Fatigue Behavior of the Resinous Cement to Zirconia Bond

Abstract

Resinous cements are widely used for luting zirconia restorations. Adhesive failures have occurred at the cement/zirconia interface, rather than at the cement/dentin interface, suggesting that the cement/zirconia bond may lack durability; however, few comprehensive, comparative evaluations of fatigue effects have been reported. The rate of fatigue-induced loss of bond strength may be a more important predictor of long-term success than a single snapshot of bond strength after an arbitrary number of thermocycles. Previous studies have failed to identify trends by investigating bond strengths at several different numbers of cycles. This may result in invalid conclusions about which cements have superior bond strengths. The purpose of this study was to investigate the effects of artificial aging by thermocycling and resinous cement type on bond strengths to zirconia. The effect of the number of thermocycles (0, 1, 10, 100, 1000, and 10,000) on the bond strengths of five resinous cements, two of which were used with and without a primer, and an oxygen-inhibiting gel, was studied. Specimens were randomly assigned to thermocycle number/cement-type test groups. Because zirconia has a very low thermal diffusivity, exceptionally long thermocycle dwell times were used. Cylinders of zirconia were bonded end-to-end. One end of each bonded specimen was insulated, specimens were thermocycled and tested in shear, and bond strengths were calculated and analyzed. Two-way ANOVA revealed that the effects of cement type, the number of thermocycles, and their interaction all significantly affected bond strength (p < 0.0001). By 10,000 cycles, most cements had lost at least half of their initial bond strengths, and two cements effectively recorded zero bond strengths. Failure modes were cement specific, but adhesive modes predominated. Fatigue resistance of two cements was greatly improved by use of a primer and an oxygen-inhibiting gel, as recommended by their respective manufacturers. Both the type of resin cement and the number of thermocycles influenced bond strength. Fatigue through thermocycling affected different cement types in different ways. Some materials displayed more rapid loss of bond strength than others. Cements differed in their failure modes.