Effect of Surface Treatment on Shear Bond Strength between Resin Cement and Ce-TZP/Al2O3

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.

Alumina and glass-bead blasting effect on bond strength of zirconia using 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing self-adhesive resin cement and primers

In fact, bonding of zirconia restorations is still a big challenge in clinical situations and many bonding protocols discussed in literature might be still controversial. The aim of this was to study assess the bond strength of zirconia after alumina and glass-bead pre-treatments with two different primers in combination with conventional resin cement and 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing self-adhesive resin cement without priming. Fully sintered high translucent zirconia samples (n = 160) were assigned into 2 groups of pre-treatments (n  = 80): Alumina-sandblasting (AB) and Glass-bead (GB). Then, each group was divided into 4 sub-groups according to priming and cement used (n  = 20 each): conventional self-adhesive resin cement, MDP-silane Primer, MDP primer both with conventional self-adhesive resin cement, and MDP contained cement. Shear bond strength (SBS) was measured after thermocycling. Failure mode was analyzed using stereomicroscope. Contact angle and surface topography were investigated using other fully sintered samples (n  = 30) constructed for that sole purpose, divided into control (no pre-treatment [unmodified], alumina-, and glass-bead sandblasted groups). Two-way ANOVA was performed for SBS and failure mode was analyzed. The use of Alumina-sandblasting showed higher SBS compared to Glass-bead pre-treatment for MDP-silane primer (p = 0.034) and MDP primer (p < 0.001). While MDP contained cement showed higher but insignificant SBS when pre-treated with glass-beads. Alumina-sandblasting and glass-bead pre-treatments improve bond strength of zirconia combined using primers before cementation with conventional resin cement. Also, self-adhesive MDP contained cement along with surface pre-treatment showed the highest achievable bond strength. It was concluded that both alumina-sandblasting and glass-bead blasting improved SBS combined with MDP containing self-adhesive resin cement reducing the required clinical steps during cementation of zirconia restorations.

Effects of MDP-based primers on shear bond strength between resin cement and zirconia

Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics are widely used for fixed dental prostheses and dental implants. Various primers have been introduced to enhance the bonding strength of zirconia crowns. The aim of current study was to analyze the effects of 10-methacryloyloxydecyl dihydrogen phosphate (MDP) primers on the shear bond strength between zirconia crowns and resin cement were assessed. The total sample size included 90 samples of Y-TZP ceramic surfaces. Samples in group I were abraded with aluminum oxide. Samples in groups II and III were abraded and primed with the zirconia and Z-PrimePlus MDP primers, respectively. Group IV samples did not undergo any treatment or application. Group V and VI samples did not undergo any abrasion but were primed with zirconia and Z-PrimePlus MDP primers, respectively. Prior to bonding of the resin cement, the primers were applied for 1 min and air-dried. Then, Clearfil SA luting self-adhesive resin cement was coated onto the zirconia crowns. The highest bond strength was achieved in group III, followed by group II, and group IV exhibited the lowest bond strength between Y-TZP ceramic and adhesive resin cement. Therefore, the application of MDP primers yielded greater bond strength between Y-TZP ceramics and adhesive resin cement, compared with the group without the use of primers.