Shear bond strength of composite cement to alumina-coated versus tribochemical silica-treated zirconia

Effect of different surface treatments on the bonding potential and physical and mechanical properties of ultratranslucent zirconia

STATEMENT OF PROBLEM

Studies to determine a suitable surface treatment that improves bonding without compromising the strength or translucency of ultratranslucent zirconia are scarce.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of different surface treatments on translucency, surface topography, phase transformation, biaxial flexural strength, bond strength, and durability.

MATERIAL AND METHODS

A total of 169 ultratranslucent zirconia disks were randomly divided into 4 groups according to the surface treatment applied: airborne-particle abrasion (APA) (n=46), tribochemical silica airborne-particle abrasion (TS) (n=46), nonthermal oxygen plasma (NTP) (n=46), and no treatment, control (C) (n=31). The translucency parameter (ΔTP00) was evaluated with a spectrophotometer (n=15), phase transformation was assessed with an X-ray diffractometer (n=5), surface topography was evaluated with a scanning electron microscope (SEM) (n=3), and biaxial flexural strength (BFS) was tested with a universal testing machine (n=15). For the microshear bond strength (μSBS) test, 40 composite resin specimens were attached to 8 disks and tested with a universal testing machine; 20 specimens were tested after 24 hours, and 20 specimens after hydrothermal aging in a thermocycler (TC). The data were analyzed with ANOVA followed by the Tukey post hoc test (α=.05). Weibull analysis was performed for the flexural strength and μSBS results.

RESULTS

Significant ΔTP00 differences were found among all groups and were highest for the APA group (7.33) and lowest for the NTP group (4.79). The NTP group had a significantly higher monoclinic weight fraction value (4.54%) than other groups. The NTP group had significantly higher BFS (581.31) than other groups, while the APA group showed significantly lower values than other groups (340.43). The APA group had significantly higher μSBS values after 24 hours (13.51 MPa) and after TC (13.68 MPa) than the other groups (P<.05).

CONCLUSIONS

Although APA and TS are effective techniques for improving resin-zirconia bonding, they result in significantly higher deterioration of translucency and strength. NTP significantly improved the BFS of zirconia; however, it showed lower bond strength values than other methods.

The influence of Zircos-E® etchant, silica coating, and alumina air-particle abrasion on the debonding resistance of endocrowns with three different preparation designs

OBJECTIVES

The study aimed to evaluate the debonding resistance of three different endocrown designs on molar teeth, using three different zirconia surface pretreatments.

MATERIAL AND METHOD

Ninety human mandibular first molars were divided into three main groups: endocrowns without ferrule, with 1 mm ferrule, and with 2 mm ferrule. The subgroups were defined by their surface pretreatment method used (n = 15): 50 μm alumina air-particle abrasion, silica coating using 30 μm Cojet™ particles, and Zircos-E® etching. The endocrowns were fabricated using multilayer zirconia ceramic, cemented with self-adhesive resin cement, and subjected to 5000 thermocycles (5-55°C) before debonding. The data obtained were analyzed using a two-way ANOVA.

RESULTS

All test specimens survived the thermocyclic aging. The results indicated that both the preparation design and the surface treatment had a significant impact on the resistance to debonding of the endocrowns (p < .001). The 2 mm ferrule followed by the 1 mm ferrule designs exhibited the highest debonding resistance, both were superior to the endocrown without ferrule. Zircos-E® etching and silica coating yielded comparable debonding resistance, which were significantly higher than alumina air-particle abrasion. All endocrowns demonstrated a favorable failure mode.

CONCLUSIONS

All designs and surface treatments showed high debonding resistance for a single restoration. However, ferrule designs with Zircos-E® etching or silica coating may represent better clinical options compared to the nonferrule design or alumina airborne-particle abrasion. Nonetheless, further research, including fatigue testing and evaluations with different luting agents is recommended.

Effect of artificial aging on optical properties and crystalline structure of high-translucency zirconia

PURPOSE

To investigate the effect of different in vitro aging protocols on the optical properties and crystalline structure of high-translucency (HT) zirconia.

MATERIALS AND METHODS

Thirty-six specimens of HT and extra-high translucency (XT) zirconia were divided into three groups: control (CO)-no treatment; hydrothermal aging (HA)-autoclave aging for 12.5 h at 134°C, 2 bar; clinically related aging (CRA)-aging in the chewing simulator for 1.2 million cycles, followed by 50,000 thermocycles (5-55°C) and immersion in HCl (pH 1.2) for 15 h. Optical properties, crystalline structure, and surface roughness were analyzed and compared using analysis of variance (5% significance level).

RESULTS

There was no statistically significant effect of aging on translucency (p = 0.10), but CRA promoted the development of a high contrast ratio (p = 0.03). Aging did not cause significant color changes for HT (p = 0.65) or XT (p = 0.36). The proportion of monoclinic crystals increased to 40% for HT-zirconia after HA and 5% after CRA. No monoclinic crystals were detected for XT groups. There was no effect of aging on surface roughness (p = 0.77).

CONCLUSIONS

Although hydrothermal aging has been widely used to verify zirconia crystalline stability, it did not generate an effect similar to clinically related aging on the optical properties and crystalline structure of zirconia. HA affected the crystalline structure of HT-zirconia, and CRA compromised the optical properties of XT zirconia.

Zirconia bond strength durability following artificial aging: A systematic review and meta-analysis of in vitro studies

The present study systematically reviewed the literature regarding the bond strength durability of zirconia ceramics to resin-based luting cements after application of different bonding protocols and aging conditions. Electronic searches in PubMed, Scopus, and Web of Science databases were performed for relevant literature published between January 1st 2015 and November 15th 2022. Ninety-three (93) English language in-vitro studies were included. The percentage of the mean bond strength change was recorded prior to and after artificial aging, and the weighted mean values and 95% confidence intervals were calculated. Bonding protocols were classified based on the combination of MDP/non-MDP containing cement/primer and surface pretreatment, as well as the level of artificial aging performed. Alumina sandblasting (SA) was identified as the most frequently used surface pre-treatment while an insufficient number of studies was identified for each category of alternative surface treatments. The combination of MDP cement with tribochemical silica coating (TSC) or SA yielded more durable results after aging, while the application of SA and TSC improved bond durability when a non-MDP cement and a non-MDP primer were used. TSC may lead to increased bond durability compared to SA, whereas MDP cements may act similarly when combined with SA or TSC.

Effect of glass-ceramic coating versus alumina air-abrasion on the bond strength and residual stress of zirconia

OBJECTIVES

To assess the effect of glass-ceramic coated zirconia versus alumina air-abraded zirconia on the shear bond strength (SBS) of resin cement and investigate the residual stresses present on both mechanically pre-treated surfaces.

MATERIALS AND METHODS

A total of 180 zirconia disks, with diameters of 10 mm and 5 mm, were divided into two groups: DCMhotbond glass-ceramic coated, followed by hydrofluoric acid etching (DCM), and alumina air-abraded (AB). All mechanically pre-treated disks were conditioned with G-Multi Primer and bonded using G-Cem Linkforce Cement. Ninety specimens were immersed in distilled water for 24 h and subsequently allocated into three groups based on aging conditions (n = 15/subgroups): immediate testing, 5000 thermal cycles, and 10,000 thermal cycles. Then, the shear bond strength was assessed, and the obtained data were subjected to analysis using a two-way ANOVA, followed by a one-way ANOVA and Tukey's HSD post hoc test (α = 0.05). The residual stresses present on both mechanically pre-treated surfaces were examined using X-ray diffraction analysis.

RESULTS

The mean SBS values of the DCM and AB groups showed no significant difference under each aging condition. The SBS of DCM groups was not affected by thermal cycles, whereas the SBS of AB groups exhibited a significant decrease following thermal cycles. Glass-ceramic coated surfaces exhibited higher compressive stresses than alumina air-abrasion.

CONCLUSIONS

The DCMhotbond glass-ceramic coated zirconia showed comparable bond strength to the alumina air-abrasion technique.

CLINICAL RELEVANCE

The DCMhotbond glass-ceramic coating technique is a promising alternative for zirconia surface pre-treatment. However, further investigations are needed before suggesting its clinical use.

Ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced adhesion to resin-matrix cements used in dentistry: An integrative review

Surface modification of yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) using lasers for adhesion enhancement with resin-matrix cement has been increasingly explored. However, Y-TZP is chemically inert and non-reactive, demanding surface modification using alternative approaches to enhance its bond strength to resin-matrix cements. The main aim of this study was to conduct an integrative review on the influence of ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced bonding to resin-matrix cements. An electronic search was performed on web of science, SCOPUS, Pubmed/Medline, Google Scholar and EMBASE using a combination of the following search items: zirconia, 3Y-TZP, surface modification, laser surface treatment, AND laser, ultrashortpulse laser, bonding, adhesion, and resin cement. Articles published in the English language, up to January 2022, were included regarding the influence of surface patterning on bond strength of Y-TZP to resin-matrix cements. Out of the 12 studies selected for the present review 10 studies assessed femtosecond lasers while 2 studies assessed picosecond lasers. Ultrashort pulsed laser surface patterning successfully produced different surface morphological aspects without damaging the bulk properties of zirconia. Contrarily, defects such as micro-cracks occurs after surface modification using traditional methods such as grit-blasting or long-pulsed laser patterning. Ultrashort pulsed laser surface patterning increase bond strength of zirconia to resin-matrix cements and therefore such alternative physical method should be considered in dentistry. Also, surface defects were avoided using ultrashort pulsed laser surface patterning, which become the major advantage when compared with traditional physical methods or long pulse laser patterning.

The Effect of Surface Treatments on Zirconia Bond Strength and Durability

To evaluate the effects of airborne particle abrasion (APA) combined with MDP-containing resin cement, a glass-ceramic spray deposition (GCSD) method on the shear bond strengths (SBSs) and durability of 3 mol% yttrium oxide-stabilized zirconia ceramic (3Y-TZP) compared with lithium disilicate glass ceramics (LDGC). 3Y-TZP disks were randomly treated as follows: for Group APA+MDP, 3Y-TZP was abrased using 50 μm Al₂O₃ particles under 0.1 Mpa and bonded with MDP-containing resin cement; for Group GCSD, 3Y-TZP was treated with the GCSD method, etched by 5% HF for 90 s, silanized and bonded with resin cement without MDP. Group LDGC was bonded as the Group GCSD. X-ray diffraction (XRD), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and energy dispersive X-ray detector (EDX) were used to analyze the surface chemical and micro-morphological changes of the ceramics before bonding. The bonded ceramic specimens were randomly divided into subgroups, and the SBSs were determined before and after 10,000 thermocycling. The SBSs were analyzed with a one-way ANOVA analysis. Failure modes were determined with optical microscopy and SEM. The XRD, ATR-FTIR and XPS results identified the formation of lithium disilicate and zirconium silicate on 3Y-TZP after GCSD. The SEM micrographs revealed that 3Y-TZP surfaces were roughened by APA, while 3Y-TZP with GCSD and LDGC surfaces could be etched by HF to be porous. The APA treatment combined with MDP-containing resin cement produced the high immediate zirconia shear bond strengths (SBSs: 37.41 ± 13.51 Mpa) that was similar to the SBSs of the LDGC (34.87 ± 11.02 Mpa, p > 0.05), but, after thermocycling, the former dramatically decreased (24.00 ± 6.86 Mpa, maximum reduction by 35.85%) and the latter exhibited the highest SBSs (30.72 ± 7.97 Mpa, minimum reduction by 11.9%). The 3Y-TZP with GCSD treatment displayed the lower zirconia SBSs before thermocycling (27.03 ± 9.76 Mpa, p < 0.05), but it was similar to the 3Y-TZP treated with APA and MDP containing resin cement after thermocycling (21.84 ± 7.03 vs. 24.00 ± 6.86 Mpa, p > 0.05). The APA combined with MDP-containing resin cement could achieve the high immediate zirconia SBSs of those of the LDGC, but it decreased significantly after thermocycling. The GCSD technique could yield the immediate zirconia SBSs similar to those of LDGC before thermocycling, and long-term zirconia SBSs were similar to those of 3Y-TZP treated with APA followed by MDP-containing resin cement after thermocycling. Hence, the GCSD technique could enrich zirconia surface treatments and is an alternative to zirconia surface pretreatment for 3Y-TZP bond durability.

Influence of ceramic-coating techniques on composite-zirconia bonding: Strain energy release rate evaluation

OBJECTIVES

To compare ceramic-coating techniques versus conventional techniques on bonding between composite cements and zirconia by means of strain energy release rate (G_c, J/m²).

METHODS

Two sizes of zirconia bars (30 mm × 8 mm × 1.5 mm and 14.8 mm × 8 mm × 1.5 mm) were fabricated. Two smaller bars were treated and cemented to the surface of a large bar using one of the following methods: (i) AlN-nano-structured alumina coating with RelyX Unicem 2; (ii) HOT-DCM hotbond coating with G-Multi Primer and G-Cem Linkforce; (iii) LiDi-lithium disilicate glass-ceramic coating with Monobond N Primer and Multilink Speed; (iv) COJ-tribochemical silica treatment with RelyX Ceramic Primer and RelyX Unicem 2; (v) GCEM-alumina grit blasting with G-Multi Primer and G-Cem LinkForce; (vi) MUL-alumina grit blasting with Multilink Speed; and (vii) PAN-alumina grit blasting with Clearfil Ceramic Primer and Panavia F2.0. A total of 30 bilayered specimens in each group were stored in distilled water at 37 °C for 24 h and assigned to three subgroups (n = 10/test group): short-term test, thermocycling for 5000 cycles, and thermocycling for 10,000 cycles and tested in 4-point bending configuration. Results were analysed using two-way ANOVA, followed by one-way ANOVA and Games-Howell (α = 0.05). Failure mode and surfaces were analysed using optical microscopy and SEM.

RESULTS

The bonding (J/m²) of COJ and MUL groups was significantly higher than the other groups among all aging conditions. Thermocycling affected the bonding in COJ and GCEM groups.

SIGNIFICANCE

Surface pre-treatments and artificial aging affect the bonding between composite cements and zirconia.

Bond durability and surface states of titanium, Ti-6Al-4V alloy, and zirconia for implant materials

PURPOSE

Screw-retained implant crowns used as dental implants comprise a zirconia coping and titanium base bonded using resin cement. These devices are prone to debonding failures. This study investigated the bond characteristics of implant materials based on shear bond strength (SBS) and surface characteristics.

METHODS

Chemically pure (CP) titanium grade-4 (Ti), Ti-6Al-4V alloy (Ti-6Al-4V), and tetragonal polycrystalline zirconia (zirconia) were evaluated as adherent materials. Plates of each material were polished, primed for the respective resin cements, and cemented using either methyl methacrylate-based resin cement (Super-Bond) or composite-based resin cement (Panavia). The cemented samples were subjected to 10,000 thermocycles alternating between 5 and 55 °C, and the SBS were obtained before and after thermocycling. The sample surfaces were characterized based on surface observations, roughness, and free energy (SFE).

RESULTS

The SBSs of all materials bonded using Panavia were significantly compromised during thermocycling and reached zero. Although the SBSs of Ti and Ti-6Al-4V bonded using Super-Bond were not significantly affected by thermocycling, those of zirconia decreased significantly. The bond durability between zirconia and Super-Bond was improved via alumina air-abrasion, which caused no significant loss of SBS after thermocycling. Surface analyses of the air-abraded zirconia validated these results and confirmed that its surface roughness and SFE were significantly increased.

CONCLUSIONS

The bond durability between resin cement and zirconia was lower than that between Ti and Ti-6Al-4V. The alumina air-abrasion pretreatment of zirconia improved the SFE and surface roughness, thereby enhancing bond durability.