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 different surface treatments on adhesion of In-Ceram Zirconia to enamel and dentin substrates.
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
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 .