . SUMMARY BACKGROUND DATA The laser group was compared to a control group in which the high-speed drill was employed . Parameters measured included histological evaluation of the pulp , scanning electron microscopy of the surface morphology of the tooth , dye penetration studies , bond strength measurements , and rating of the laser 's ability to remove caries and form the preparation . METHODS We collectively evaluated 60 patients with 106 teeth in both the laser and control groups over a 1-year period . Teeth were treated in vivo and then extracted immediately , at 2 days , 1 month , and up to 1-year to assess pulpal healing , surface morphology , and the quality of the preparation , restoration , and pain . RESULTS The dental laser was shown to be equal or better than the drill in the tested procedures of caries removal , cavity preparation , and etching prior to acid etching . The scanning electron microscopy revealed no microfracturing , open dentinal tubules , and effective etching with the laser having a mean of 2.7 with an optimum rating of 3 . The histological testing confirmed that the pulp was not compromised using the laser with scores of theta for hemorrhage , 0.47 for hyperemia , and 0.12 for inflammation on a scale of 0 to 3 where 0 is no effect . CONCLUSIONS The FDA has recently cleared the Er : YAG to remove all classes of caries , form the cavity preparation , and modify the enamel and dentin prior to acid etching . In this Phase I study conducted as part of the clinical trials , there were no complications and no tooth was compromised . Patients were consistently treated without anesthesia with the same or better results than the drill as confirmed by scanning electron microscopy and histological studies
Airborne-particle abrasion and tribochemical silica coating are reference pretreatment methods .
STATEMENT OF PROBLEM With a number of  zirconia ceramic material s currently available for clinical use , an overview of the scientific literature on the adhesion methods and their potential influence is indicated .
PURPOSE The purpose of this systematic review was to classify and analyze the existing methods and material s proposed to improve adhesion to zirconia surfaces .
Adhesive monomers are necessary for chemical bonding .
Surface contamination and aging have negative effects on adhesion to zirconia .