The effect of five kinds of surface treatment agents on the bond strength to various ceramics with thermocycle aging

Different surface treatments and adhesive monomers for zirconia-resin bonds: A systematic review and network meta-analysis

This review examined the efficacy of surface treatments and adhesive monomers for enhancing zirconia-resin bond strength. A comprehensive literature search in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library yielded relevant in vitro studies. Employing pairwise and Bayesian network meta-analyses, 77 articles meeting inclusion criteria were analyzed. Gas plasma was found to be ineffective, while treatments including air abrasion, silica coating, laser, selective infiltration etching, hot etching showed varied effectiveness. Air abrasion with finer particles (25-53 µm) showed higher immediate bond strength than larger particles (110-150 µm), with no significant difference post-aging. The Rocatec silica coating system outperformed the CoJet system in both immediate and long-term bond strength. Adhesives containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) were superior to other acidic monomers. The application of 2-hydroxyethyl methacrylate and silane did not improve bonding performance. Notably, 91.2 % of bonds weakened after aging, but this effect was less pronounced with air abrasion or silica coating. The findings highlight the effectiveness of air abrasion, silica coating, selective infiltration etching, hot etching, and laser treatment in improving bond strength, with 10-MDP in bonding agents enhancing zirconia bonding efficacy.

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 alpha-humulene incorporation on the properties of experimental light-cured periodontal dressings

The objective of this study was to formulate an experimental light-cured periodontal dressing containing alpha-humulene and to compare its physical, antimicrobial, and cytotoxicity properties with commercial gold standards (Barricaid® and Periobond®). Two periodontal dressing formulations were developed (a and b). The formulations were divided into 5 groups according to the alpha-humulene concentration as follows: Ea - control group, Ea1 - 1%, Ea5 - 5%, Ea10 - 10%, and Ea20 - 20%; Eb - control group, Eb1 - 1%, Eb5 - 5%, Eb10 - 10%, and Eb20 - 20%. Materials characterization was performed using the degree of conversion, cohesive strength, sorption, and solubility assays. Antimicrobial assay was performed using the modified direct contact test against E. faecalis and S. aureus. Cytotoxicity was assessed by the cell viability experiment using L929 fibroblasts. In general, the cohesive strength values of materials decreased as the alpha-humulene concentration increased. All the experimental dressings showed antimicrobial activity against both bacteria tested. Cell viability results for the Ea, Ea1, Eb, and Eb1 groups showed moderate cytotoxic effect. The formulations containing alpha-humulene showed similar behavior to the commercial references. Thus, formulations containing alpha-humulene have potential to be used as periodontal dressing.

Evaluation of Tensile Bond Strength between Self-Adhesive Resin Cement and Surface-Pretreated Zirconia

The tensile bond strength between zirconia subjected to different surface-pretreatment methods and methacryloyloxydecyl-dihydrogen-phosphate (MDP)-containing self-adhesive resin cement was evaluated herein. Eighty-eight cylindrical zirconia specimens were randomly divided into the following four groups based on the pretreatment method: (1) no treatment, (2) air abrasion, (3) HNO3/HF etching, and (4) zirconia-nanoparticle coating. The tensile bond strength of the zirconia−resin-cement complexes was investigated. One-way ANOVA and post hoc tests were performed at a 95% significance level, and the Weibull modulus was calculated. Fracture patterns were visualized by SEM. The surface roughness of the specimens without resin bonding was evaluated by AFM. The tensile bond strength of the specimens decreased as follows: Groups 3 > 4 > 2 > 1 (28.2 ± 6.6, 26.1 ± 5.7, 16.6 ± 3.3, and 13.9 ± 3.0 MPa, respectively). Groups 3 and 4 had significantly higher tensile bond strengths (p < 0.05) and lower fracture probabilities than those of Groups 1 and 2. They also showed both mixed failure and resin-cement cohesive failure, whereas Groups 1 and 2 showed mixed failure exclusively. The zirconia−resin tensile bond was stronger after HNO3/HF etching or ZrO2-nanoparticle coating than after air abrasion or no treatment. The estimated surface roughness decreased as follows: Groups 3 > 4 > 2 > 1. The combination of zirconia pretreated with HNO3/HF etching or ZrO2-nanoparticle coating and an MDP-containing self-adhesive resin cement can increase the clinical longevity of zirconia restorations by preventing their decementation.

Current scenario on adhesion to zirconia; surface pretreatments and resin cements: A systematic review

Several methods have been proposed to increase bonding of zirconia with resin. However, we are still to find the Holy Grail. A systematic literature review was performed through PubMed on international literature from January 2000 to May 2021 with relevant Medical Subject Headings terms. 56 articles were found to be relevant. Of all the different methods proposed, mechanochemical pretreatment of zirconia surface with alumina oxide and use of 10-methacryloyloxydecyl dihydrogen phosphate were found to be most effective as per majority of studies. New methods that require further research also surfaced.

Investigations of silane-MDP interaction in universal adhesives: A ToF-SIMS analysis

OBJECTIVES

The purposes of this study were to investigate whether the presence of silane in universal adhesives affects the functions of 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and adhesion to zirconia.

METHODS

Two silane-containing universal adhesives (Scotchbond Universal (SBU) and Clearfil Universal-Bond (CUB)) and two silane-free adhesives (All-Bond Universal (ABU) and SE-Bond primer (SE)) were individually applied on zirconia disks. Time-of-flight secondary-ion-mass-spectrometry (ToF-SIMS) examined the distributions of MDP- and silane-related ions, as well as evidence of zirconium phosphate (ZrP) compounds, on the surface and interfacial regions using a depth profiling mode. The hydrophilicity and resin wettability of the treated zirconia were examined using a contact angle test. For the shear bond strength (SBS) test, the zirconia disks were air-blasted, treated with the assigned adhesives, and bonded with pre-cured composite cylinders using a resin cement. These resin-zirconia assemblies received a bond test after 24-h storage.

RESULTS

Both SBU and CUB exhibited silane-related ions and ZrO₂(OH)^-, but fewer PO^- ions in the interfacial regions. CUB had more siloxane-related ions. SE-treated zirconia had abundant PO^- ions and particularly high PO₃^-- and ZrP- related ions in the interfacial regions. The silane-free adhesives exhibited a higher affinity to both water and adhesive liquids. SE showed significantly higher SBSs compared to ABU, while SBU and CUB were not statistically different.

SIGNIFICANCE

The silane content may cause hydroxylation of zirconia and affect MDP adsorption. An acidic pH accelerated the condensation of silanol. The bond performance of the MDP-based adhesive could be influenced by the silane content and other components.

Adhesion to Zirconia: A Systematic Review of Surface Pretreatments and Resin Cements

This systematic review aims to evaluate the different pretreatments of the zirconia surface and resin cement in order to determine a valid operative protocol for adhesive cementation. Methodologies conducted for this study followed the Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. An electronic search was performed in four databases. The established focus question was: “What type of surface conditioning method is the one that obtains the best adhesion values to zirconia over time by applying a resin cement?” Forty-five relevant papers were found to qualify for final inclusion. In total, 260 different surface pretreatment methods, mainly combinations of air-abrasion protocols and adhesive promoters, were investigated. Altogether, the use of two artificial aging methods, three types of cement and four testing methods was reported. The results showed that mechanicochemical surface pretreatments offered the best adhesive results. Self-adhesive cement and those containing 10-MDP obtained the best results in adhesion to zirconia. Artificial aging reduced adhesion, so storage in water for 30 days or thermocycling for 5000 cycles is recommended. A standardized adhesive protocol has not been established due to a lack of evidence

The effect of different ceramic surface treatments on the repair bond strength of resin composite to lithium disilicate ceramic

This study aimed to evaluate the bonding abilities and long-term durability of different repair agents when applied to lithium disilicate ceramics (LDS). Blocks of IPS e.max CAD were prepared and divided into four groups according to the surface treatment: Monobond Etch & Prime (ME), K-etchant GEL+Clearfil Universal Bond (UB), Bondmer Lightless (BL), and K-etchant GEL+G-Multi Primer (GMP). All treated ceramic specimens were bonded to resin composite and light-cured. The micro-shear bond strength was measured after 24 h of water storage or 5,000 thermocycles. ME and BL showed significantly higher initial bond strengths than UB and GMP (p<0.05). After 5,000 thermocycles, there was no significant difference in ME (p>0.05), but BL and GMP showed considerable reduction in bond strength (p<0.05); moreover, the samples of UB were all de-bonded before testing. ME and BL proved to be effective surface treatment materials for LDS.

Shear bond strength between gingival composite resin and glazed gingival porcelain for implant-supported prostheses

This study determined the shear bond strength (SBS) between an indirect gingival composite resin and glazed gingival porcelain after various surface treatments. A total of 176 porcelain disks with natural glazing were used and assigned to one of four groups: no surface treatment, airborne-particle abrasion, hydrofluoric acid etching, or a combination of airborne-particle abrasion followed by hydrofluoric acid etching. Each group was divided into two subgroups: one subgroup was unprimed, and the other was silanized. An indirect composite resin was then bonded to the porcelain disks. Half of the specimens in each group (n = 11) were exposed to 5000 thermocycles. SBSs were measured, and data were analyzed with the Kruskal-Wallis and Steel-Dwass tests. Among silanized specimens, those treated with the combination of airborne-particle abrasion and hydrofluoric acid etching exhibited the highest bond strengths both before and after thermocycling. However, the SBS values of the silanized and unprimed hydrofluoric acid etched specimens did not differ significantly. Airborne-particle abrasion followed by hydrofluoric acid etching with silane application yielded stronger, more durable bonds between the indirect gingival composite resin and glazed gingival porcelain.

The effect of curing mode of dual-cure resin cements on bonding performance of universal adhesives to enamel, dentin and various restorative materials

The effect of curing mode of dual-cure resin cements on the tensile bond strength (TBS) of universal adhesives to enamel, dentin, zirconia, lithium disilicate ceramics (LDS), feldspathic porcelain (FP), and a Pd-Au alloy was evaluated. The substrates were bonded using Tokuyama Universal Bond (TUB) or Scotchbond Universal Adhesive (SBU), followed by luting with Estecem II (ECII) or Rely-X Ultimate (RXU), respectively, which were used either in light-curing or self-curing mode. The TBS test was performed after 24 h or 5,000 thermal cycles. Light-curing significantly improved the 24-h TBS of TUB/ECII to enamel, dentin and FP, as well as the TBS of SBU/RXU to all substrates except LDS. After thermal cycling, light-curing significantly increased the TBS of both adhesives/cements to dentin, but significant differences between curing modes were seldom observed for other substrates. This suggested that light-curing is essential for the hydrophilic dentin, but self-curing might be sufficient for other substrates.

Long-term evaluation of warm-air treatment effect on adaptation of silane-containing universal adhesives to lithium disilicate ceramic

The effect of warm air-blowing on the sealing ability of two one-bottle and one two-bottle silane-containing universal adhesives (UAs) applied to lithium disilicate ceramics (LDS) was evaluated. Tapered cavities prefabricated in LDS blocks (IPS e.max CAD) were treated by the adhesives, air-blown either with normal air (23±1°C) or warm air (60±5°C), and filled with a flowable resin composite. Interfacial gap formation was observed using swept-source optical coherence tomography immediately after filling, after 24 h, 5,000 and 10,000 thermal cycles, and an additional 1-year water storage. Specimens bonded using normal air-blown one-bottle UAs exhibited a significantly higher gap formation than the two-bottle UA (p<0.001), and detached within 24 h. Warm air-blowing significantly decreased the gap formation of one-bottle UAs (p<0.001), but the specimens dislocated within 24 h or during thermocycling. The two-bottle UA withstood all aging procedures and warm air-blowing significantly decreased its 1-year gap formation compared to normal air-blowing (p=0.002).

In Vitro Analysis of Quality of Dental Adhesive Bond Systems Applied in Various Conditions

Introduction: There are several methods of reducing a microleakage, and one of them is choosing appropriate adhesive material. The aim of the work was the in vitro analysis of 4 bonds: 3M ESPE “Single bond”, Dentsply “Prime and Bond Active”, Coltene “One Coat 7 Universal”, and Kuraray “Clearfil Universal Bond Quick”. Material and methods: 136 healthy molar teeth were collected and randomly split into 4 groups and Vth Class cavities were prepared. Chosen adhesives were used in four groups of teeth with the same composite. Teeth were the thermocycled, sealed, covered with lacquer, and submerged in 1% methylene blue solution for 24 h. After the thermocycling, the vertices of each tooth were sealed using dental wax. Each tooth was then fully covered with lacquer. All teeth were then submerged into 1% methylene blue solution for 24 h in room temperature. In the next step they were transversely cut through a center of restoration. The Olympus BX43 microscope was used to photograph each cut tooth. With the usage of Olympus stream software, measurement of the dye’s leakage was performed. Results. The statistical analysis proved that the most effective material when applied to ideally prepared cavity surface was Dentsply “Prime and Bond Active”. The second material was 3M ESPE “Single Bond”, third—Coltene “One Coat 7 Universal” and fourth—Kuraray “Clearfil Universal Bond Quick”. The most effective material applied to a too-dry surface was Dentsply “Prime and Bond Active”, second—3M ESPE “Single Bond”, third—Coltene “One Coat 7 Universal” and fourth—Kuraray “Clearfil Universal Bond Quick”. When it comes to too damp surfaces the best results were obtained with Dentsply “Prime and Bond Active” then Coltene “One Coat 7 Universal”, 3M ESPE “Single Bond” and Kuraray “Clearfil Universal Bond Quick”. Conclusion: The level of cavity dampness influences the quality of adhesives. Better results are obtained with over-dried surfaces than over-damp, which is connected with the dilution of the material.

Bonding Strength of Universal Adhesives to Indirect Substrates: A Meta-Analysis of in Vitro Studies

PURPOSE

To evaluate the in vitro bond strength of universal adhesive systems to indirect substrates.

MATERIAL AND METHODS

Two reviewers performed a literature search up to March 2018 in seven databases: PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO. The review included studies that compared the bond strength of universal adhesives and well-established material-specific primers to indirect substrates: lithium disilicate ceramic, yttrium-stabilized zirconium dioxide ceramic, leucite-reinforced ceramic, feldspathic porcelain, polymer infiltrated ceramic material, resin composite or metal alloys. Analyses were carried out using RevMan 5.3.5. A global comparison was performed with the standardized mean difference using a random-effects models at a significance level of p < 0.05.

RESULTS

A total of 45 studies were included in the qualitative analysis, and the meta-analysis was performed with 42 studies. Bond strength to glass-based ceramics and alloys was improved with the use of a specific-primer as separate step before the bonding procedures (lithium disilicate, p < 0.001; alloys, p < 0.001). The bond strength to zirconium substrates was improved with the use of universal adhesives (p < 0.001). For bond strength to composite resin as indirect substrate, universal adhesives performed in a manner similar to that of the material-specific primer (p = 0.11).

CONCLUSIONS

The clinical procedure of luting zirconia and resin composite restorations could be simplified by using single-bottle universal adhesives. However, the ability of universal adhesives to achieve an adequate and durable bond to glass-based ceramics and alloys appears to be limited.

Adhesion to Zirconia: A Systematic Review of Current Conditioning Methods and Bonding Materials

Background. Reliable bonding between resin composite cements and high strength ceramics is difficult to achieve because of their chemical inertness and lack of silica content that makes etching impossible. The purpose of this review is to classify and analyze the existing methods and materials suggested to improve the adhesion of zirconia to dental substrate by using composite resins, in order to explore current trends in surface conditioning methods with predictable results. Methods. The current literature, examining the bond strength of zirconia ceramics, and including in vitro studies, clinical studies, and a systematic review, was analyzed. The research in the literature was carried out using PubMed and Cochrane Library databases, only papers in English, published online from 2013 to 2018. The following keywords and their combinations were used: Zirconia, 3Y-TZP, Adhesion, Adhesive cementation, Bonding, Resin, Composite resin, Composite material, Dentin, Enamel. Results. Research, in PubMed and Cochrane Library databases, provided 390 titles with abstracts. From these, a total of 93 publications were chosen for analysis. After a full text evaluation, seven articles were discarded. Therefore, the final sample was 86, including in vitro, clinical studies, and one systematic review. Various adhesive techniques with different testing methods were examined. Conclusions. Airborne-particle abrasion and tribo-chemical silica coating are the pre-treatment methods with more evidence in the literature. Increased adhesion could be expected after physico-chemical conditioning of zirconia. Surface contamination has a negative effect on adhesion. There is no evidence to support a universal adhesion protocol.

Aged Translucent Aesthetic Zirconia: Bond Strength Analysis

Objective This study evaluates the bond strength of two compositions of aesthetic translucent zirconia (TZ).

Materials and Methods For this evaluation, test specimens were prepared from ICE Zirkon TZ and Prettau Anterior zirconia (PAZ) that were stored in distilled water at 37°C for two time periods: T1 (24 h) and T2 (90 days) to simulate aging. Two factors were evaluated for the samples—ceramic and aging time. The samples were subjected to tests of microshear strength and fracture type and were evaluated using scanning electron microscopy.

Results The results were analyzed using the D'Agostino test, analysis of variance, and Tukey's test ( p < 0.01). Statistically significant differences were observed for ceramic type and aging time.

Conclusion The results showed that PAZ provides significantly superior performance to TZ at the two aging times evaluated.

Bonding of different self-adhesive resins to high-strength composite resin block treated with surface conditioning

PURPOSE

This study aimed to evaluate the effects of chemical conditioning and self-adhesive resins (SARs) on the bonding of mechanically conditioned high-strength composite resin block (HSCRB).

METHODS

Eighteen sections of HSCRB (KZR-CAD HR 3 Gammatheta, Yamakin) were treated with alumina air abrasion and randomly divided into 3 groups according to the SARs for bonding: RelyX Unicem 2 (RXU), SA Luting Plus (SAL), and G-Cem ONE (GCO). The sections were further divided into 3 subgroups according to the chemical conditioning of the adherend surfaces: no conditioning (C), universal adhesive (UA), and a mixture of γ-MPTS and 10-MDP (MM). After the surface conditioning, the sections were cemented with the SARs. Each cemented section was cut into 40 beams. Half of the beams were thermocycled (4°C/60°C, 10,000 cycles). The micro-tensile bond strength (μTBS) values were measured using a universal testing machine. Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), contact angles, and surface roughness measurements were performed on the adherend surfaces of each subgroup.

RESULTS

RXU showed the highest μTBS values among the 3 SARs tested, while MM application exhibited the highest μTBS values among the 3 chemical conditioning methods tested. After thermocycling, the samples in the RXU/MM, RXU/UA, and GCO/MM groups showed no significant changes in the μTBS values, whereas the others showed a significant reduction.

CONCLUSIONS

The bond strength of HSCRB was influenced by the chemical conditioning, SARs, and aging. γ-MPTS and 10-MDP application yielded higher μTBS values of mechanically treated HSCRB than the UA.

Effect of a filled adhesive as the desensitizer on bond strength of "Self-Adhesive Cements To" differently severity of fluorosed dentin

The objectives were to evaluate the efficacy of a filled adhesive named Prime & Bond NT (P&B NT) as the dentin desensitizer in occluding fluorosis dentinal tubules and compare the shear bond strength (SBS) of RelyX U200 self-adhesive resin cement (RXU) and RelyX Luting self-adhesive resin-modified glass ionomer cement (RMGIC) before and after P&B NT pretreatment. 176 non-carious fluorosis were classified into four subgroups by the Thylstrup and Fejerskov index (TFI): normal group (TFI = 0), mild group (TFI = 1-3), moderate group (TFI = 4-5), severe group (TFI = 6-9). 160 composite cylinders (4 × 5 mm) were fabricated, then every severity of fluorosed dentin was subjected to four treatments: P&B NT + RXU (n = 40), RXU (n = 40), P&B NT + RMGIC (n = 40), RMGIC (n = 40). The specimens were immersed in water at 37°C for 24 hr first and half of them underwent 5,000 thermocycling before shear bond strength test. A factorial design (factorial 4 × 2 × 2 × 2) was developed to make statistical analysis. Scanning electron microscope (SEM) analysis (n = 16) in cross section and longitudinal section view characterized the occlusion situation of dentinal tubules. P&B NT might occlude dentinal tubules as the dentin desensitizer for normal teeth and mild-moderate fluorosis. P&B NT significantly increased the SBS of RXU (p < .05) but had no statistical significance on the SBS of RMGIC (p > .05). RXU could benefit from P&B NT desensitization to achieve a better quality of adhesion.