Effects of Er,Cr:YSGG Laser Surface Treatments and Composites with Different Viscosities on the Repair Bond Strength of CAD/CAM Resin Nanoceramic

This study aims to evaluate the repair micro-shear bond strength of the CAD/CAM resin nanoceramic block treated using four different surface treatments and composite resins of different viscosities. For the current study, 96 samples with dimensions of 14 × 12 × 2 mm were obtained from a CAD/CAM resin nanoceramic block (Cerasmart) with a low-speed precision cutting saw under water cooling. The relevant samples were randomly divided into four groups according to the surface treatment processes: grinding with diamond bur, aluminum oxide airborne-particle abrasion, long-pulse laser, and short-pulse laser. Following silane application, universal adhesive was applied to all surface-treated samples and cured with an LED for 10 s. The samples prepared for the repair procedure were divided into two subgroups (microhybrid composite and injectable composite) according to the viscosity of the repair material to be used (n = 12). After the repair procedure, care was taken to keep the samples in distilled water in an incubator at 37 °C for 24 h. The repair micro-shear bond strength values (μSBSs) of CAD/CAM resin nanoceramic-composite resin complexes were tested. In addition, randomly selected samples from each group were examined with a scanning electron microscope to evaluate the surface topography after both surface treatments and the micro-shear bond strength test. Data were analyzed by two-way ANOVA and Bonferroni test. It was determined that the surface treatment preferred in the repair protocol significantly affected the μSBS value (p < 0.001). While the highest μSBS value was obtained with the short-pulse laser airradiation group, the lowest μSBS values were found in samples with long pulse laser irradiation. However, samples grinded with a bur and airborne-particle abrasion showed similar μSBS values (p > 0.05). The preferred composite viscosity in the repair procedure has a significant effect on the μSBS value (p < 0.001). However, the interaction between the surface treatment and the viscosity of the repair composite does not affect the μSBS values in a statistically significant way (p = 0.193). It may be recommended to clinicians to repair CAD/CAM resin nanoceramic restoration surfaces with injectable composites or after treatment with short-pulse lasers.

Repair protocols for indirect monolithic restorations: a literature review

Despite the advancements in indirect monolithic restorations, technical complications may occur during function. To overcome this issues, intraoral repair using resin composite is a practical and low-cost procedure, being able to increase the restoration's longevity. This review aimed to evaluate the need for repair and suggest a standardized repair protocol to the main indirect restorative materials. For this, studies were surveyed from PubMed with no language or date restriction, to investigate the scientific evidence of indirect monolithic restoration repair with direct resin composite. A classification to guide clinical decisions was made based on the FDI World Dental Federation criteria about defective indirect restorations considering esthetic and functional standards, along with the patient's view, to decide when polishing, repairing or replacing a defective restoration. Based on 38 surveyed studies, different resin composite intraoral repair protocols, that included mechanical and chemical aspects, were defined depending on the substrate considering resin-based, glass-ceramic or zirconia restorations. The presented criteria and protocols were developed to guide the clinician's decision-making process regarding defective indirect monolithic restorations, prolonging longevity and increasing clinical success.

Zirconia-Reinforced Lithium Silicate Ceramic in Digital Dentistry: A Comprehensive Literature Review of Our Current Understanding

Zirconia-reinforced lithium silicate (ZLS) ceramic is a new innovative dental material with unique a chemical composition that is designed to combine harmoniously with the appropriate optical properties of lithium disilicate and the enhanced mechanical strength of zirconia. A thorough understanding of ZLS materials is essential for both clinicians and dental technicians. At present, the mechanical behavior and optical properties of the ZLS ceramic system have not been extensively researched, and there is still a lack of consensus regarding the fabrication process and clinical behavior of ZLS all-ceramic restorations. The aim of the present study was to present a selection of comprehensive information concerning zirconia-reinforced lithium silicate ceramics and their optical and mechanical properties, as well as to assess data regarding cementation procedures and clinical outcomes for ZLS all-ceramic restorations. Three electronic databases (PubMed, Web of Science, and the Cochrane Library) were used for the research by two independent reviewers. The search was limited to articles published in the English language, as well as clinical and in vitro studies of color and studies on mechanical behavior and the cementation procedures of ZLS restorations. The exclusion criteria comprised abstracts, questionnaire-based studies, case reports, literature reviews, and studies that were not available in English. Zirconia-reinforced lithium-silicate-based ceramic presents a unique and complex microstructure that increases mechanical resistance but decreases aesthetic appearance, especially its translucency, due to tetragonal zirconia content. A material's thickness, the color of the underlying tooth structure, and the resin cement shade are important factors that influence the final shade and aesthetic appearance of ZLS restorations. Mechanical properties, which are defined by the fracture toughness, flexural strength, elastic modulus, and hardness of ZLS ceramic are higher compared to feldspathic, lithium disilicate, and hybrid ceramics, as well as resin nanoceramics; however, they are lower than translucent or high-translucency zirconia. Acid etching, sandblasting, and laser etching represent the most used methods to prepare the ZLS restoration surfaces for proper bonding procedures.

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.

Do different protocols affect the success rate or bond strength of glass-ceramics repaired with composite resin? A systematic review and meta-analysis

STATEMENT OF PROBLEM

Intraoral repair techniques prevent unnecessary replacement of ceramic restorations, thereby increasing the survival rate. However, adhesion between ceramics and the composite resin is challenging and how different protocols influence adhesion is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to analyze the influence of different protocols on repairing glass-ceramic surfaces with composite resins.

MATERIAL AND METHODS

PubMed, Scopus, ISI Web of Science, and Embase electronic databases were searched to select studies comparing bond strength values or survival rates of glass-ceramic repaired with composite resins using different surface treatment protocols. No publication year or language restriction was applied. Data sets were extracted from all included studies, and the mean differences calculated. A 95% confidence interval was calculated by using the random effect model (Rev Man 5.4).

RESULTS

The search identified 5037 studies, and 165 were assessed for eligibility. Finally, 123 in vitro studies were included in the systematic review and 48 in the meta-analysis. Considering different glass-ceramics, bond strength tests, and aged or not aged specimens, 37 meta-analyses found the effect of repair protocols: only adhesive, silane plus adhesive alone or preceded by hydrofluoric (HF) acid, airborne-particle abrasion (APA) with Al2O3 particles, silica-coated APA (SCAPA), diamond rotary instrument (DRI), and laser irradiation (LI).

CONCLUSIONS

For feldspathic porcelain, HF acid, APA, SCAPA, or DRI improved the repair micromechanical retention; applying silane is essential to HF-conditioned surfaces but the use of adhesive is optional when silane is applied. Results for leucite and lithium disilicate were inconclusive in terms of suggesting a treatment other than HF acid plus silane and adhesive applications.

Comparison of the Micro-Shear Bond Strength of Resin Cements to CAD/CAM Glass Ceramics with Various Surface Treatments

This study aimed to compare the effect of acid etching, sandblasting, or silica coating on the micro-shear bond strength of dual-cured resin cements to computer-aided design and computer-aided manufacturing (CAD/CAM) glass ceramic materials. Feldspathic, lithium disilicate, and zirconia-reinforced CAD/CAM ceramics were divided into four groups: control group (C), no surface treatment; hydrofluoric (HF) group, 5% HF acid-etched; sandblasting (SB) group, abraded with 50 µm aluminum oxide (Al₂O₃) particles; silica-coated (CJ) group, abraded with 30 µm silica-modified Al₂O₃ particles. Roughness values were obtained by using a profilometer. The cements were condensed on the surface-treated specimens and a micro-shear bond test was conducted. The ceramic material (p < 0.001) and surface treatment type (p < 0.001) significantly affected the micro-shear bond strength values. HF acid etching can be recommended for the surface pretreatment of feldspathic, lithium disilicate, and zirconia-reinforced CAD/CAM ceramics. Better bond strengths can be obtained with HF acid etching than with sandblasting and silica coating.

The enhanced shear bond strength of resin cement to zirconia with ordered conical spots through the CO2 laser process

In this study, a new shear bonding system was created that uses a CO₂ laser to form a pattern of conical spots on a zirconia prosthesis surface to improve mechanical interlocking. Four types of zirconia substrates were employed, which underwent particle abrasion after being polished, machined, spotted, and spot-particle abraded. The surface roughness of each substrate was measured via scanning electron microscopy and X-ray diffraction (XRD). A shear bond strength test was performed with the zirconia-based material and a composite resin assuming abutment construction. XRD did not indicate that forming spots caused a phase transformation in zirconia with respect to machined zirconia. The shear bond strength was approximately twice that of the machined samples and approximately 2.3 times that of the samples that underwent particle and spot-particle abrasion. Surface modification by spotting improved the mechanical fitting force. However, no significant difference was observed between particle abrasion and spot-particle abrasion.

Repair bond strength of different CAD-CAM ceramics after various surface treatments combined with laser irradiation

The aim of this study was to evaluate the effect of different surface treatments combined with laser irradiation on the shear bond strength of different CAD-CAM ceramics to composite resin. A total of hundred forty-seven ceramic specimens with thicknesses of 2.5 mm were prepared from three different CAD-CAM ceramics (an yttrium oxide partially stabilized tetragonal zirconia polycrystal (Y-TZP); a zirconia-reinforced lithium silicate glass ceramic (ZLS); and a lithium disilicate-strengthened lithium aluminosilicate glass ceramic (LD-LAS)) and subjected to seven groups of treatment (n = 7): (1) control (no treatment), (2) Er:YAG laser irradiation, (3) Nd:YAG laser irradiation, (4) etching with hydrofluoric acid (HFA), (5) Er:YAG + HFA, (6) Nd:YAG + HFA, and (7) sandblasting. After surface treatment procedures, a ceramic primer (Clearfil Ceramic Primer Plus, Kuraray, Japan) was applied to the ceramics. Bonding agent (Single Bond Universal Adhesive, 3 M ESPE, USA) was then applied, and the composite resin (Estelite Sigma Quick, Kuraray, Japan) was layered on the ceramic surfaces. The shear bond strength test was performed using a universal testing machine at a load of 0.5 mm/min. Data were analyzed by 2-way analysis of variance (ANOVA), and the Bonferroni correction was used for pairwise comparisons (α = 0.05). Compared to the bond strength of the control group, irradiation by Er:YAG and Nd:YAG lasers alone improved the bond strength of the composite resin to the Y-TZP (P < 0.001) but did not change the bond strength of composite resin to the ZLS and LD-LAS (P > 0.05). Compared to the bond strength of the control group, etching with HFA alone increased the bond strength of the composite resin to the ZLS and LD-LAS (P < 0.001) but did not affect the bond strength of the composite resin to the Y-TZP (P > 0.05). The highest bond strength of ZLS was obtained using HFA + Er:YAG, and the highest bond strength for LD-LAS was obtained using HFA + Nd:YAG. It was concluded that Er:YAG and Nd:YAG laser treatments presented the highest repair bond strength between the composite resin and Y-TZP ceramics. Er:YAG and Nd:YAG laser treatments in conjuction with HFA presented the highest repair bond strength between the composite resin and the glassy ceramics, ZLS, and LD + LAS.

Surface Treatment and Cementation of Lithium Silicate Ceramics Containing ZrO2

Objective

To evaluate the effect of different surface treatments on the shear bond strength (SBS) of lithium silicate (LS) and lithium disilicate (LD) ceramics, after thermocycling.

Methods and Materials

For SBS test, 72 ceramic blocks (18×14×2 mm) were made (24 blocks from each ceramic material): VITA Suprinity (LSS), Celtra Duo (LSC), and Lithium disilicate (LD). The blocks were polished with sandpaper of increasing grit (#280, #400, #800, and #1200) and embedded in chemically activated acrylic resin. Afterwards, they were randomly divided into 12 groups (6 blocks per group) according to: “Ceramic” (LD, LSC, and LSS) and “Surface treatment” (HFS: hydrofluoric acid + silane; MEP: Monobond Etch & Prime/Ivoclar). From each treated surface ceramic block, four dual-curing resin cement cylinders (RelyX U200, 3M Oral Care) were prepared using a Tygon tube (Ø=3 mm and h=2 mm) and light cured for 40 seconds (1000 mW/cm2) (N=288/n=24). All specimens were submitted to thermocycling (10,000 cycles, 5°C and 55°C, 30 seconds) and then to SBS test at a crosshead speed of 1 mm/min using a 50-kgf load cell. Forty-five additional blocks were made for roughness and SEM analysis. Failure mode was also performed. The data (MPa) were statistically analyzed by oneway analysis of variance (ANOVA), Tukey test (5%), and Weibull analysis. The Ra was analyzed by Kruskal–Wallis and Dunn Test (5%). The other variables were analyzed qualitatively.

Results

ANOVA revealed that “surface treatment” was significant for all ceramic materials (p&lt;0.05). The LD-HFS (18.66±3.49), LSC-HFS (16.81±2.62), and LSS-HFS (16.33±3.08) groups had significantly higher SBS than the LD-MEP (7.00±4.2), LSC-MEP (14.12±3.51), and LSS-MEP (13.87±2.52) groups. Complete adhesive failures at the cement– dentin interface were more frequent. Weibull modulus was superior for the LD-HFS (6.22), LSC-HFS (8.8), and LSS-HFS (7.4) groups.

Conclusion

HF followed by silanization is the most suitable surface treatment for the cementation of LS and LD glass ceramics.

Is the bond strength of zirconia-reinforced lithium silicate lower than that of lithium disilicate? A systematic review and metaanalysis

PURPOSE

This study systematically reviewed the literature to compare the bond strength of resin composites with that of zirconia-reinforced lithium silicate (ZLS) and lithium disilicate (LD).

STUDY SELECTION

This review was structured based on the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA 2020) statement. This study was registered at the International Prospective Register of Systematic Reviews (CRD42021256900). Studies were searched via PubMed, Web of Science, and Google Scholar databases without language or publication year limits. In vitro studies that evaluated the bond strength of the resin composites to ZLS and LD were included. The risk of bias in all the included articles was evaluated. Statistical analyses were performed using the Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK).

RESULTS

Of the 90 potentially related articles, the full texts of 16 articles were evaluated after screening. Finally, sevenstudies were included in the qualitative synthesis and meta-analysis. All the studies presented a medium risk of bias. The results showed no significant difference in bond strength between the ZLS and LD groups (P = 0.94, mean difference=0.08, and 95% confidence interval=-1.93 to 2.10). However, a significant difference was found in the subgroup analysis considering different types of aging treatments (P = 0.0008) and different types of bond strength tests (P < 0.00001).

CONCLUSION

The bond strength of resin composites was found to be similar to that of ZLS and LD, but different aging treatments and bond strength tests exhibited varying effects on the bond strength.

Optical behaviors, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate (ZLS): A narrative review

OBJECTIVES

The present narrative review was focused on the optical properties, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate ceramics (ZLS) for Computer-aided design / Computer-aided manufacturing (CAD/CAM) technologies.

DATA/SOURCES

A literature search was performed by 3 calibrated independent researchers on PubMed, Scopus, Embase, Google Scholar, Dynamed, and Open Grey. The criteria for inclusion were: 1) papers addressing at least one of the following variables about ZLS: optical properties, surface treatment, adhesion, and clinical indications; 2) in vitro, in silico, or in vivo studies; 3) case reports; 4) systematic reviews. The exclusion criteria were: 1) animal studies; 2) non-dental studies; 3) studies only focusing on ZLS used in the heat-pressed process.

STUDY SELECTION

98 records among in vitro studies and case reports were included.

CONCLUSIONS

Despite the promising microstructure characteristics of ZLS, increased translucency compared to lithium disilicate ceramics (LS₂) was not proven, but acceptable color changes and stability were reported. Mechanical polishing was the most effective method to reduce surface roughness. Moreover, machinability and handling of ZLS resulted harder than LS₂. Conventional acid etching procedures seemed effective in conditioning ZLS surface, but no protocol has been established yet. Besides, silane-coupling and dual-curing resin cements were recommended.

CLINICAL SIGNIFICANCE

ZLSs can be used for anterior and posterior fixed single-unit CAD/CAM restorations onto both natural teeth and implants, but do not seem to represent a viable treatment option for endocrowns onto posterior teeth or fixed dental prostheses.

Effect of different surface treatments on the biaxial flexure strength, Weibull characteristics, roughness, and surface topography of bonded CAD/CAM silica-based ceramics

OBJECTIVE

To investigate the influence of different surface treatments on biaxial flexure strength, roughness, and surface topography of lithium silicate/disilicate-based ceramics.

METHODS

225 discs (∅: 12 mm; 1.2 mm - ISO 6872) were made from three ceramics: IPS e.max CAD (LD - Ivoclar Vivadent), Suprinity (LSS - Vita) and Celtra Duo (LSC - Dentsply). The samples were randomly divided into 5 groups (n = 15): no treatment (C); 10% hydrofluoric acid + silane (HF); sandblasting Al₂O₃ + silane (SB); silicatization + silane (SC); and self-etching ceramic primer (SEP). After surface treatment, a resin cement layer was applied to the disc surface (RelyX U200, 3M ESPE), mechanical cycled (1.2 × 10⁶ cycles, 50 N, 3.8 Hz) and submitted to biaxial flexural strength test (1 mm/min, 1000 Kgf). Roughness, EDS and SEM were also performed. Data were analyzed by one-way ANOVA, Tukey test (5%) and Weibull.

RESULTS

ANOVA revealed that the "surface treatment" factor was significant for all ceramics (p < 0.05). The groups LD-HF (289.30 ± 40) LD-SEP (298. 87 ± 53.29), LSC-HF (195.51 ± 42.12), LSS-HF (269.58 ± 27.07) and LSS-SEP (207.45 ± 28.63) presented significantly higher biaxial flexure strength than respective control groups, except for the LSC-SEP (165.41 ± 33.86), which was statistically similar to the control. The Weibull modulus was significantly higher for the LD-SB, LSC-SC groups. Additionally, the LD-SB, LSC-SC and LSS-HF groups showed higher roughness compared to the other treatments.

SIGNIFICANCE

HF etching followed by silanization and self-etching ceramic primer are the most suitable surface treatments for lithium silicate/disilicate-based glass-ceramics.

Repair strength and surface topography of lithium disilicate and hybrid resin ceramics with LLLT and photodynamic therapy in comparison to hydrofluoric acid

AIM

The aim was to compare the repair bond strength and surface topography of lithium disilicate ceramics (LDC) and hybrid resin ceramics (HRC) using different surface conditioning treatments [low level laser therapy (LLLT), photodynamic therapy (PDT), hydrofluoric acid (HF) with silane and air abrasion (AA) and silane].

MATERIAL AND METHOD

Sixty specimens each of LDC and HRC were used. Discs were prepared for each group (6 × 2 mm), conditioned using different regimes. Specimens in group 1 and 5 were laser irradiated using Er,Cr:YSGG (ECYL), group 2 and 6 were conditioned using methylene blue photosensitizer (PDT), group 3 and 7 surface was treated with hydrofluoric acid and silane (HFA-S), group 4 and 8 conditioned with Al₂O₃ air abrasion and silane (AA-S). A Porcelain Repair Kit was used according to manufacturer recommendation in all samples. Peak universal bond adhesive was rubbed on ceramic surface and then bonded with composite resin. For shear bond strength testing the specimens were placed in a universal testing machine. A stereomicroscope at 40x magnification was used to analyse failure pattern. Five specimens in each group after surface treatment were evaluated for surface changes and topography using scanning electron microscopy. The mean repair bond strength was calculated using ANOVA and Tukey's post hoc test at a significance level of (p < 0.05).

RESULT

The highest repair bond strength was observed in group 3 (LDC) (20.57 ± 3.58 MPa) (HFA-S), whereas, the lowest score was displayed in Group 2 (LDC) using methylene blue photosensitizer (MBPS) (12.18 ± 1.08 MPa). Similarly, in HRC the highest repair SBS was presented in group 8 (AA-S) (20.52 ± 2.51 MPa) and the lowest SBS values were exhibited by PDT treated group 6 (13.22 ± 0.62 MPa).

CONCLUSION

A combination of mechanical and chemical surface treatments should be used in order to achieve adequate repair bond strength between resin composites and ceramic interface of LDC and HRC.

Evaluation of the repair capacities and color stabilities of a resin nanoceramic and hybrid CAD/CAM blocks

PURPOSE

This study evaluated the color stabilities of two computer-aided design and computer-aided manufacturing (CAD/CAM) blocks and a nanofill composite resin and the microtensile bond strength (µTBS) between the materials.

MATERIALS AND METHODS

Twelve specimens of 4 mm height were prepared for both Lava Ultimate (L) and Vita Enamic (E) CAD/CAM blocks. Half of the specimens were thermocycled (10,000 cycle, 5° to 55℃) for each material. Both thermocycled and non-thermocycled specimens were surface treated with one of the three different methods (Er,Cr:YSGG laser, bur, or control). For each surface treatment group, one of the thermocycled and one of non-thermocycled specimens were restored using silane (Ceramic Primer II), universal adhesive (Single Bond Universal), and nanofill composite resin of 4-mm height (Filtek Ultimate). The other specimens were restored with the same procedure without using silane. For each group, 1 × 1 × 8 mm bar specimens were prepared using a microcutting device. Bar specimens were thermocycled (10,000 cycle, 5° to 55℃) and microtensile tests were performed. Staining of the materials in coffee solution was also compared using a spectrophotometer. Data were analyzed using one-way ANOVA, t-test and post-hoc Scheffe tests.

RESULTS

µTBS were found similar between the thermocycled and non-thermocycled groups (P>.05). The highest µTBS (20.818 MPa) was found in the non-thermocycled, bur-ground, silane-applied E group. Silane increased µTBS at some E groups (P<.05). Composite resin specimens showed more staining than CAD/CAM blocks (P<.05).

CONCLUSION

CAD/CAM blocks can be repaired with composite resins after proper surface treatments. Using silane is recommended in repair process. Color differences may be shown between CAD/CAM blocks and the nanofill composite after a certain time period.

Effect of elapsed time after air abrasion on bond strength of luting agent to CAD/CAM resin blocks

This experiment assessed the effect of elapsed time between air abrasion and bonding on tensile bond strength (TBS) between computer-aided design/computer-aided manufacturing (CAD/CAM) composite resin blocks and luting agents. Specimens were divided into eight groups classified by block type (Estelite Block or HC Block), elapsed time after air abrasion (none [D0] or 1 week [D7]), luting agent type (Estecem [ESC] or Rely X Ultimate [RLU]), and polymerization condition (chemical cured [CC] or light cured [LC]). In the CC+ESC group, TBS was significantly higher at D0 than at D7. There was also a significant difference between blocks in all groups except the LC+ESC group. Scanning electron microscopy and atomic force microscopy were used to observe the surfaces of blocks after air abrasion and indicated that blocks absorbed water in air with elapsed time, which affected TBS between CAD/CAM composite resin blocks and luting agents.

HF etching of CAD/CAM materials: influence of HF concentration and etching time on shear bond strength

Background

The required pretreatment of CAD/CAM ceramic materials before resin composite cement application varies among studies. The aim of the present study was to evaluate the effect of hydrofluoric acid concentration and etching time on the shear bond strength (SBS) of two adhesive and two self-adhesive resin composite cements to different CAD/CAM ceramic materials.

Methods

SBS of two adhesive (Panavia V5, Kuraray, [PV5]; Vita Adiva F-Cem, Vita Zahnfabrik, [VAF]) and two self-adhesive (RelyX Unicem 2 Automix, 3 M Espe, [RUN]; Vita Adiva S-Cem, Vita, [VAS]) cements to four different CAD/CAM materials (Vitablocs Mark II, Vita, [VM]; Vita Enamic, Vita, [VE]; e.max CAD, Ivoclar Vivadent, [EC]; Vita Suprinity PC, Vita, [VS]) was measured. The effect of the surface pretreatment by using two different hydrofluoric acid products (HF5% Vita Ceramics Etch, Vita and HF9% buffered, Ultradent Porcelain Etch, Ultradent Products) were assessed at etching times of 0 s, 5 s, 15 s, 30s and 60s for each cement and restorative material combination (n = 10 per group, total n = 1440).

Results

Significant effects were found for the etching time and cement for all materials with highest shear bond strength for etching times of 60s = 30s = 15 s ≥ 5 s > 0 s and for RUN>PV5 = VAF > VAS (p < 0.05). Etching with HF5% for 5 s to 15 s resulted in higher SBS values, while no differences were observed between HF5% and HF9% buffered when the substrates were etched for 30s to 60s (p < 0.05).

Conclusions

Within the limitations of this study the recommended surface pretreatment of silicate ceramics is HF etching with concentrations of 5% or 9% for 15 s to 60s to achieve highest shear bond strength while the glassy matrix is sufficiently dissolved. The tested resin composite cements can be applied with all tested materials and suggested for clinical application.