title: Effect Of Nd:YAG laser and CO2 laser treatment on the resin bond strength to zirconia ceramic. Resistance to bond degradation between dual-cure resin cements and pre-treated sintered CAD-CAM dental ceramics Effects of different surface treatments on bond strength between resin cements and zirconia ceramics. Effect of thermocycling on the bond strength between dual-cured resin cements and zirconium-oxide ceramics. The effect of different power outputs of carbon dioxide laser on bonding between zirconia ceramic surface and resin cement Effect of conditioning methods on the microtensile bond strength of phosphate monomer-based cement on zirconia ceramic in dry and aged conditions. Association of different primers and resin cements for adhesive bonding to zirconia ceramics. Investigational study of the use of Er:YAG laser versus dental drill for caries removal and cavity preparation--phase I. The influence of surface modification techniques on the performance of a Y-TZP dental ceramic. Improved bonding of zirconia substructures to resin using a "glaze-on" technique. The effect of nano-structured alumina coating on resin-bond strength to zirconia ceramics. Effect of various surface conditioning methods on the adhesion of dual-cure resin cement with MDP functional monomer to zirconia after thermal aging. Effect of an experimental zirconia-silica coating technique on micro tensile bond strength of zirconia in different priming conditions. Bond strength of resin cement to zirconia ceramic with different surface treatments New zirconia primer improves bond strength of resin-based cements. Effect of etching and airborne particle abrasion on the microstructure of different dental ceramics. A new modified laser pretreatment for porcelain zirconia bonding. Effect of surface conditioning methods on the bond strength of luting cement to ceramics. Influence of different adhesive resin cements on the fracture strength of aluminum oxide ceramic posterior crowns. The Effect of Laser Treatment on Bonding Between Zirconia Ceramic Surface and Resin Cement Shear bond strength of resin cement to zirconia ceramic after aluminum oxide sandblasting and various laser treatments. Effect of surface pre-treatments on the zirconia ceramic-resin cement microtensile bond strength. Effect of surface treatments and aging in water on bond strength to zirconia. Influence of sandblasting granulometry and resin cement composition on microtensile bond strength to zirconia ceramic for dental prosthetic frameworks. Durable bonding to mechanically and/or chemically pre-treated dental zirconia.
abstract: OBJECTIVE this study evaluated the effect of surface treatments ( Nd : YAG laser , CO2 laser , Al203 airborne-particle abrasion , and silica-coating ) on the  zirconia-to-resin shear bond strength ( SBS ) .  METHOD AND MATERIAL S eighty-one Lava ( 3 M ESPE ) blocks ( 13 x 4 x 2 mm ) were embedded in acrylic resin , polished , and r and omly divided into three groups , which received the following surface treatments : no abrasion , Al203 airborne-particle abrasion ( 50 Μm ) , or silica-coating ( Cojet , 3 M ESPE ) . Each group was divided into three subgroups that were treated with Nd : YAG laser , CO2 laser , or no laser irradiation . Following application of a monomer phosphate-containing primer , cylinders of resin cement ( Panavia F , Kuraray ) ( n = 18 ) were built on the surface . SBS testing was carried out after 24 hours of storage in water . Surface roughness and topography ( SEM ) after treatments were evaluated . RESULTS according to ANOVA and Tukey test ( α = 0.05 ) , mean SBS after Nd : YAG laser treatment ranged from 14.09 to 16.20 MPa and was statistically higher than CO2 laser ( 6.24 to 10.51 MPa ) and no laser treatment ( 4.65 to 8.79 MPa ) . The Nd : YAG laser created more roughness on zirconia when compared to the CO2 laser and abrasion treatments . Silica-coating increased the SBS of lased and nonlased zirconia . Significant microcracks were found on specimens treated with CO2 . CONCLUSION Nd : YAG laser pretreatment , whether associated with abrasion methods or not , created consistent roughness on the zirconia surface and significantly increased zirconia SBS to Panavia F. Silica-coating could potentially increase the SBS of lased and nonlased zirconia . Significant microcracks were found on specimens treated with the CO2 laser Objective : To evaluate the bond stability of resin cements when luted to glass-reinforced alumina and zirconia CAD/CAM dental ceramics . Study design : Eighteen glass-infiltrated alumina and eighteen densely sintered zirconia blocks were r and omly conditioned as follows : Group 1 : No treatment ; Group 2 : S and blasting ( 125 µm Al2O3-particles ) ; and Group 3 : Silica-coating ( 50 µm silica-modified Al2O3-particles ) . Composite sample s were r and omly bonded to the pre-treated ceramic surfaces using different resin cements : Subgroup 1 : Clearfil Esthetic Cement ( CEC ) ; Subgroup 2 : RelyX Unicem ( RXU ) ; and Subgroup 3 : Calibra ( CAL ) . After 24 h , bonded specimens were cut into 1 ± 0.1 mm2 sticks . One-half of the beams were tested for microtensile bond strength ( MTBS ) . The remaining one-half was immersed in 10 % NaOCl aqueous solution ( NaOClaq ) for 5 h before testing . The fracture pattern and morphology of the debonded surfaces were assessed with a field emission gun scanning electron microscope ( FEG-SEM ) . A multiple ANOVA was conducted to analyze the contributions of ceramic composition , surface treatment , resin cement type , and chemical challenging to MTBS . The Tukey test was run for multiple comparisons ( p < 0.05 ) . Results : After 24 h , CEC luted to pre-treated zirconia achieved the highest MTBS . Using RXU , alumina and zirconia registered comparable MTBS . CAL failed prematurely , except when luted to s and blasted zirconia . After NaOClaq storage , CEC significantly lowered MTBS when luted to zirconia or alumina . RXU decreased MTBS only when bonded to silica-coated alumina . CAL recorded 100 % of pre-testing failures . Micromorphological alterations were evident after NaOClaq immersion . Conclusions : Resin-ceramic interfacial longevity depended on cement selection rather than on surface pre-treatments . The MDP-containing and the self-adhesive resin cements were both suitable for luting CAD/CAM ceramics . Despite both cements being prone to degradation , RXU luted to zirconia or untreated or s and blasted alumina showed the most stable interfaces . CAL experimented spontaneous debonding in all tested groups . Key words : CAD/CAM ceramic , alumina , zirconia , resin cement , surface pre-treatment , s and blasting , silica-coating , chemical aging , bond degradation , microtensile bond strength This study compares the bond strength of resin cement and yttrium-stabilized tetragonal zirconia polycrystalline ( Y-TZP ) ceramic with different surface conditioning methods . Two hundred presintered Y-TZP ceramic specimens were prepared , sintered ( 4 × 4 × 4 mm ) , and r and omly assigned to four equal groups as control ( C , no conditioning ) ; airborne particle abraded ( APA , air abrasion with 11 μm Al2O3 ) ; tribochemical silica coating/silane coupling system ( TSC , Rocatec , air abrasion with 110 μm Al2O3 , 30 μm silica-coated Al2O3 and silane ) ; and laser ( L , Er : YAG laser irradiation treated at a power setting of 200 mJ ) . After specimen preparation , composite resin cylinders were prepared and cemented with resin cements ( Clearfil Esthetic , Panavia F 2.0 , Rely X-U100 , Super Bond C&B , and Multilink Automix ) on the ceramic surfaces and kept in an incubator at 37 ° C for 60 days . All specimens were tested for shear bond strength with a universal testing machine , and fractured surfaces were evaluated by environmental scanning electron microscopy . Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-tests ( α=0.05 ) . The bond strengths for C and L groups were not significantly different according to adhesive resin cement . APA and TSC result ed in increased bond strength for Panavia F 2.0 and Rely X-U100 resin cements . Additionally , TSC presented higher bond strength with Multilink Automix . Adhesive fracture between the ceramic and resin cement was the most common failure . Complete cohesive fracture at the ceramic or composite cylinders was not observed . Regardless of the adhesive resin cement used , laser treatment did not improve resin bond strength The present study evaluated the durability of bond strength between zirconia and 3 different resin cements . Thirty stabilized tetragonal zirconium-dioxide blocks were duplicated in dual-curing resin core build-up material specimens . Resin blocks were r and omly luted to zirconium surfaces using 1 ) Clearfil Esthetic Cement ( CLF ) , 2 ) RelyX Unicem Aplicap ( RELX ) , or 3 ) Multilink Automix ( MLA ) . After 24 h , half of the specimens from each of the 3 groups were loaded in tension until fracture ( 0.5 mm/min ) . The remaining half were tested after 6,000 thermal cycles ( 5 to 55 ° C ) . Data were analyzed using 2-way ANOVA and the Tukey test ( α = 0.05 ) . Fractographic analysis was performed using a stereomicroscope . Tensile bond strength values were significantly affected by the luting agent system employed and by thermal aging ( P < 0.001 ) . The highest tensile bond strength values in non-thermal-aged groups were observed for specimens from the RELX and CLF groups . In contrast , in the thermal-aged groups , the highest tensile bond strength values were for the MLA and RELX groups . Moreover , while thermocycling significantly affected bond strengths in the RELX and CLF groups , the mean strength of the MLA group did not significantly change after aging . There was little difference in the distribution of failure modes in any group Abstract Objective . The purpose of this in vitro study was to evaluate the influence of different power outputs of a carbon dioxide ( CO2 ) laser on shear bond strength of resin cement to zirconium dioxide-based ceramic . Material s and methods . Fifty zirconium dioxide core specimens ( 10 mm diameter and 2 mm thickness ) were produced and they were embedded in the centers of auto-polymerizing acrylic resin blocks . Ten specimens served as control and no surface treatment was applied . Subsequently specimens were r and omly divided into four groups , each containing 10 specimens for surface treatment with CO2 laser with different output power ; laser treated with 2 W ( Group 2 W ) , 3 W ( Group 3 W ) , 4 W ( Group 4 W ) and finally 5 W ( Group 5 W ) . Fifty composite resin discs were fabricated and cemented with adhesive resin cement to the specimen surfaces . A universal test machine was used for shear bond strength test at a crosshead speed 1 mm/min . Data were statistically analyzed by one-way analyses of variance ( ANOVA ) with Post-Hoc Tukey tests ( α = 0.05 ) . Results . It was found that the shear bond strength values were affected by power outputs of laser ( p < 0.05 ) . Highest shear bond strength values were obtained with group 2 W ( 21.0 ± 2.7 ) . Lowest values were obtained with group 5 W ( 14.4 ± 1.6 ) . Conclusion . The current study revealed that there was a relationship between laser output power and shear bond strength for zirconium dioxide ceramics . However , output power of the laser and the energy level is a critical factor on micromechanical retention The objective of this study was to evaluate the durability of bond strength between a resin cement and aluminous ceramic su bmi tted to various surface conditioning methods . Twenty-four blocks ( 5 x 5 x 4 mm(3 ) ) of a glass-infiltrated zirconia-alumina ceramic ( In-Ceram Zirconia Classic ) were r and omly divided into three surface treatment groups : ST1-Air-abrasion with 110-mum Al2O3 particles + silanization ; ST2-Laboratory tribochemical silica coating method ( 110-microm Al2O3 , 110-microm silica ) ( Rocatec ) + silanization ; ST3-Chairside tribochemical silica coating method ( 30-microm SiO(x ) ) ( CoJet ) + silanization . Each treated ceramic block was placed in its silicone mold with the treated surface exposed . The resin cement ( Panavia F ) was prepared and injected into the mold over the treated surface . Specimens were sectioned to achieve nontrimmed bar specimens ( 14 sp/block ) that were r and omly divided into two conditions : ( a ) Dry-microtensile test after sectioning ; ( b ) Thermocycling (TC)-(6,000x , 5 - 55 degrees C ) and water storage ( 150 days ) . Thus , six experimental groups were obtained ( n = 50 ) : Gr1-ST1 + dry ; Gr2-ST1 + TC ( ; ) Gr3-ST2 + dry ; Gr4-ST2 + TC ; Gr5-ST3 + dry ; Gr6-ST3 + TC . After microtensile testing , the failure types were noted . ST2 ( 25.1 + /- 11 ) and ST3 ( 24.1 + /- 7.4 ) presented statistically higher bond strength ( MPa ) than that of ST1 ( 17.5 + /- 8) regardless of aging conditions ( p < 0.0001 ) . While Gr2 revealed the lowest results ( 13.3 + /- 6.4 ) , the other groups ( 21.7 + /- 7.4 - 25 . 9 + /- 9.1 ) showed statistically no significant differences ( two-way ANOVA and Tukey 's test , alpha = 0.05 ) . The majority of the failures were mixed ( 82 % ) followed by adhesive failures ( 18 % ) . Gr2 presented significantly higher incidence of ADHESIVE failures ( 54 % ) than those of other groups ( p = 0.0001 ) . Both laboratory and chairside silica coating plus silanization showed durable bond strength . After aging , air-abrasion with 110-microm Al(2)O(3 ) + silanization showed the largest decrease indicating that aging is fundamental for bond strength testing for acid-resistant zirconia ceramics in order to estimate their long-term performance in the mouth PURPOSE To evaluate the shear bond strength ( SBS ) to zirconia ceramics using different associations of primers and resin cements . MATERIAL S AND METHODS Two blocks of LAVA zirconia ( 3Y-TZP ) were r and omly su bmi tted to an application of three different commercially available primers : Alloy Primer ( AP ) , Z-Prime Plus ( ZP ) , and Signum Zirconia Bond ( SZB ) . Nonprimed specimens were considered controls . After treatment , the 80 specimens ( 5 mm × 5 mm × 2 mm ) were r and omly cemented with one of the resin cements : Panavia F , Multilink , seT , and NX3 . For cementation , cylinders of resin cement were built on the ceramic surfaces using the SDI SBS apparatus . The specimens were su bmi tted to the SBS test . Fractured surfaces were observed under stereomicroscopy to determine the failure mode , and mean bond strength values were analyzed using the Kruskal-Wallis and Mann-Whitney tests ( α = 0.05 ) . RESULTS Signum Zirconia Bond had the highest SBS compared to all other primers and the control group , regardless of the resin cement used . The highest values were obtained when associating Panavia F with Signum Zirconia Bond . Alloy Primer increased bonding values when associated with seT cement only . When no primer was used , no statistical difference was observed among resin cements . All specimens fractured due to adhesive failure . CONCLUSION Signum Zirconia Bond is capable of increasing bonding values of resin cements to zirconia ceramics . Its association with Panavia F shows enhanced results when considering short-term adhesion to zirconia OBJECTIVE We determined that the Er : YAG pulsed 2.94 micron radiation was successful in the removal of caries , cavity preparation , and etching prior to acid etching . SUMMARY BACKGROUND DATA The laser group was compared to a control group in which the high-speed drill was employed . Parameters measured included histological evaluation of the pulp , scanning electron microscopy of the surface morphology of the tooth , dye penetration studies , bond strength measurements , and rating of the laser 's ability to remove caries and form the preparation . METHODS We collectively evaluated 60 patients with 106 teeth in both the laser and control groups over a 1-year period . Teeth were treated in vivo and then extracted immediately , at 2 days , 1 month , and up to 1-year to assess pulpal healing , surface morphology , and the quality of the preparation , restoration , and pain . RESULTS The dental laser was shown to be equal or better than the drill in the tested procedures of caries removal , cavity preparation , and etching prior to acid etching . The scanning electron microscopy revealed no microfracturing , open dentinal tubules , and effective etching with the laser having a mean of 2.7 with an optimum rating of 3 . The histological testing confirmed that the pulp was not compromised using the laser with scores of theta for hemorrhage , 0.47 for hyperemia , and 0.12 for inflammation on a scale of 0 to 3 where 0 is no effect . CONCLUSIONS The FDA has recently cleared the Er : YAG to remove all classes of caries , form the cavity preparation , and modify the enamel and dentin prior to acid etching . In this Phase I study conducted as part of the clinical trials , there were no complications and no tooth was compromised . Patients were consistently treated without anesthesia with the same or better results than the drill as confirmed by scanning electron microscopy and histological studies OBJECTIVES The purpose of the current study was to examine the influence of the pre-cementation surface modification techniques , namely alumina abrasion and surface grinding , routinely employed by dental practitioners prior to cementation and placement of crown and bridge restorations on the performance of a Y-TZP dental ceramic . METHODS Twelve sets of 30 Lava ceramic discs ( 13 mm diameter , 1.5 mm thickness ) supplied by the manufacturer were r and omly selected . Six groups were  abraded utilising 25 , 50 and 110 microm alumina and stored dry or in a water bath at 37+/-1 degrees C for 24 h. Four groups were ground utilising a fine or a coarse grit diamond bur , specimens were ground dry or while using water as a coolant . The mean bi-axial flexure strengths , st and ard deviations and associated Weibull moduli ( m ) were determined . The surface roughness , hardness and phase composition were assessed utilising profilometry , the Vicker 's hardness indentation and X-ray diffraction , respectively . RESULTS No significant difference ( P > 0.05 ) was identified in the bi-axial flexure strength of the 25 , 50 and 110 microm alumina-abraded and the control specimens stored dry and wet for 24h . However , a significant increase in m was identified for the alumina-abraded specimens stored dry ( 10.7+/-1.9 , 10.6+/-1.9 and 10.6+/-1.9 ) compared with the control ( 7.5+/-1.3 ) and the specimens stored in a water bath . In addition , the alumina abrasion regimes reduced the surface roughness compared with the controls . The coarse grinding regime significantly reduced both the bi-axial flexure strength and the associated m compared with the control whilst no significant difference was identified for the fine grinding regimes . The surface modification techniques initiated a phase transformation mechanism and result ed in the formation of a layer of compressive stresses on the surface of the disc-shaped specimens . CONCLUSIONS The combination of the reduced surface roughness and the formation of a surface layer of compressive stress as a result of the alumina abrasion regimes investigated increased the reliability of the bi-axial flexure strength . The presence of water in the current study did not detrimentally influence the performance of the Y-TZP ceramic under investigation . Coarse grinding significantly reduced the bi-axial flexure strength and m due to the increased surface roughness . The Y-TZP specimens in the current investigation underwent a toughening mechanism as a result of a phase transformation mechanism which generated a transformation compressive stress that opposes the externally applied , crack-propagating tensile stress OBJECTIVE To investigate the influence of applying thin intermediary coatings of acid-etchable glasses on the shear bond strength between a methacrylate resin based cement and an yttria-stabilized zirconia dental ceramic substrate . METHODS The upper and lower surfaces of 110 sintered yttria-stabilised tetragonal zirconia polycrystalline disc-shaped specimens were polished using sequential grade s of Silicon Carbide , then air-abraded with 25 μm diameter alumina particles . Specimens were r and omly allocated to 11 groups ( A-K ) ( n=10 ) , group A acting as control . The upper surface of Group A specimens was subjected to a tribochemical coating regime ( CoJet , 3 M ESPE ) . Five glazing ceramics were applied and fired according to the manufacturer 's recommended firing regime . The glaze was etched with 10 % HF acid and all specimens coated with a silane primer . Two differing storage regimes were employed ( wet storage vs thermocycling ) . Shear bond strength testing specimens were created by cementing resin-based composite cylinders to the centre of the prepared ceramic surface using Rely-X Unicem ( 3 M ESPE ) resin based cement . Shear bond strength testing was performed and load at failure recorded . RESULTS A factorial analysis of variance at a 95 % significance level demonstrated that all glazing techniques result ed in a significant increase in the shear bond strength compared with using the resin based cement alone ( P<0.01 ) , with the different glazing ceramics result ing in significant differences in mean shear bond strength ( P=0.008 ) . The differences were a function of the storage state ( wet storage vs thermocycling ( P=0.013 ) ) . CONCLUSION The glazing techniques used in the current investigation result ed in a significantly enhanced shear bond stress to the resin based cement when compared with the current ' gold st and ard ' - tribochemical coating OBJECTIVES The aim of this study was to functionalize the surface of yttria partially stabilized tetragonal zirconia ceramics ( Y-TZP ) with a nano-structured alumina coating to improve resin bonding . MATERIAL S AND METHODS A total of 120 densely sintered disc-shaped specimens ( 15.5+/-0.03 mm in diameter and 2.6+/-0.03 mm thick ) were produced from biomedical- grade TZ-3YB-E zirconia powder ( Tosoh , Tokyo , Japan ) , r and omly divided into three groups of 40 and subjected to the following surface treatments : AS - as-sintered ; APA - airborne-particle abraded ; POL - polished . Half of the discs in each group received an alumina coating that was fabricated by exploiting the hydrolysis of aluminium nitride ( AlN ) powder ( groups AS-C , APA-C , POL-C ) . The coating was characterized using scanning electron microscopy ( SEM ) , atomic force microscopy ( AFM ) , and transmission electron microscopy ( TEM ) . The shear-bond strength of the self-etching composite resin ( RelyX Unicem , 3 M ESPE , USA ) was then studied for the coated and uncoated surfaces of the as-sintered , polished and airborne-particle abraded specimens before and after thermocycling ( TC ) . RESULTS The SEM/TEM analyses revealed that the application of an alumina coating to Y-TZP ceramics created a highly retentive surface for resin penetration . The coating showed good surface coverage and a uniform thickness of 240 nm . The resin-bond strength to the groups AS-C , APA-C , POL-C was significantly higher than to the groups AS , APA and POL , both before and after TC ( p < or = 0.05 ) . During TC all the specimens in the POL and AS groups debonded spontaneously . In contrast , the TC did not affect the bond strength of the AS-C , POL-C and APA-C groups . SIGNIFICANCE A non-invasive method has been developed that significantly improves resin-bond strength to Y-TZP ceramics . After surface functionalization the bond survives thermocycling without reduction in strength . The method is relatively simple and has the potential to become an effective conditioning method for zirconia ceramics This study evaluated the effect of chairside and laboratory types of surface conditioning methods on the adhesion of dual-cure resin cement with MDP functional monomer to zirconia ceramic after thermocycling . Disk-shaped ( diameter : 10 mm , thickness : 2 mm ) Y-TZP ceramics ( Lava , 3 M ESPE ) were used ( N=40 ) and finished with wet 1200-grit silicon carbide abrasive paper . Specimens were r and omly divided into four experimental groups according to the following surface conditioning methods ( n=10 per group ) : Group 1 - -Chairside airborne particle abrasion with 50-microm Al2O2 + Alloy Primer ( Kuraray ) ; Group 2 - -Airborne particle abrasion with 50-microm Al2O3 + Cesead II Opaque Primer ( Kuraray ) ; Group 3 - -Airborne particle abrasion with 50-microm A12O3 + Silano-Pen + silane coupling agent ( Bredent ) ; Group 4 - -Laboratory tribochemical silica coating ( 110-microm Al2O3 + 110-microm SiOx ) ( Rocatec ) + silane coupling agent ( ESPE-Sil ) . Adhesive cement , Panavia F 2.0 ( Kuraray ) , was bonded incrementally to the ceramic surfaces using polyethylene molds ( diameter : 3.6 mm , height : 5 mm ) . All specimens were thermocycled ( 5 and 55 degrees C , 6,000 cycles ) and subjected to shear bond strength test ( 1 mm/min ) . Data were statistically analyzed ( one-way ANOVA , alpha=0.05 ) , whereby no significant differences were found among the four groups ( 8.43+/-1.3 , 8.98+/-3.6 , 12.02+/-6.7 , and 8.23+/-3.8 MPa ) ( p=0.1357 ) . Therefore , the performance of chairside conditioning methods used for zirconia was on par with the laboratory alternative tested OBJECTIVES This study aim ed to evaluate the adhesive properties of a MDP-containing resin cement to a colored zirconia ceramic , using an experimental zirconia-silica coating technique with different priming conditions . METHODS 18 zirconia ceramic discs ( Cercon base colored ) were divided into two groups : the control group and the experimental zirconia-silica coating group . Specimens in each group were further divided into 3 subgroups ( n = 3 ) according to the priming conditions : no primer , a MDP-containing primer ( ED Primer II ) or a silane coupling primer ( RelyX ™ Ceramic Primer ) . Then resin-composite discs ( Filtek ™ Z250 ) were bonded to the treated surface using a MDP-containing resin cement ( Panavia F 2.0 ) . The bi-layered specimens were cut into microbars and 20 microbars were r and omly selected from each specimen , half of which were stored in 37 ° C water bath for 24h , and the other half were stored for 30 days . After water storage , the sample s were exposed to a micro tensile bond strength test ( MTBS ) . The results were analyzed by ANOVA , while the fracture surfaces were examined by SEM . RESULTS After 24h water storage , zirconia-silica coating followed by silanization showed a significantly ( P<0.001 ) higher MTBS value 45.0 (10.9)MPa . Water storage affected ( P<0.05 ) MTBS in the control group ( 24.1 - 30.3 MPa to 2.8 - 3.1 MPa ) , but only partially in the zirconia-silica coating group ( 20.0 - 45.1 MPa to 17.4 - 25.9 MPa ) . SEM analysis revealed a failure mode change after water storage . SIGNIFICANCE The combination of zirconia-silica coating with silane coupling can improve the bonding of resin cement to this colored zirconia Zirconia-based ceramics offer strong restorations in dentistry , but the adhesive bond strength of resin cements to such ceramics is not optimal . This study evaluated the influence of surface treatments on the bond strength of resin cement to yttrium-stabilized tetragonal zirconia ( Y-TZP ) ceramic . Seventy-five plates of Y-TZP ceramic were r and omly assigned to five groups ( n = 15 ) according to the surface treatments [ airborne particle abrasion , neodymium-doped yttrium aluminum garnet ( Nd : YAG ) laser irradiation ( Fidelis Plus 3 , Fotona ; 2 W , 200 mJ , 10 Hz , with two different pulse duration s 180 or 320 μs ) , glaze applied , and then 9.5 % hydrofluoric acid gel conditioned , control ] . One specimen from each group was r and omly selected , and specimens were evaluated with x-ray diffraction and SEM analysis . The resin cement ( Clearfil Esthetic Cement , Kuraray ) was adhered onto the zirconia surfaces with its corresponding adhesive components . Shear bond strength of each sample was measured using a universal testing machine at a crosshead speed of 1 mm/min . Bond strengths were analyzed through one-way ANOVA/Tukey tests . Surface treatments significantly modified the topography of the Y-TZP ceramic . The Nd : YAG laser-irradiated specimens result ed in both increased surface roughness and bond strength of the resin cement . The highest surface roughness and bond strength values were achieved with short pulse duration . Nd : YAG laser irradiation increased both surface roughness of Y-TZP surfaces and bond strength of resin cement to the zirconia surface OBJECTIVE Various chemical interactions can be used to develop ceramic-resin bonding and specific approaches are available for zirconia ceramics . This study evaluated the effect of a new experimental primer , a mixture of organophosphate and carboxylic acid monomers , on the  zirconia-to-resin shear bond strength ( SBS ) . METHODS Forty Y-TZP blocks ( 15x4x2 mm ) were embedded in an acrylic resin base , polished , Al(2)O(3)-s and blasted and r and omly divided into eight groups .  Three different resin-based luting agents ( BisCem , Duo-Link , Panavia F ) were used to build 2.4mm-diameter cylinders ( n=15 ) onto the zirconia surface with and without the new experimental zirconia primer . The new primer was also tested with Z100 restorative composite resin cylinders . In addition , Panavia was used with its own primer ( Clearfil Ceramic Primer ) . SBS testing was carried out after 24h of storage in water . Scanning electron microscopy ( SEM ) was used to evaluate the zirconia surface topography and failure mode . RESULTS According to ANOVA and Tukey test ( alpha=0.05 ) , the association of the experimental primer with the restorative composite resin Z100 yielded the highest SBS ( 29.35MPa ) followed by DuoLink with the new primer ( 26.68MPa ) . The groups that did not receive the experimental primer presented the lowest SBS values ( from 5.95 to 9.79MPa ) . The failure mode was adhesive for the non-primed specimens and predominantly mixed in the primed groups . SIGNIFICANCE The use of the new zirconia experimental primer based on organophosphate/carboxylic acid monomers increased the bond strength of different resin-based luting agents including Z100 restorative material STATEMENT OF PROBLEM The ceramic composition and microstructure surface of all-ceramic restorations are important components of an effective bonding substrate . Both hydrofluoric acid etching and airborne aluminum oxide particle abrasion produce irregular surfaces necessary for micromechanical bonding . Although surface treatments of feldspathic and leucite porcelains have been studied previously , the high alumina-containing and lithium disilicate ceramics have not been fully investigated . PURPOSE The purpose of this study was to assess the surface topography of 6 different ceramics after treatment with either hydrofluoric acid etching or airborne aluminum oxide particle abrasion . MATERIAL AND METHODS Five copings each of IPS Empress , IPS Empress 2 ( 0.8 mm thick ) , Cergogold ( 0.7 mm thick ) , In-Ceram Alumina , In-Ceram Zirconia , and Procera ( 0.8 mm thick ) were fabricated following the manufacturer 's instructions . Each coping was longitudinally sectioned into 4 equal parts by a diamond disk . The result ing sections were then r and omly divided into 3 groups depending on subsequent surface treatments : Group 1 , specimens without additional surface treatments , as received from the laboratory ( control ) ; Group 2 , specimens treated by use of airborne particle abrasion with 50-microm aluminum oxide ; and Group 3 , specimens treated with 10 % hydrofluoric acid etching ( 20 seconds for IPS Empress 2 ; 60 seconds for IPS Empress and Cergogold ; and 2 minutes for In-Ceram Alumina , In-Ceram Zirconia , and Procera ) . RESULTS Airborne particle abrasion changed the morphologic surface of IPS Empress , IPS Empress 2 , and Cergogold ceramics . The surface topography of these ceramics exhibited shallow irregularities not evident in the control group . For Procera , the 50-microm aluminum oxide airborne particle abrasion produced a flattened surface . Airborne particle abrasion of In-Ceram Alumina and In-Ceram Zirconia did not change the morphologic characteristics and the same shallows pits found in the control group remained . For IPS Empress 2 , 10 % hydrofluoric acid etching produced elongated crystals scattered with shallow irregularities . For IPS Empress and Cergogold , the morphologic characteristic was honeycomb-like on the ceramic surface . The surface treatment of In-Ceram Alumina , In-Ceram Zirconia , and Procera did not change their superficial structure . CONCLUSION Hydrofluoric acid etching and airborne particle abrasion with 50-microm aluminum oxide increased the irregularities on the surface of IPS Empress , IPS Empress 2 , and Cergogold  ceramics . Similar treatment of In-Ceram Alumina , In-Ceram Zirconia , and Procera did not change their morphologic microstructure OBJECTIVES The aim of this study was to compare the effects of three different surface treatments in enhancing  porcelain zirconia bonding . METHODS Totally , 160 densely sintered zirconia specimens were prepared and r and omly divided into four study groups : control ( no treatment , Group C ) , s and blasting ( Group S ) , s and blasting followed by regeneration firing ( Group SH ) , and laser irradiation ( pulse mode ) on a CO₂ laser system ( Group L ) . After surface treatment , porcelain powders were veneered on zirconia surface . Half of the specimens in each group were evaluated without aging ( initial shear bond strength - initial SBS ) , and the other half was tested after being stored in water for one month ( aging SBS ) . X-ray diffractometry ( XRD ) was used to observe any crystallographic transformation at zirconia surface . Results were statistically analyzed using analysis of variance ( ANOVA ) and Turkey test ( = 0.05 ) . RESULTS The initial average SBS values of Group S , Group SH , and Group L were 31.3 ± 5.7 MPa , 29.2 ± 7.0 MPa and 32.1 ± 7.5 MPa , respectively . The differences among these three groups were not significant . The control group had significantly lower value , 24.8 ± 6.7 MPa , than those of Group S and Group L. Furthermore , there was no significant difference between initial and aging values in each group . XRD analysis showed that s and blasting  caused tetragonal to monoclinic phase transformation . Regeneration firing reversed such a transformation . However , crystallographic transformation could not be detected in laser treated specimens . SIGNIFICANCE Both s and blasting and laser irradiation  increased porcelain zirconia bond strength . The presented new modified laser pre-treatment might be an alternative way to s and blasting for improving zirconia/porcelain integration OBJECTIVES This study evaluated the effect of three different surface conditioning methods on the bond strength of a Bis-GMA based luting cement to six commercial dental ceramics . METHODS Six disc shaped ceramic specimens ( glass ceramics , glass infiltrated alumina , glass infiltrated zirconium dioxide reinforced alumina ) were used for each test group yielding a total number of 216 specimens . The specimens in each group were r and omly assigned to one of the each following treatment conditions : ( 1 ) hydrofluoric acid etching , ( 2 ) airborne particle abrasion , ( 3 ) tribochemical silica coating . The resin composite luting cement was bonded to the conditioned and silanized ceramics using polyethylene molds . All specimens were tested at dry and thermocycled ( 6.000 , 5 - 55 degrees C , 30 s ) conditions . The shear bond strength of luting cement to ceramics was measured in a universal testing machine ( 1 mm/min ) . RESULTS In dry conditions , acid etched glass ceramics exhibited significantly higher results ( 26.4 - 29.4 MPa ) than those of glass infiltrated alumina ceramics ( 5.3 - 18.1 MPa ) or zirconium dioxide ( 8.1 MPa ) ( ANOVA , P<0.001 ) . Silica coating with silanization increased the bond strength significantly for high-alumina ceramics ( 8.5 - 21.8 MPa ) and glass infiltrated zirconium dioxide ceramic ( 17.4 MPa ) compared to that of airborne particle abrasion ( ANOVA , P<0.001 ) . Thermocycling decreased the bond strengths significantly after all of the conditioning methods tested . SIGNIFICANCE Bond strengths of the luting cement tested on the dental ceramics following surface conditioning methods varied in accordance with the ceramic types . Hydrofluoric acid gel was effective mostly on the ceramics having glassy matrix in their structures . Roughening the ceramic surfaces with air particle abrasion provided higher bond strengths for high-alumina ceramics and the values increased more significantly after silica coating/silanization STATEMENT OF PROBLEM The influence of different types of adhesive resin cements on the long-term prognosis of aluminum oxide ceramic posterior crowns is unclear . PURPOSE The purpose of this study was to evaluate the fracture resistance of  aluminum oxide ceramic on maxillary posterior crowns cemented with different resin luting agents before and after cyclic thermomechanical loading . Material and methods Forty-eight maxillary first molars were prepared and restored with st and ardized aluminum oxide ceramic ( In-Ceram Alumina ) crowns .  The test specimens were r and omly divided into 3 groups ( n=16 ) . The crowns were luted with an acrylic resin cement ( Super-Bond C&B , control , Group SB ) and 2 composite luting agents ( Panavia F , Group PV ; and Rely X Unicem , Group RX ) . Half of the specimens were exposed to thermomechanical fatigue in a masticatory simulator . All specimens were tested for fracture strength ( N ) using quasistatic loading . The Wilcoxon rank sum test was used to compare the fracture strength ( alpha=.05 ) . RESULTS All specimens survived the exposure to the simulator . The following median fracture strength values were obtained without/with thermomechanical fatigue loading : Group SB , 2726 N/2673 N ; Group PV , 2520 N/2083 N ; and Group RX , 2036 N/2369 N. The fracture strength in Group PV after thermomechanical fatigue loading was significantly lower compared to the fracture strength in Group PV without artificial aging ( P = .016 ) , as well as significantly lower compared to Group SB with artificial aging ( P = .003 ) . CONCLUSION Within the limitations of this study , all tested cements are capable of successfully luting aluminum oxide ceramic crowns . The fracture strength of Group PV after artificial aging was comparatively low Abstract Objective . The purpose of this in-vitro study was to evaluate and compare the effects of different surface treatments and laser irradiation on the shear bond strength of resin cement to zirconia-based ceramic . Material and methods . Forty zirconia core specimens ( 10-mm diameter , 2-mm thickness ) were produced and embedded in the centers of autopolymerizing acrylic resin blocks . Subsequently , specimens were r and omly divided into four groups , each containing 10 specimens , for different surface treatment methods . The details of the groups are as follows : Group C , no treatment applied ( control ) ; Group SB , bonding surfaces of ceramic disks were airborne particle-abraded with 110-μm alumina oxide particles ; Group HF , bonding surfaces of ceramic disks were etched with 9.6 % hydrofluoric acid ; and Group L , bonding surfaces of ceramic disks were irradiated by a CO2 laser . A total of 40 composite resin disks were fabricated and cemented with an adhesive resin cement to the specimen surfaces . A universal test machine was used for the shear bond strength test at a crosshead speed of 1 mm/min . Results . The highest shear bond strength values were obtained with Group L ( 20.99 ± 3.77 MPa ) and the lowest values with Group C ( 13.39 ± 3.10 MPa ) . Although there was no significant difference between Groups C , HF and SB ( P > 0.05 ) , Group L showed a significant difference from all other groups ( p < 0.05 ) . Conclusion . All surface treatment methods improved the bond strength between resin cement and the zirconium oxide ceramic surface . CO2 laser etching may represent an effective method for conditioning zirconia surfaces , enhancing micromechanical retention and improving the bond strength of resin cement on zirconia ceramic OBJECTIVE The aim of this study was to evaluate the effect of different surface treatments ; s and blasting , Er : YAG , Nd : YAG , or CO(2 ) laser irradiation on the shear bond strength ( SBS ) of zirconia ceramic to dentin . BACKGROUND DATA Zirconia is not properly luted with resin cements . Various surface treatment methods have been suggested for zirconia to obtain high bond strength to resin cements . There is no study that compared the effect of different laser types ( Er : YAG , Nd : YAG , CO(2 ) ) with s and blasting on SBS between zirconia and dentin . METHODS One hundred and twenty human maxillary third molar teeth were sectioned 3 mm below the occlusal surfaces , embedded in a metal ring with autopolymerizing acrylic resin , and stored in distilled water at 37(0)C. One hundred and twenty disc-shaped zirconia specimens were fabricated ( 6 mm in diameter and 4 mm in thickness ) , and r and omly assigned to six groups ( n=20 ) : Group 1 , untreated ( control ) ; Group 2 , s and blasted ; Group 3 , Er : YAG laser irradiated ; Group 4 , Nd : YAG laser irradiated with contact ; Group 5 , Nd : YAG laser irradiated with non-contact ; Group 6 , CO(2 ) laser irradiated . They were cemented onto the dentin with dual-cured resin cement ( Variolink ( ® ) ) . After they were stored in distilled water at 37(0)C for 24 h , the SBS test was performed at a crosshead speed of 1 mm/min . The fractured specimens were examined under a stereomicroscope to evaluate the fracture pattern . RESULTS Results of this study did not show statistically significant differences between Groups 1 and 2 , or among Groups 3 , 4 and 5 . The lowest SBS was recorded in Group 6 ( CO(2 ) laser ) , and the highest SBS was recorded in Group 4 ( Nd : YAG laser with contact ) , followed by Group 3 ( Er : YAG laser ) . The adhesive failure mode was predominantly observed in Groups 2 , 3 , 5 , and 6 . Group 1 showed 45 % mixed failure and Group 4 showed 50 % mixed failure . CONCLUSIONS This study shows that Er : YAG and Nd : YAG laser treatment increased the bond strength of zirconia compared to s and basting and CO(2 ) laser treatment OBJECTIVE To evaluate the influence of different surface treatments on the microtensile bond strength of resin cement to zirconia ceramic . MATERIAL S AND METHODS Twelve cylinder-shaped ( ∅ 12 × 5.25 mm high ) blocks of a commercial zirconium-oxide ceramic ( Cercon ® Zirconia , DENTSPLY ) were r and omly divided into 4 groups ( n=3 ) , based on the surface treatment to be performed : ( 1 ) airborne particle abrasion with 125 μm Al₂O₃ particles ( S ) ; ( 2 ) selective infiltration etching ( SIE ) ; ( 3 ) experimental hot etching solution applied for 30 min ( ST ) and ( 4 ) no treatment ( C ) . Paradigm MZ100 blocks ( 3 M ESPE ) were cut into twelve cylinders of 4 mm in thickness . Composite cylinders were bonded to conditioned ceramics using a resin cement ( Calibra ® , DENTSPLY ) , in combination with the proprietary adhesive system . After 24h bonded specimens were cut into microtensile sticks and loaded in tension until failure . Bond strength data were analyzed with Kruskall-Wallis and Dunn 's Multiple Range test for multiple comparisons ( p < 0.05 ) . Failure mode distribution was recorded and the interfacial morphology of debonded specimens was analyzed using a scanning electron microscope ( SEM ) . RESULTS Bond strength values achieved after SIE and ST treatment were significantly higher than after S treatment and without any treatment ( p < 0.05 ) . Premature failures were mostly recorded in the S group . SIGNIFICANCE Conditioning the high-strength ceramic surface with SIE and ST treatments yielded higher bond strengths of the resin cement than when zirconia ceramic was treated with airborne particle abrasion or left untreated The current study evaluated the effects of various pretreatments and aging in water on the bond strength to hot isostatic pressed yttrium-oxide partially stabilized zirconia . Sixty zirconia ceramic specimens ( Denzir ) were r and omly divided into three groups of 20 . One group of specimens ( n=10 ) was then bonded to each other using a resin composite cement ( RelyX Unicem ) , the second group ( n=10 ) was bonded with RelyX Unicem and a metal primer ( Metal Primer II ) , while the third group ( n=10 ) was bonded with RelyX Unicem and a ceramic primer ( Ceramic Primer ) . The specimens were then subjected to shear force before and after s and blasting and before and after aging in water for 180 days . Before aging , no significant differences ( p > 0.05 ) were seen within the different groups , either before or after s and blasting . S and blasting and pretreatment with the metal ( p < 0.01 ) or ceramic ( p < 0.001 ) primers significantly improved the bond strength compared to that of the non-treated specimens . After aging , the bond strength of the s and blasted specimens with metal primer was significantly higher than that of the s and -blasted specimens with ceramic primer ( p < 0.01 ) and the specimens with no primer ( p < 0.001 ) . For the specimens that were s and blasted and pretreated with the metal primer , the bond strength was not significantly affected after aging ( p > 0.05 ) , whereas , for those specimens with the ceramic primer ( p < 0.001 ) and no primer ( p < 0.05 ) , the bond strength significantly decreased . Thus , air abrasion and pretreatment with a metal primer seems to be an appropriate method for improving bond strength OBJECTIVES To evaluate the effect of the particle size of s and blasting and the composition of the resin cement on the microtensile bond strength ( MTBS ) to zirconia . METHODS Forty zirconia blocks ( Cercon , Dentsply ) were polished and r and omly treated as follows : Group 1 ( NT ) : no treatment ; Group 2 ( APA-I ) : airborne particle abrasion ( Cobra , Renfert ) using 25-μm aluminium-oxide ( Al(2)O(3))-particles ; Group 3 ( APA-II ) : APA with 50-μm Al(2)O(3)-particles ; and Group 4 ( APA-III ) : APA using 110-μm Al(2)O(3)-particles . Ceramic blocks were duplicated in composite resin . Sample s of each pretreatment group were r and omly divided into two subgroups depending on the resin cement used for bonding the composite disks to the treated zirconia surfaces . Subgroup 1 ( PAN ) , which was a 10-MDP-containing luting system , used Clearfil Ceramic Primer plus Panavia F 2.0 ( Kuraray ) and Subgroup 2 ( BIF ) used Bifix SE ( VOCO ) self-adhesive cement . After 24h , bonded specimens were cut into 1±0.1mm(2 ) sticks . MTBS values were obtained using a universal testing machine ( cross-head speed=0.5mm/min ) . Failure modes were recorded and the interfacial morphology of the debonded microbars was SEM-assessed . Two-way ANOVA , Student-Newman-Keuls tests , and the step-wise linear regression analysis were performed with the MTBS being the dependent variable ( p<0.05 ) . RESULTS Despite the s and blasting granulometry , PAN bonded to air-abraded surfaces attained the highest MTBS and frequently showed mixed fractures . BIF recorded no significant differences in MTBS depending on the conditioning method , and registered the highest rates of premature and adhesive failures . CONCLUSIONS The 10-MDP-containing luting system seems to be the most suitable to bond zirconium-oxide ceramic , mainly after s and blasting OBJECTIVES To evaluate the effect of mechanical and chemical surface pre-treatment on the bond durability of two composite cements to dental zirconia . METHODS Fully sintered IPS e.max ZirCAD ( Ivoclar-Vivadent ) blocks were either subjected to tribochemical silica s and blasting ( CoJet , 3 M ESPE ) or not mechanically pre-treated . Next , the zirconia sample s were either additionally pre-treated using one of two silane/MDP-combined ceramic primers ( Clearfil Ceramic Primer , Kuraray ; Monobond Plus , Ivoclar-Vivadent ) , or not further chemically pre-treated . Finally , two identically pre-treated zirconia blocks were bonded together using either a conventional BisGMA-based ( Clearfil Esthetic Cement , Kuraray ) or an MDP-based ( Panavia F2.0 , Kuraray ) ' self-etch ' dual-cure composite cement . The specimens were trimmed at the interface to a cylindrical hour-glass shape and stored for 7 days in distilled water ( 37 ° C ) , after which they were r and omly exposed to one of three ageing protocol s : ( 1 ) immersed in 37 ° C water for 10 days ( 10d ) ; ( 2 ) subjected to 10,000 thermo-cycles ( TC ) ; or ( 3 ) immersed in 37 ° C water for 6 months ( 6 m ) . After storage , the micro-tensile bond strength ( μTBS ) was determined in MPa ( n=15 - 21/group ) . Fractographic analysis was performed using SEM . RESULTS Weibull analysis revealed the highest Weibull scale and shape parameters for the ' CoJet/Clearfil Ceramic Primer/Panavia F2.0/10d ' combination . While the BisGMA-based composite cement Clearfil Esthetic Cement ( Kuraray ) bonded equally well to zirconia using either tribochemical silica s and blasting ( CoJet , 3 M ESPE ) or not , s and blasting appeared indispensable for the MDP-based and more hydrophilic composite cement Panavia F2.0 ( Kuraray ) . CONCLUSIONS Combined mechanical and chemical pre-treatment can best be recommended to durably bond to zirconia . CLINICAL SIGNIFICANCE As a st and ard procedure to durable bond zirconia to tooth tissue , both mechanical ( tribochemical silica coating ) and chemical ( silane/MDP-combined ceramic primers ) is clinical ly highly recommended
target: Airborne-particle abrasion and tribochemical silica coating are reference pretreatment methods .
background: STATEMENT OF PROBLEM With a number of  zirconia ceramic material s currently available for clinical use , an overview of the scientific literature on the adhesion methods and their potential influence is indicated .
  PURPOSE The purpose of this systematic review was to classify and analyze the existing methods and material s proposed to improve adhesion to zirconia surfaces .
  Adhesive monomers are necessary for chemical bonding .
  Surface contamination and aging have negative effects on adhesion to zirconia .