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 .
Durable bonding to mechanically and/or chemically pre-treated dental 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
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 .