Effect of Surface Treatments on the Bond Strength of Computer-aided Design and Computer-aided Manufacturing Lithium Disilicate to Restorative Materials: A Systematic Review.

Abstract

Using computer-aided design and manufacturing (CAD-CAM) technology in restorative dentistry increased the application of lithium disilicate (LD) materials. The bond strength to core and repairing materials is crucial in the restoration's longevity. This systematic review evaluates the shear bond strength (SBS) of CAD-CAM-LD restorative materials to other materials using different surface treatments. An electronic literature search was performed through PubMed/Medline, Embase, Web of Science, Scopus, and Google Scholar. Studies were selected based on specific criteria. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. Eleven studies were included, primarily investigating composite resin as the repair material. SBS values ranged from 0.82 to 32.96MPa, with the highest values observed for IPS e.max-CAD subjected to silicon carbide polishing, hydrofluoric acid (HF) etching, and silane application. For core materials, the highest SBS was reported for HFtreated IPS e.max-CAD bonded to tribochemically coated titanium and air-abraded zirconia, with SBS values ranging from 5.88 to 34MPa. This review indicates that HF etching combined with silane application is the most effective method for improving bond strength in CAD/CAM-LD restorations. Applying surface treatments to both the core material and CAD/CAM-LD can further enhance bond strength.