A facile one-step strategy for development of a double network fibrous scaffold for nerve tissue engineering

Biomedical applications of stimuli-responsive "smart" interpenetrating polymer network hydrogels

In recent years, owing to the ongoing advancements in polymer materials, hydrogels have found increasing applications in the biomedical domain, notably in the realm of stimuli-responsive "smart" hydrogels. Nonetheless, conventional single-network stimuli-responsive "smart" hydrogels frequently exhibit deficiencies, including low mechanical strength, limited biocompatibility, and extended response times. In response, researchers have addressed these challenges by introducing a second network to create stimuli-responsive "smart" Interpenetrating Polymer Network (IPN) hydrogels. The mechanical strength of the material can be significantly improved due to the topological entanglement and physical interactions within the interpenetrating structure. Simultaneously, combining different network structures enhances the biocompatibility and stimulus responsiveness of the gel, endowing it with unique properties such as cell adhesion, conductivity, hemostasis/antioxidation, and color-changing capabilities. This article primarily aims to elucidate the stimulus-inducing factors in stimuli-responsive "smart" IPN hydrogels, the impact of the gels on cell behaviors and their biomedical application range. Additionally, we also offer an in-depth exposition of their categorization, mechanisms, performance characteristics, and related aspects. This review furnishes a comprehensive assessment and outlook for the advancement of stimuli-responsive "smart" IPN hydrogels within the biomedical arena. We believe that, as the biomedical field increasingly demands novel materials featuring improved mechanical properties, robust biocompatibility, and heightened stimulus responsiveness, stimuli-responsive "smart" IPN hydrogels will hold substantial promise for wide-ranging applications in this domain.

Fast Recovery Double-Network Hydrogels Based on Particulate Macro-RAFT Agents

Synthetic hydrogels struggle to match the high strength, toughness, and recoverability of biological tissues under periodic mechanical loading. Although the hydrophobic polymer chain of polystyrene (PS) may initially collapse into a nanosphere upon contact with water, it has the ability to be elongated when it is subjected to an external force. To address this challenge, we employ the reversible addition-fragmentation chain transfer (RAFT) method to design a carboxyl-substituted polystyrene (CPS) which can form a covalently cross-linked network with four-armed amino-terminated polyethylene glycol (4-armed-PEG-NH2), and a ductile polyacrylamide network is introduced in order to prepare a double-network (DN) hydrogel. Our results demonstrate that the DN hydrogel exhibits exceptional mechanical properties (0.62 kJ m-2 fracture energy, 2510.89 kJ m-3 toughness, 0.43 MPa strength, and 820% elongation) when a sufficient external force is applied to fracture it. Moreover, when the DN hydrogel is subjected to a 200% strain, it displays superior recoverability (94.5%). This holds a significant potential in enhancing the mechanical performance of synthetic hydrogels and can have wide-ranging applications in fields such as tissue engineering for hydrophobic polymers.

Eggshell Membrane as a Biomaterial for Bone Regeneration

The physicochemical features of the avian eggshell membrane play an essential role in the process of calcium carbonate deposition during shell mineralization, giving rise to a porous mineralized tissue with remarkable mechanical properties and biological functions. The membrane could be useful by itself or as a bi-dimensional scaffold to build future bone-regenerative materials. This review focuses on the biological, physical, and mechanical properties of the eggshell membrane that could be useful for that purpose. Due to its low cost and wide availability as a waste byproduct of the egg processing industry, repurposing the eggshell membrane for bone bio-material manufacturing fulfills the principles of a circular economy. In addition, eggshell membrane particles have has the potential to be used as bio-ink for 3D printing of tailored implantable scaffolds. Herein, a literature review was conducted to ascertain the degree to which the properties of the eggshell membrane satisfy the requirements for the development of bone scaffolds. In principle, it is biocompatible and non-cytotoxic, and induces proliferation and differentiation of different cell types. Moreover, when implanted in animal models, it elicits a mild inflammatory response and displays characteristics of stability and biodegradability. Furthermore, the eggshell membrane possesses a mechanical viscoelastic behavior comparable to other collagen-based systems. Overall, the biological, physical, and mechanical features of the eggshell membrane, which can be further tuned and improved, make this natural polymer suitable as a basic component for developing new bone graft materials.

Peptide-functionalized double network hydrogel with compressible shape memory effect for intervertebral disc regeneration

As a prominent approach to treat intervertebral disc (IVD) degeneration, disc transplantation still falls short to fully reconstruct and restore the function of native IVD. Here, we introduce an IVD scaffold consists of a cellulose-alginate double network hydrogel-based annulus fibrosus (AF) and a cellulose hydrogel-based nucleus pulposus (NP). This scaffold mimics native IVD structure and controls the delivery of Growth Differentiation Factor-5 (GDF-5), which induces differentiation of endogenous mesenchymal stem cells (MSCs). In addition, this IVD scaffold has modifications on MSC homing peptide and RGD peptide which facilitate the recruitment of MSCs to injured area and enhances their cell adhesion property. The benefits of this double network hydrogel are high compressibility, shape memory effect, and mechanical strength comparable to native IVD. In vivo animal study demonstrates successful reconstruction of injured IVD including both AF and NP. These findings suggest that this double network hydrogel can serve as a promising approach to IVD regeneration with other potential biomedical applications.

Controlled Release of Epigenetically-Enhanced Extracellular Vesicles from a GelMA/Nanoclay Composite Hydrogel to Promote Bone Repair

Extracellular vesicles (EVs) have garnered growing attention as promising acellular tools for bone repair. Although EVs' potential for bone regeneration has been shown, issues associated with their therapeutic potency and short half-life in vivo hinders their clinical utility. Epigenetic reprogramming with the histone deacetylase inhibitor Trichostatin A (TSA) has been reported to promote the osteoinductive potency of osteoblast-derived EVs. Gelatin methacryloyl (GelMA) hydrogels functionalised with the synthetic nanoclay laponite (LAP) have been shown to effectively bind, stabilise, and improve the retention of bioactive factors. This study investigated the potential of utilising a GelMA-LAP hydrogel to improve local retention and control delivery of epigenetically enhanced osteoblast-derived EVs as a novel bone repair strategy. LAP was found to elicit a dose-dependent increase in GelMA compressive modulus and shear-thinning properties. Incorporation of the nanoclay was also found to enhance shape fidelity when 3D printed compared to LAP-free gels. Interestingly, GelMA hydrogels containing LAP displayed increased mineralisation capacity (1.41-fold) (p ≤ 0.01) over 14 days. EV release kinetics from these nanocomposite systems were also strongly influenced by LAP concentration with significantly more vesicles being released from GelMA constructs as detected by a CD63 ELISA (p ≤ 0.001). EVs derived from TSA-treated osteoblasts (TSA-EVs) enhanced proliferation (1.09-fold), migration (1.83-fold), histone acetylation (1.32-fold) and mineralisation (1.87-fold) of human bone marrow stromal cells (hBMSCs) when released from the GelMA-LAP hydrogel compared to the untreated EV gels (p ≤ 0.01). Importantly, the TSA-EV functionalised GelMA-LAP hydrogel significantly promoted encapsulated hBMSCs extracellular matrix collagen production (≥1.3-fold) and mineralisation (≥1.78-fold) in a dose-dependent manner compared to untreated EV constructs (p ≤ 0.001). Taken together, these findings demonstrate the potential of combining epigenetically enhanced osteoblast-derived EVs with a nanocomposite photocurable hydrogel to promote the therapeutic efficacy of acellular vesicle approaches for bone regeneration.

Avian Egg: A Multifaceted Biomaterial for Tissue Engineering

Most components in avian eggs, offering a natural and environmentally friendly source of raw materials, hold great potential in tissue engineering. An avian egg consists of several beneficial elements: the protective eggshell, the eggshell membrane, the egg white (albumen), and the egg yolk (vitellus). The eggshell is mostly composed of calcium carbonate and has intrinsic biological properties that stimulate bone repair. It is a suitable precursor for the synthesis of hydroxyapatite and calcium phosphate, which are particularly relevant for bone tissue engineering. The eggshell membrane is a thin protein-based layer with a fibrous structure and is constituted of several valuable biopolymers, such as collagen and hyaluronic acid, that are also found in the human extracellular matrix. As a result, the eggshell membrane has found several applications in skin tissue repair and regeneration. The egg white is a protein-rich material that is under investigation for the design of functional protein-based hydrogel scaffolds. The egg yolk, mostly composed of lipids but also diverse essential nutrients (e.g., proteins, minerals, vitamins), has potential applications in wound healing and bone tissue engineering. This review summarizes the advantages and status of each egg component in tissue engineering and regenerative medicine, but also covers their current limitations and future perspectives.

Avian Eggshell Membrane as a Novel Biomaterial: A Review

The eggshell membrane (ESM), mainly composed of collagen-like proteins, is readily available as a waste product of the egg industry. As a novel biomaterial, ESM is attractive for its applications in the nutraceutical, cosmetic, and pharmaceutical fields. This review provides the main information about the structure and chemical composition of the ESM as well as some approaches for its isolation and solubilization. In addition, the review focuses on the role and performance of bioactive ESM-derived products in various applications, while a detailed literature survey is provided. The evaluation of the safety of ESM is also summarized. Finally, new perspectives regarding the potential of ESM as a novel biomaterial in various engineering fields are discussed. This review provides promising future directions for comprehensive application of ESM.

Recent Advances in Injectable Dual Crosslinking Hydrogels for Biomedical Applications

Injectable dual crosslinking hydrogels hold great promise to improve therapeutic efficacy in minimally invasive surgery. Compared with prefabricated hydrogels, injectable hydrogels can be implanted more accurately into deeply enclosed sites and repair irregularly shaped lesions, showing great applicable potential. Here, the current fabrication considerations of injectable dual crosslinking hydrogels are reviewed. Besides, the progress of the hydrogels used in corresponding applications and emerging challenges are discussed, with detailed emphasis in the fields of bone and cartilage regeneration, wound dressings, sensors and other less mentioned applications for their more hopeful employments in clinic. It is envisioned that the further development of the injectable dual crosslinking hydrogels will catalyze their innovation and transformation in the biomedical field.

Recent Advances on Bioprinted Gelatin Methacrylate-Based Hydrogels for Tissue Repair

Bioprinting of body tissues has gained great attention in recent years due to its unique advantages, including the creation of complex geometries and printing the patient-specific tissues with various drug and cell types. The most momentous part of the bioprinting process is bioink, defined as a mixture of living cells and biomaterials (especially hydrogels). Among different biomaterials, natural polymers are the best choices for hydrogel-based bioinks due to their intrinsic biocompatibility and minimal inflammatory response in body condition. Gelatin methacryloyl (GelMA) hydrogel is one of the high-potential hydrogel-based bioinks due to its easy synthesis with low cost, great biocompatibility, transparent structure that is useful for cell monitoring, photocrosslinkability, and cell viability. Furthermore, the potential of adjusting properties of GelMA due to the synthesis protocol makes it a suitable choice for soft or hard tissues. In this review, different methods for the bioprinting of GelMA-based bioinks, as well as various effective process parameters, are reviewed. Also, several solutions for challenges in the printing of GelMA-based bioinks are discussed, and applications of GelMA-based bioprinted tissues argued as well. Impact statement Bioprinting has been demonstrated as a promising and alternative approach for organ transplantation to develop various types of living tissue. Bioinks, with great biological characteristics similar to the host tissues and rheological/flow features, are the first requirements for the successful bioprinting approach. Gelatin methacryloyl (GelMA) hydrogel is one of the high-potential hydrogel-based bioinks. This review provides a comprehensive look at different methods for the bioprinting of GelMA-based bioinks and applications of GelMA-based bioprinted tissues for tissue repair.

Additive-lathe 3D bioprinting of bilayered nerve conduits incorporated with supportive cells

Nerve conduits have been identified as one of the most promising treatments for peripheral nerve injuries, yet it remains unsolved how to develop ideal nerve conduits with both appropriate biological and mechanical properties. Existing nerve conduits must make trade-offs between mechanical strength and biocompatibility. Here, we propose a multi-nozzle additive-lathe 3D bioprinting technology to fabricate a bilayered nerve conduit. The materials for printing consisted of gelatin methacrylate (GelMA)-based inner layer, which was cellularized with bone marrow mesenchymal stem cells (BMSCs) and GelMA/poly(ethylene glycol) diacrylate (PEGDA)-based outer layer. The high viability and extensive morphological spreading of BMSCs encapsulated in the inner layer was achieved by adjusting the degree of methacryloyl substitution and the concentration of GelMA. Strong mechanical performance of the outer layer was obtained by the addition of PEGDA. The performance of the bilayered nerve conduits was assessed using in vitro culture of PC12 cells. The cell density of PC12 cells attached to cellularized bilayered nerve conduits was more than 4 times of that on acellular bilayered nerve conduits. The proliferation rate of PC12 cells attached to cellularized bilayered nerve conduits was over 9 times higher than that on acellular bilayered nerve conduits. These results demonstrate the additive-lathe 3D bioprinting of BMSCs embedded bilayered nerve conduits holds great potential in facilitating peripheral nerve repair.

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A multi-nozzle additive-lathe 3D bioprinting technology is developed to fabricate a bilayered nerve conduit.

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The outer layer of nerve conduit provide a strong mechanical property and the inner layer has a good biocompatibility.

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Bone marrow mesenchymal stem cells (BMSCs) are incorporated in the inner layer of nerve conduit using bioprinting.

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In vitro culture of PC12 cells demonstrates the neuron outgrowth is significantly improved in BMSCs embedded nerve conduits.

Polycaprolactone fumarate acts as an artificial neural network to promote the biological behavior of neural stem cells

Herein, we investigated the effect of electrospun polycaprolactone fumarate (PCLF) nanofibers on neural stem cell (NSC) behavior in the in vitro setting. Murine NSCs were isolated from adult mice subventricular zone and immunophenotyped by flow cytometry assay and immunofluorescence staining. Cells were cultured on the plastic surface, laminin-coated surface, and electrospun PCLF nanofibers. Cell morphology, attachment, and spreading were evaluated by scanning electron microscopy analysis. Cell viability and proliferation rates were evaluated by MTT assay. The proliferation of plated cells was investigated by monitoring Ki-67-positive cells using flow cytometry analysis. The protein levels of Map-2 and GFAP were detected by using immunofluorescence staining to show neural and astrocyte differentiation capacity. Scanning electron microscopy images revealed an extensive distribution, morphological adaptation, and cell-to-cell connectivity in NSCs upon culture on the PCLF surface. MTT analysis showed that the NSCs had more survival rates on the PCLF surface compared to the laminin and control groups over time (p < 0.05). In contrast to the laminin group, Ki-67 analysis showed a decrease of proliferating cells in the PCLF group. Immunofluorescence staining revealed the prominent increase of Map-2 and GFAP reduction in NSCs from the PCLF group compared to the laminin and control groups, showing the stimulatory effect of PCLF on targeted maturation of NSCs (p < 0.05). In brief, PCLF based construct promotes NSCs morphological adaptation and neuronal differentiation, suggesting PCLF as an appropriate and applicable substrate in neural tissue engineering.

Advancements and Frontiers in the High Performance of Natural Hydrogels for Cartilage Tissue Engineering

Cartilage injury originating from trauma or osteoarthritis is a common joint disease that can bring about an increasing social and economic burden in modern society. On account of its avascular, neural, and lymphatic characteristics, the poor migration ability of chondrocytes, and a low number of progenitor cells, the self-healing ability of cartilage defects has been significantly limited. Natural hydrogels, occurring abundantly with characteristics such as high water absorption, biodegradation, adjustable porosity, and biocompatibility like that of the natural extracellular matrix (ECM), have been developed into one of the most suitable scaffold biomaterials for the regeneration of cartilage in material science and tissue engineering. Notably, natural hydrogels derived from sources such as animal or human cadaver tissues possess the bionic mechanical behaviors of physiological cartilage that are required for usage as articular cartilage substitutes, by which the enhanced chondrogenic phenotype ability may be achieved by facilely embedding living cells, controlling degradation profiles, and releasing stimulatory growth factors. Hence, we summarize an overview of strategies and developments of the various kinds and functions of natural hydrogels for cartilage tissue engineering in this review. The main concepts and recent essential research found that great challenges like vascularity, clinically relevant size, and mechanical performances were still difficult to overcome because the current limitations of technologies need to be severely addressed in practical settings, particularly in unpredictable preclinical trials and during future forays into cartilage regeneration using natural hydrogel scaffolds with high mechanical properties. Therefore, the grand aim of this current review is to underpin the importance of preparation, modification, and application for the high performance of natural hydrogels for cartilage tissue engineering, which has been achieved by presenting a promising avenue in various fields and postulating real-world respective potentials.

Core-shell fibrous membranes of PVDF-Ba0.9Ca0.1TiO3/PVA with osteogenic and piezoelectric properties for bone regeneration

The goal of this research was to promote the bioactivity and osteogenic characteristics of polyvinylidene fluoride(PVDF) fibrous membrane, while preserving its piezoelectric property for bone regeneration. In this regard, core-shell fibrous membrane of PVDF-Ba_0.9Ca_0.1TiO₃/polyvinyl alcohol(PVA) was developed via emulsion electrospinning approach. While PVA was in the outer layer of fibers with thickness of 53 ± 18 nm, the Ba_0.9Ca_0.1TiO₃ nanoparticles was uniformly dispersed in the PVDF core. The formation of PVA shell resulted in significant improvement of its hydrophilicity (3 times) and degradation rate, while piezoelectricity did noticeably modulate. In addition, incorporation of Ba_0.9Ca_0.1TiO₃ nanopowder remarkably improved bioactivity, protein adsorption and mechanical properties of PVDF/PVA fibrous membranes. Finally, the osteogenic differentiation of mesenchymal stem cells on the nanocomposite fibrous membranes, in the absence of osteogenic supplements, was also observed. Overall, the results confirmed the promising potential of PVDF-Ba_0.9Ca_0.1TiO₃/PVA fibrous membrane containing 1-2 wt% nanopowder for bone regeneration.

Design and characterisation of PHBV-magnesium oleate directional nanofibers for neurosupport

The focus of significance in neuronal repair strategies is the design of scaffold systems capable of promoting neuronal regeneration and directional guidance via provision of a biomimetic environment resemblance of native neural tissue. The purpose of this study was to synthesize triple-cue electrospun aligned nanofibrous films (physical cue) of poly(3-hyroxybutyric acid-co-3-hydroxyvaleric acid) (PHBV) blended with magnesium-oleate (MgOl) (chemical cue) and N-acetyl-L-cysteine (NAC) (therapeutic cue) with potential incorporation into hollow nerve guidance conduits for an enhanced regenerative strategy. A Box-Behnken experimental design of 15 formulations, were analysed for crystallinity, textural properties and in vitro water-uptake, erosion, NAC-release and PC12 cell viability. Nucleating effects of MgOl provided tuning of PHBV electrospinning-induced crystallinity and mechanical properties. Tensile strengths and deformation moduli of ±12 MPa and ±7 MP, respectively, were attainable, thereby matching native nerve mechanics. Crystallinity changes ascribed differing release kinetics to NAC over 30 d: diffusion-based (42%-58% crystallinity with 33%-47% fractional release) and polymer-relaxational (59%-65% crystallinity with 60%-82% fractional release). The synergistic activity of MgOl and NAC increased PC12 proliferation by 32.6% compared to the control. MgOl produced dual actions as non-toxic plasticiser and PC12 cell proliferation-promoter via nucleation and neurotrophic-like effects, respectively. Controlled release of NAC imparted neuro-protectant effects on PC12 cells and promoted neurite extension, thus, making electrospun PHBV-MgOl nanofibrous films a versatile and promising approach for axonal guidance in peripheral nerve repair strategies.

Interactions at scaffold interfaces: Effect of surface chemistry, structural attributes and bioaffinity

Effective regenerative medicine relies on understanding the interplay between biomaterial implants and the adjoining cells. Scaffolds contribute by presenting sites for cellular adhesion, growth, proliferation, migration, and differentiation which lead to regeneration of tissues over desired periods of time. The fabrication and recruitment of scaffolds often fail to consider the interactions that occur at the interfaces, thereby risking rejection. This lack of knowledge on interfacial microenvironments and related exchanges often causes reduced cellular interactions, poor cell survival and intervention failure. Successful regenerative therapy requires scaffolds with bespoke biocompatibility, optimum pore structure, and cues for cell attachments. These factors determine the development of cellular affinity in scaffolds. For biomedical applications, a detailed understanding of scaffolds and their interfaces is required for better tuning of biomaterials to suit the microenvironments. In this review, we discuss the role of biointerfaces with a focus on surface chemistry, pore structure, scaffold hydro-affinity and their biointeractions. An understanding of the effect of scaffold interfacial properties is crucial for enhancing the progress of tissue engineering towards clinical applications.

A Review on Graphene-Based Nanomaterials in Biomedical Applications and Risks in Environment and Health

Graphene-based nanomaterials (GBNs) have attracted increasing interests of the scientific community due to their unique physicochemical properties and their applications in biotechnology, biomedicine, bioengineering, disease diagnosis and therapy. Although a large amount of researches have been conducted on these novel nanomaterials, limited comprehensive reviews are published on their biomedical applications and potential environmental and human health effects. The present research aimed at addressing this knowledge gap by examining and discussing: (1) the history, synthesis, structural properties and recent developments of GBNs for biomedical applications; (2) GBNs uses as therapeutics, drug/gene delivery and antibacterial materials; (3) GBNs applications in tissue engineering and in research as biosensors and bioimaging materials; and (4) GBNs potential environmental effects and human health risks. It also discussed the perspectives and challenges associated with the biomedical applications of GBNs.

Double network hydrogel for tissue engineering

Double network (DN) hydrogels, a kind of promising soft and tough hydrogels, are produced by two unique contrasting networks with designed network entanglement burst into the field of materials science as versatile functional systems for a very broad range of applications. A part of the DN hydrogels is characterized by extraordinary mechanical properties providing efficient biocompatible and high strength for holding considerable promise in tissue engineering. Following DN hydrogels principles and consideration of biomedical applications, we provide an overall view of the present various DN hydrogels and look forward to the future of DN hydrogels for tissue engineering. In this review, the preparation methods, structure, properties, current situation, and challenges are mainly discussed for the purpose of tissue engineering. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.

Nanohybrid hydrogels of laponite: PVA-Alginate as a potential wound healing material

The aim of this study was to develop a novel nanohybrid interpenetrating network hydrogel composed of laponite:polyvinyl alcohol (PVA)-alginate (LAP:PVA-Alginate) with adjustable mechanical, physical and biological properties for wound healing application. Results demonstrated that compared to PVA-Alginate, mechanical strength of LAP:PVA-Alginate significantly enhanced (upon 2 times). Moreover, incorporation of 2wt.% laponite reduced swelling ability (3 times) and degradation ratio (1.2 times) originating from effective enhancement of crosslinking density in the nanohybrid hydrogels. Furthermore, nanohybrid hydrogels revealed admirable biocompatibility against MG63 and fibroblast cells. Noticeably, MTT assay demonstrated that fibroblast proliferation significantly enhanced on 0.5wt.% LAP:PVA-alginate compared to PVA-alginate. Moreover, hemolysis and clotting tests indicated that the nanohybrid hydrogels promoted hemostasis which could be helpful in the wound dressing. Therefore, the synergistic effects of the nanohybrid hydrogels such as superior mechanical properties, adjustable degradation rate and admirable biocompatibility and hemolysis make them a desirable candidate for wound healing process.

The effect of subpressure on the bond strength of resin to zirconia ceramic

Objective

This study was conducted to investigate the effect of subpressure on the bond strength of resin to zirconia ceramic. The subpressure would create a pressure gradient which could clean out the bubbles in the adhesives or bonding interface.

Methods

Twenty-eight pre-sintered zirconia discs were fabricated. Half of them were polished (group P, n = 14), and the rest were sandblasted (group S, n = 14). After sintered,the surface roughness of the zirconia discs was measured. Then, they were randomly divided into two subgroups (n = 7). The groups were named as follows: PC: P + no additional treatments; PP: P + 0.04 MPa after application of adhesives; SC: S + no additional treatments; and SP: S + 0.04 MPa after application of adhesives. Resin columns were bonded to the zirconia specimens to determine shear bond strength (SBS). The bonding interfaces were observed and the fracture modes were evaluated. Statistical analysis was performed on all data.

Results

The surface roughness of group S was significantly higher than that of group P (P<0.05). The SBS values were PC = 13.48 ± 0.7 MPa, PP = 15.22 ± 0.8 MPa, SC = 17.23 ± 0.7 MPa and SP = 21.68 ± 1.4 MPa. There were significant differences among the groups (P<0.05). Scanning electron microscopy (SEM) results showed that the adhesives of group SP and PP were closer and denser to the zirconia ceramic than that of group PC and SC. The proportion of the mixed fracture mode significantly increased after adding subpressure (P< 0.05).

Conclusion

Subpressure can improve the shear bond strength of resin to zirconia ceramics and increase micro-infiltration between the adhesives and the zirconia ceramics, especially on the rough surfaces.