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 .
Effect of Adhesive Cementation Strategies on the Bonding of Y-TZP to Human Dentin.
This study evaluated the effects of different adhesive strategies on the adhesion of zirconia to dentin using conventional and self-adhesive cements and their corresponding adhesive resins . The occlusal parts of human molars ( N=80 ) were sectioned , exposing the dentin . The teeth and zirconia cylinders ( N=80 ) ( diameter=3.4 mm ; height=4 mm ) were r and omly divided into eight groups according to the factors " surface conditioning " and " cement type " ( n=10 per group ) . One conventional cement ( CC : RelyX ARC , 3 M ESPE ) and one self-adhesive cement ( SA : RelyX U200 , 3 M ESPE ) and their corresponding adhesive resin ( for CC , Adper Single Bond Plus ; for SA , Scotchbond Universal Adhesive-SU ) were applied on dentin . Zirconia specimens were conditioned either using chairside ( CJ : CoJet , 30 μm , 2.5 bar , four seconds ) , laboratory silica coating ( RC : Rocatec , 110 μm , 2.5 bar , four seconds ) , or universal primer ( Single Bond Universal-UP ) . Nonconditioned groups for both cements acted as the control ( C ) . Specimens were stored in water ( 37 ° C , 30 days ) and subjected to shear bond strength ( SBS ) testing ( 1 mm/min ) . Data ( MPa ) were analyzed using two-way analysis of variance and a Tukey test ( α=0.05 ) . While surface conditioning significantly affected the SBS values ( p=0.0001 ) ( C < RC = CJ = UP ) , cement type did not ( p=0.148 ) ( CC = SA ) . The interaction terms were significant ( p=0.014 ) . Failure types were predominantly adhesive . Air-abrasion and the use of the universal primer improved the bond strength of zirconia to dentin compared to the control group , regardless of the type of resin cement used
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 .