Ceramic Primer Research Articles

Self-Etching Ceramic Primer Application Time Influences Durability of Bonding to Lithium Disilicate and Advanced Lithium Disilicate Ceramics

Background: Monobond Etch & Prime (MEP; Ivoclar) has a material-dependent effect on dental ceramics. This study evaluated the impact of MEP application time on the resin–ceramic shear bond strength (SBS) of lithium disilicate (LD) and advanced lithium disilicate (ALD) ceramics. Methods: LD and ALD discs were distributed into four groups (n = 20): no surface treatment; 5% HF etching followed by the application of a silane-containing primer (S); MEP applied for 40 s and maintained for 20 s; MEP applied for 2 min and maintained for 40 s. Resin–ceramic SBS was evaluated at 24 h and after thermocycling. The statistical analysis of SBS was performed by using the three-way ANOVA and Tukey’s multiple comparisons tests. Additional ceramic samples were prepared to assess the surface topography. Results: There was no statistically significant difference in the SBS of the MEP groups (20 s and 2 min) and HF + S. However, only the HF + S and MEP (2 min) groups showed durable adhesion after thermocycling. MEP resulted in less distinct surface alterations compared with HF etching. Conclusion: Increasing the application time of MEP to 2 min resulted in more durable resin–ceramic adhesion compared with the application time (40 s) recommended by the manufacturer. The adhesion of resin–ceramic to LD and ALD did not significantly differ.

Provides Efficient Shear Bond Strength and Durability Between Lithium Disilicate Glass-ceramic and Resin Cement: A Potential Alternative to the Conventional Hydrofluoric Acid Protocal

Objectives: This study investigated the effects of two surface treatment protocols on the shear bond strength, bond durability, and failure mode at the interface between lithium disilicate glass-ceramic and resin cement. The protocols compared were a self-etching ceramic primer and the conventional hydrofluoric acid (HF) etching followed by silane. Methods: Fifty lithium disilicate specimens were randomly divided into five surface treatment groups (n=10 each). A control group received no treatment. The remaining 4groups included: 5% HF etch with Monobond Plus thermocycled and non-thermocycled, Monobond Etch & Prime (MEP), thermocycled and non-thermocycled. Microshear bond strength (microSBS) was assessed before and after thermocycling to evaluate bond durability. Failure modes (adhesive, mixed, cohesive in resin/ceramic) were recorded under a stereomicroscope. Results: Both surface treatment protocols exhibited comparable microSBS for both pre- and post-thermocycling results. Moreover, bone durability obtained from the two treatment protocols seemed to be comparable. Most groups displayed adhesive/mixed failures. Notably, the self-etching ceramic primer group showed cohesive failure in half of the specimens initially, persisting in 20% after thermal aging. Conclusions: Compared with the conventional HF protocol, the self-etching ceramic primer protocol provided similar microSBS and bond durability between lithium disilicate glass-ceramic and resin cement. The data suggest a self-etching ceramic primer is a viable option for the conventional HF protocol in bonding to glass-ceramic, minimizing the HF hazard and simplifying the clinical procedure.

Self-Etching Ceramic Primer Affects Surface Topography and Roughness of Two Zirconia-Reinforced Lithium Silicate Ceramics.

This article evaluates the etching efficacy of a self-etching ceramic primer (SECP) on zirconia-reinforced lithium silicate (ZLS) ceramics. Celtra Duo (DeguDent GmbH, Hanau-Wolfgang, Germany) and Vita Suprinity (Vita Zahnfabrik, Bad Säckingen, Germany) were used in this study. A total of 36 ceramic slices were prepared from each ceramic material and randomly distributed into three groups according to the surface treatment applied (n = 12 per group). Group 1 (polished) was polished with silicon carbide paper discs and did not undergo any surface treatment; group 2 (SECP) was surface treated with SECP (Monobond Etch and Prime, Ivoclar Vivadent, Schaan, Liechtenstein); group 3 (hydrofluoric acid [HF]) was surface treated with 4.7% HF etching. Half of the specimens (n = 6) from each group were gold-sputtered, and the surface topographic alterations were evaluated by scanning electron microscopy at magnifications of 5,000× and 10,000 × . The surface roughness of the other half (n = 6) from each group was tested using a three-dimensional optical profiler. Data were statistically analyzed using two-way analysis of variance and Tukey's multiple comparisons test. Both SECP and HF etching surface treatments resulted in a statistically significant increase (p < 0.05) in the surface roughness of both ceramic materials, compared to that of their respective control group specimens (polished). HF etching resulted in a significant dissolution of the glassy phase of each ceramic. SECP can effectively etch ZLS ceramics. The etching patterns created after the application of SECP were mild compared to those produced by HF etching. The topographic surface features of ceramics are affected by both, surface treatment and material composition.

Shear Bond Strength of Five Different Repair Systems to Three Different Ceramic Materials.

The purpose of the current study was to investigate the shear bond strength of composite resin in five different ceramic repair systems for three different ceramic materials. 225 monolithic zirconia (Zr) and lithium disilicate (LDS) and cobalt chromium (CoCr) specimens with feldspathic porcelain (FP) veneer were fabricated (N=75 per material). The specimens underwent thermo-cycling and were randomly divided into five groups for the following intra-oral repair systems (n=15): 1) Clearfil Ceramic Primer Plus, Kuraray Noritake, Japan; 2) Ibond Intraoral Repair Kit, Kulzer, Germany; 3) VOCO Cimara, VOCO GmbH Germany; 4) Ivoclar Vivadent, Ceramic Repair System Kit, IvoclarVivadent, Liechtenstein; 5) Ultradent Porcelain Repair Kit, Ultradent Products Inc, USA. After surface conditioning, composite was applied using a cylindrical mold and a second round of thermocycling was performed. Each specimen was then subjected to shear load until failure. Microshear bond strength was compared using analysis of variance (one-way ANOVA, Tukey's test, a <0.05). Type of porcelain repair kit significantly affected the shear bond strength. For Zr, the repair systems from Kulzer and VOCO had significantly higher shear bond strength than the other systems (p<0.001) without significant difference between Kulzer and VOCO. For the LDS and CoCr with FP, hydrofluoric acid had the highest shear bond strength (p<0.001). For zirconia, a 10-Methacryloyloxydecyl dihydrogen phosphate (10-MDP) system should be used. The results also suggest that a cleaning bur may be beneficial. For glass-based ceramics and feldspathic porcelain, etching with hydrofluoric acid remains the product of choice.

The Effect of Multiple-Time Applications of Metal Primers Containing 10-MDP on the Repair Strength of Base Metal Alloys to Resin Composite

This experimental study was performed to assess whether applying a metal primer containing 10-MDP multiple times affected the repair shear bonding ability of base metal alloys to resin composites. Ten base metal alloys were randomly assigned to each group in the manner described, following multiple applications of a metal primer (Clearfil Ceramic Primer Plus), namely one to five applications, and no primer application as a negative control. On the specimens’ prepared surfaces, the resin composite was pushed into the mold and then light-activated for 40 s. The bonded samples were kept for 24 h at 37 °C in distilled water in an incubator. The shear bond strength was determined using a universal testing device. A stereomicroscope was used to determine the debonded surface. The one-way ANOVA and Tukey’s test were implemented to statistically analyze. The lowest shear bond strength was found in group 6 (6.14 ± 1.12 MPa), demonstrating a significant difference (p = 0.000) when compared to groups 1 to 5. The shear bond strength of group 3 was highest at 21.49 ± 1.33 MPa; there was no significant difference between group 3 and groups 4 and 5 (20.21 ± 2.08 MPa and 20.98 ± 2.69 MPa, respectively) (p = 0.773, p = 1.000, respectively). All fractured specimens in groups 1, 2, and 6 were identified as adhesive failure. Groups 3 and 4 exhibited the highest percentage of mixed failures. To achieve the repair shear bonding ability of base metal alloys to resin composites, the sandblasted base metal alloys should be coated with three applications of a metal primer before applying the adhesive agent.

Effect of Surface Treatment with Zirconium Dioxide Slurry on the Bond Strength of Resin Cement to Ultratranslucent Zirconia.

This laboratory study aimed to evaluate the effects of zirconium dioxide (ZrO2) slurry surface treatment on the bond strength of ultratranslucent zirconia to resin cement using different ceramic primers. The surface morphology was evaluated by scanning electron microscopy (SEM) and atomic force microscopy (AFM), and the interface was evaluated by SEM. Additionally, the phase composition was analyzed by X-ray diffraction (XRD). Specimens of zirconia (n=120) were obtained and divided into two groups according to the surface treatment: (1) airborne particle abrasion with 50-μm aluminum oxide (n=60) and (2) ZrO2 slurry (n=60). The 60 specimens were then further divided into three groups (n=20) according to the ceramic primer application: no primer (NP), Monobond N (MB), and Clearfil ceramic primer (CP). Four resin cement cylinders were built on each ceramic specimen. Half of the specimens (n=10) were subjected to a microshear bond strength (μSBS) test after 24 hours of storage in distilled water, and the other half (n=10) were subjected to a μSBS test after thermocycling. Additional specimens were prepared for SEM, AFM, and XRD analyses. According to the Kruskal-Wallis and Student-Newman-Keuls post hoc tests, the μSBS values were significantly higher for MB and CP than for NP (p<0.05), and there were no significant differences in μSBS for both surface treatments associated with MB and CP after 24 hours of storage (p>0.05). Thermocycling significantly decreased the μSBS values for all specimens, especially for the NP groups and ZrO2 slurry treatment groups, and gaps at the interface were observed by SEM. SEM and AFM analyses showed agglomerate-type irregularities on the ceramic surface for ZrO2 slurry treatment. XRD spectra showed that ZrO2 slurry did not cause phase transformation. It was concluded that ZrO2 slurry promoted irregularities on the ultratranslucent zirconia surface, not causing phase transformation; moreover, the values of μSBS were comparable to those of airborne particle abrasion with aluminum oxide. However, neither surface treatment nor ceramic primer prevented the degradation of the interface.

Shelf-life effect of silane-containing universal adhesive on bonding effectiveness to glass-ceramic

ObjectiveTo evaluate the shelf-life effect of a silane-containing universal adhesive (UA) on its shear bond strength (SBS) to lithium disilicate glass-ceramic (LiSi2). MethodsSBS to mirror-polished (‘MP’) and hydrofluoric acid-etched ground (‘HF’) lithium disilicate glass-ceramic (Initial LiSi, GC) with/without prior separate ceramic primer application (G-Multi Primer, GC: ‘G-MP’) was measured. Scotchbond Universal Plus (‘SBUp’) (3M Oral Care) was used 33 (‘fresh’) and 6 (‘expiring’) months before the expiration date. ‘MP’ specimen preparation involved (1) ‘G-MP’ priming (or not), (2) ‘SBUp’ application, (3) composite (Clearfil AP-X, Kuraray Noritake) placement, and (4) 20 s light-curing (SmartLite Pro, Dentsply Sirona). ‘HF’ specimen preparation involved (1) HF (Porcelain Etch, Ultradent) etching, (2) phosphoric acid (K-Etchant, Kuraray Noritake) post-etching, with (3) and (4) being the same as for ‘MP’. Upon light-curing, all specimens were stored in 37 °C water for either 1 week (‘immediate’) or 3 months (‘aged’) prior to SBS measurement. Statistics involved Linear Mixed-Effects modelling (α = 0.05). ResultsSBS was not significantly affected by SBUp's shelf life, except for a significantly higher SBS recorded for ‘fresh’ SBUp applied on HF-etched and separately silane-primed LiSi2. Aging did not significantly decrease SBS. In fact, a significant increase in SBS upon aging was recorded for HF-etched LiSi2 that was not separately silane-primed. The significantly highest bond strength was measured when LiSi2 was HF-etched followed by separate silane-priming. SignificanceDespite the UA investigated has silane in its formulation, the most effective and durable bonding to LiSi2 was achieved by HF-etching followed by separate silane-priming, irrespective of the UA's shelf life.

Evaluation of vertical marginal discrepancy and load-to-failure of monolithic zirconia and lithium disilicate laminate veneers manufactured in different thicknesses

ObjectivesThis study aimed to evaluate the feasibility of monolithic zirconia laminate veneers (MZLV) compared to lithium disilicate laminate veneers (LDLV).Materials and methodsSixty resin replicas, each prepared with depths of 0.5 mm, 0.7 mm, and 1 mm, were produced using a 3D printer from acrylic teeth. Laminate veneers of these thicknesses were milled from pre-sintered monolithic zirconia (3rd generation) and lithium disilicate blocks. The intaglio surface of MZLV was treated with air abrasion using 110 μm diameter silica-modified aluminium oxide particles and ceramic primer, while LDLV was etched with etchant gel and treated with the ceramic primer before cementation with resin cement. Vertical marginal discrepancy (VMD) was assessed using a stereomicroscope, and a load-to-failure test was conducted using a universal testing machine. Failure modes were evaluated macroscopically on fractured surfaces. Data were analysed statistically using Two-way ANOVA and Bonferroni correction (α = 0.05).ResultsLDLV samples exhibited significantly larger VMD compared to MZLV samples across all thicknesses, especially in cervical, palatal, and mean data. Within the LDLV group, load-to-fracture values for 0.7 mm and 1.0 mm thicknesses were similar, whereas for 0.5 mm thickness, it was significantly lower. In the MZLV group, load-to-fracture values were lower for 0.7 mm and 1.0 mm thicknesses compared to LDLV, but higher for 0.5 mm thickness.ConclusionsMaterial choice and restoration thickness significantly influence laminate veneer restorations’ success. MZLV generally exhibits superior vertical marginal fit compared to LDLV, with varying load-to-failure values across different thicknesses. Clinical management of debonding in MZLV is simpler compared to restoration fracture in LDLV.Clinical relevanceConsidering clinical factors, MZLV may be a preferable option to LDLV for this restoration with the thickness of 0.5 mm.

The effect of surface conditioning techniques on the shear bond strength of zirconia-reinforced lithium silicate ceramic following adhesive cementation – An in vitro study

Aim: The aim of this study was to determine the effect of different surface conditioning techniques on the bond strength between zirconia-reinforced lithium silicate (ZLS) ceramics and resin cement. Materials and Methods: Fifty samples of ZLS ceramic were used and allotted into five groups with 10 samples per group based on the type of surface conditioning technique. The ceramic specimens were crystallized and embedded into acrylic resin. The five groups were group 1 (negative control–without surface treatment); group 2 (10% hydrofluoric [HF] acid + silanization); group 3 (10% HF acid only); group 4 (self-etching ceramic primer [SECP]); and group 5 (experimental laboratory sealing of the conditioned surface). Resin cylinders were bonded using self-adhesive resin cement and were subjected to thermocycling after 24 h storage. The shear bond strength was tested with a universal testing machine. Statistical Analysis Used: One-way ANOVA was used for comparing five groups (P &lt; 0.05 was considered significant). Results: Group 4 showed the highest mean bond strength value (23.4 MPa ± 2.21 MPa). A statistically significant difference was noted between group 4 and all the other groups tested in the study (P &lt; 0.05). Conclusion: It can be concluded that the SECP can be considered an alternative to the conventional protocol of HF acid and silane application for the surface conditioning of ZLS ceramic.

Comparison of the Shear Bond Strength Using Primers with Different Application Numbers on Dental Zirconia.

This study examined the effect of the number of phosphate-containing primer applications on the shear bond strength (SBS) of zirconia to resin cement. 315 square specimens (10 × 10 × 4 mm3) were manufactured from Cercon ht presintered zirconia blocks. Alumina particles were used to sandblast zirconia specimens. These specimens were randomly divided into six primer-based groups: No primer application (NP), CLEARFIL CERAMIC PRIMER (C), PANAVIA V5 Tooth Primer (T), M&C PRIMER (MC), Monobond N (MN), and Z-PRIME plus (Z), and then separated into application number (1-4) groups (excluding NP). Each specimen was bonded with resin cement. The SBS was measured using a universal testing machine. The debonded surface was examined with a stereomicroscope. The SBSs were analyzed using two-way analysis of variance. Applying the primer twice exhibited the highest SBSs in each group, with significant differences in the T, MN, and Z groups. However, the SBS in the MC group was significantly lower on the second application. One-hundred percent adhesive failure was observed in all groups. Within the limitations of this study, prior to cementation, the sandblasted zirconia surface should be applied twice with a phosphate-containing primer other than MC to maximize the SBS at the zirconia-resin cement interface.

A Surface Topographical Analysis of Lithium Disilicate Ceramics Pretreated With Rose Bengal, Er:YAG Laser, and Ceramic Primer on Bond Integrity, Surface Roughness, and Bond Failure to Composite Resin

To evaluate adhesive bond integrity and surface roughness (Ra) of LDS ceramics following various surface modification treatments. Forty LDS ceramic disks were manufactured and allocated into distinct groups according to the pretreatment procedure. Group 1 samples were treated with HF (hydrofluoric acid) and S (silane). Group 2 uses RBe (Rose Bengal photosensitizer) S. Group 3 utilizes SECP (self-etch ceramic primer), while Group 4 employs Er:YAG laser. The Ra, shear bond strength (SBS), and surface topography of the conditioned LDS ceramic were evaluated. The bonding of all LDS ceramics was assessed with a universal testing machine. Debonded samples were analyzed using a stereomicroscope. The Ra and bond integrity values were assessed through the utilization of a two-way ANOVA, followed by Tukey post hoc testing. The samples prepared with HF+S displayed the highest Ra and bond values. However, group 2 (RBe+S) exhibited the least bond strength. There were no notable disparities in the results regarding the strength of the bonds among group 1, group 3 (SECP), and group 4 (Er:YAG laser+S). Er:YAG and SECP show promise as potential substitutes for hydrofluoric acid (HFA) in conditioning LDS ceramics, yielding satisfactory bond scores by positively altering the surface morphology.

The effect of restorative material selection and cementation procedures on the durability of endocrowns in the anterior teeth: an in-vitro study

ObjectiveTo investigate the fracture resistance and failure modalities of anterior endocrown restorations fabricated employing diverse ceramic materials, and bonded using various cementation methodologies.Materials and methodsForty maxillary central incisors were divided into two main groups based on the ceramic materials used; GroupI (Zir): zirconia endocrwons (Zolid HT+, Ceramill, Amanngirrbach) and GroupII (E-Max): e-max endocrowns (IPS e.max CAD, Ivoclar Vivadent). Both groups were further split into two subgroups depending on the cementation protocols; subgroup IA “ZirMDP”: endocowns cemented with MDP primer + MDP resin cement, subgroup IB (ZirNon-MDP): cemented with MDP primer + non-MDP resin cement, subgroup IIA (E-maxMDP): cemented with MDP primer + MDP resin cement, subgroup IIB (E-maxNon-MDP): cemented with MDP primer + non-MDP resin cement. (n = 10/subgroup). Endocrowns were manufactured using CAD/ CAM. Teeth were subjected to 10,000 thermal cycles. The fracture test was performed at 45o with a palatal force direction until the fracture occurred. Test results were recorded in Newton. The failure mode was examined using a stereomicroscope. A One-way ANOVA test was utilized to compare different groups regarding fracture strength values. Tukey`s Post Hoc was utilized for multiple comparisons.ResultsThe comparative analysis of fracture strength across the diverse groups yielded non-significant differences, as indicated by a p-value exceeding 0.05. Nonetheless, an observable trend emerged regarding the mode of failure. Specifically, a statistically significant prevalence was noted in fractures localized within the endocrown/tooth complex below the cementoenamel junction (CEJ) across all groups, except for Group IIB, “E-max Non-MDP,” where fractures within the endocrown/tooth complex occurred above the CEJ.ConclusionsCombining an MDP-based primer with an MDP-based resin cement did not result in a significant effect on the anterior endocrown fracture strength.Clinical relevanceRegardless of the presence of the MDP monomer in its composition, adhesive resin cement achieved highly successful fracture strength when used with MDP-based ceramic primers. Additionally, ceramic materials exhibiting elastic moduli surpassing those of dentin are discouraged due to their propensity to induce catastrophic fractures within the tooth structure.

The effect of combining primers and cements from different cement systems on the bond strength between zirconia and dentin

ObjectiveThe aim of this study was to evaluate the influence of combining primers and cements from two different resin cement systems on the microtensile bond strength (μTBS) between zirconia and human dentin.Materials and methodsA total of 120 specimens of zirconia cemented to dentin were allocated into eight groups based on cement type (RelyX Ultimate or Panavia V5) and primers (Tooth Primer, Clearfil Ceramic Primer and Scotchbond Universal Adhesive) combinations, applied to dentin or ceramic surfaces. Following artificial aging with 5000 thermocycles, μTBS tests were conducted. Statistical analysis was performed using One-way ANOVA and Tukey’s post hoc tests (p ≤ 0.05), and failure modes were assessed.ResultsThe Panavia V5 cement system demonstrated the highest bond strength (19.4 ± 4.4 MPa), significantly higher than the other groups except when RelyX cement was used with Panavia primers (16.9 ± 3.7 MPa). Cohesive fractures within the cement layer were the predominant failure mode.ConclusionsThe combination of primers from different adhesive cement system brands may significantly affect the bonding effectiveness. Therefore, using products from a single product line of the same adhesive cement system, and following the manufacturer’s recommendations for indications and use, is crucial for a more predictable clinical outcome.

Effect of Polymer Infiltered Ceramic Surface Treatment Using Photoactivated Low-Level Laser Therapy, CO2 Laser, and Aluminum Oxide on Surface Roughness, Shear Bond Strength, and Color Change: An In vitro SEM EDX Analysis

Contemporary surface conditioners (Sandblasting (SB), Self-etching ceramic primer (SECP), low-level laser therapy (LLLT) in conjunction with methylene blue photosensitizer (MBPS), Carbon dioxide (CO2) laser on the color change (ΔE), surface roughness (Ra) and bond strength of hybrid ceramic (HC) to resin cement. Hundred discs were prepared from HC which were surface treated (n = 15) Group 1: HFA(S), Group 2: SB, Group 3: SECP, Group 4: LLLT (MBPS), Group 5: CO2 laser. After surface conditioning, five samples from each group underwent ΔE and Ra analysis using a spectrophotometer and Profilometer respectively. Fifty specimens were applied with dual-cure resin luting cement. Specimens were thermocycled and underwent SBS and failure mode analysis using UTM and stereomicroscope. The mean and standard deviation (SD) of ΔE, Ra, and SBS were calculated using ANOVA. Intergroup comparisons were made using post hoc Tukey multiple comparisons. A maximum score of ΔE was observed in Group 5 samples (CO2 laser+HC). The minimum value of ΔE was displayed by Group 3 (SECP+HC) specimens. Group 2 (SB+HC) treated specimens that exhibited the highest Ra scores and SBS. Sandblasting and carbon dioxide laser-treated samples presented satisfactory outcomes of surface roughness and bond strength. However, Sandblasting and carbon dioxide laser groups presented significant changes in the color of the specimens.

Effect of storage time on chemical structure of a single-bottle and a two-bottle experimental ceramic primer and micro-shear bond strength of composite to ceramic.

This study assessed the effect of storage time on chemical structure of a single-bottle and a two-bottle experimental ceramic primer and micro-shear bond strength (µSBS) of composite to ceramic. This study was conducted on 60 sintered zirconia and 60 feldspathic porcelain blocks. Half of the specimens (n = 30) were subjected to surface treatment with the single-bottle Clearfil ceramic primer (n = 15) and two-bottle experimental primer (n = 15) after 24 hours. The remaining half received the same surface treatments after 6 months storage in distilled water. Composite cylinders were bonded to the ceramics, and they were then subjected to µSBS test. Also, the primers underwent Fourier-transform infrared spectroscopy (FTIR) after 24 hours and 6 months to assess their chemical structure. Data were analyzed with 3-way ANOVA and adjusted Bonferroni test (alpha = 0.05). The µSBS of both ceramics significantly decreased at 6 months in one-bottle ceramic primer group (P = .001), but it was not significantly different from the two-bottle experimental primer group (P = .635). FTIR showed hydrolysis of single-bottle primer, cleavage of silane and 10-MDP bonds, and formation of siloxane bonds after 6 months. Six months of storage caused significant degradation of single-bottle ceramic primer, and consequently had an adverse effect on µSBS.

Enhancing bonding of zirconia lithium silicate ceramics to dentin: The effect of surface treatment and resin cement

This laboratory study evaluated the influence of surface treatments on surface topography, and the bonding of CAD/CAM (computer-aided design computer-aided manufacturing) zirconia-containing lithium silicate (ZLS) surfaces to human dentin using various contemporary resin cements. Specimens from ZLS CAD/CAM blocks (Celtra™ Duo and Vita™ Suprinity) underwent three surface pretreatments: grinding only; 5 % hydrofluoric acid etching followed by application of a silane coupling agent, and a self-etching ceramic primer. The specimens were bonded to a flat exposed dentin surface using two etch-and-rinse and two self-adhesive resin cements, and then sectioned into microspecimens for microtensile bond strength (μTBS) testing. Failure modes of bonded surfaces, and ceramic surface roughness and topography were assessed. Results indicated that surface treatment was essential for ZLS-dentin bonding. Hydrofluoric acid and silane, along with the self-etching primer resulted in comparable strengths and outperformed the control group. Etch-and-rinse cements yielded significantly higher μTBS than self-adhesive cements. Significant differences in surface roughness and topography were observed among the treatment groups. Hydrofluoric acid exhibited the highest roughness parameters and most prominent surface changes. These findings highlight the importance of surface treatment for enhancing zirconia-containing lithium silicate bonding to dentin, and emphasize the critical role of the resin cement choice in optimizing dental restorative outcomes.

Influence of Varied Silane Commercial Brands and Adhesive Application on Bond Strength and Stability to Lithium Disilicate Glass Ceramic.

This study aimed to evaluate the impact of various commercial silane brands with varied chemical compositions with or without the application of an adhesive layer on the microshear bond strength and durability of a resin luting agent to lithium disilicate glass ceramic. Lithium disilicate glass ceramic discs (EMX, IPS e.max Press, Ivoclar Vivadent) measuring 10 mm in diameter and 3 mm in thickness were fabricated (n=240). Surfaces were etched using 5% hydrofluoric acid and randomly assigned to 10 groups based on the commercial brand of silane used (n=24): [RP] RelyX Ceramic Primer (3M ESPE); [PS] Prosil (FGM); [SA] Silano (Angelus); [SM] Silano (Maquira); [SU] Silane (Ultradent); [GL] GLUMA Ceramic Primer (Kulzer); [CB] Ceramic Bond (VOCO); [MB] Monobond N (Ivoclar Vivadent); [CP] Clearfil Ceramic Primer (Kuraray); and [DE] 2-step silane (Dentsply Sirona). Half of the EMXs (n=12) received a thin adhesive layer (+) after the silane and prior to resin luting agent, while the other half (n=12) did not receive an adhesive layer (-). For the microshear bond strength test (μSBS), four light-cured resin luting agent cylinders (1 mm in diameter) were created on each EMX surface. Half of these specimens were tested after 24 hours, while the other half were stored in deionized water for 6 months. The μSBS test was conducted using a universal testing machine (DL 500, EMIC) at a crosshead speed of 1 mm/min until failure. The obtained data underwent statistical analysis using analysis of variance (ANOVA) and the Tukey test (α=0.05). There was significant influence of the silane commercial brand on bond strength. Notably, "universal primers" yielded lower bond strength results compared to "pure" silane solutions. Water storage had a detrimental effect on microshear bond strength for certain silane commercial brands. Additionally, the application of an adhesive layer negatively impacted bond strength results for all silanes. This study confirms the importance of both silane commercial brand and chemical composition in relation to bond strength of resin luting agents to lithium disilicate glass ceramic. Furthermore, the application of an adhesive layer may have an adverse effect on bond stability over time.

Failure and complication rates of different materials, designs, and bonding techniques of ceramic cantilever resin-bonded fixed dental prostheses for restoring missing anterior teeth: A systematic review and meta-analysis.

The objective of this review was to assess clinical trials that have examined the materials, design, and bonding of ceramic cantilevered resin-bonded fixed dental prostheses (RBFDPs) as a potential option for replacing missing anterior teeth. The evaluation primarily focuses on the rate of restoration failure and clinical complications. A thorough search of databases including PubMed/MEDLINE, Scopus, and the Cochrane Library, was conducted. The most recent search was performed in October 2023. Clinical studies that compared ceramic cantilevered RBFDPs with double retainers or cantilevered RBFDPs using different ceramic materials or bonding systems were included. The outcome measures considered were restoration failure and complication rates. Twelve studies met the eligibility criteria. The pooled data showed a statistically significant decrease in complication events when using cantilever designs compared with double retainer designs (p < 0.05); however, there were no differences found between the two designs in terms of restoration failure. The complication and failure rate of cantilever RBFDPs did not show a statistically significant difference with or without ceramic primer application before luting with phosphate monomer-containing luting resin (p > 0.05). Ceramic cantilevered RBFDPs have lower complication rates compared with those with double retainers. The use of a ceramic primer prior to luting composite resin for ceramic cantilevered RBFDPs decreases the occurrence of complications and failures, although this effect was not statistically significant. Additional research is required to confirm these findings. Glass ceramic cantilever RBFDPs showed a decrease in success after 6 years, requiring ongoing monitoring, but both zirconia and glass-infiltrated alumina cantilever RBFDPs have demonstrated durability with excellent long-term success and survival rates for up to 10 and 15 years. Cantilever ceramic RBFDPs in the anterior region are a less invasive and valuable treatment option, providing good esthetic results.

Can a Self-etching Primer be Effective in Bonding Aligner Attachments to Different Types of Ceramics?

This in vitro study aimed to evaluate the effectiveness of pretreatment with a self-etching primer for bonding aligner attachments to lithium disilicate (LD) and monolithic zirconia (MZ) ceramics. Forty ceramics, including LD (n=20) and MZ (n=20), were divided into four study groups according to the surface pretreatments: LD specimens pretreated with universal primer (Monobond Plus, MP) after hydrofluoric acid etching (Group 1); MZ ceramics pretreated with MP after sandblasting (Group 2); LD ceramics pretreated with self-etching ceramic primer (Monobond etch & prime, MEP) (Group 3); and MZ ceramics pretreated with MEP after sandblasting (Group 4). The aligner composite (GC Aligner Connect) and universal adhesive (GPremio Bond) were used to prepare the resin attachments. The bond strength was evaluated by micro-shear bond strength (SBS) testing (0.1 mm/min) after thermocycling, and the remnant adhesive was scored according to the resin attachment remnant index (RARI). The SBS data were analyzed using ANOVA and Tukey tests, and the RARI scores were analyzed using the chi-square test. Group 1 had the lowest SBS, and group 2 had the highest SBS. There were significant differences between the groups in terms of bond strength (p<0.05). The RARI scores showed no significant differences, regardless of the pretreatment and ceramic type. The use of a self-etching primer increased the bond strength of resin attachments on LD ceramics. For zirconia ceramics, both ceramic primers are recommended for aligner attachment bonding.

Effect of Different Primers on Shear Bond Strength of Base Metal Alloys and Zirconia Frameworks.

Ensuring a secure bond between a framework structure and layering composite resin veneer is essential for a long-lasting dental restoration. A variety of primer systems are available to facilitate the adhesive bonding. Nevertheless, the growing preference for efficiency and simplicity in dentistry has made the one-bottle universal primers a desirable option. This study aims to compare the effectiveness of universal primers on the shear bond strength (SBS) of base metal alloy (BMA) and zirconia to layering composite resin. Each 160 BMA and zirconia 20 × 10 × 5 mm test specimen was fabricated. Eight different primers (SunCera Metal Primer, Metal Primer Z, Reliance Metal Primer, Alloy Primer, MKZ Primer, Monobond Plus, ArtPrime Plus, and Clearfil Ceramic Primer Plus) were applied to 20 specimens in each group. Subsequently, a 5 × 2 mm composite resin build-up was applied. SBS tests were performed after 24 h of water storage and after thermocycling (25,000 cycles, 5-55 °C). On BMA, after water storage for 24 h, the bond strength values ranged from 26.53 ± 3.28 MPa (Metal Primer Z) to 29.72 ± 2.00 MPa (MKZ Primer), while after thermocycling, bond strength values ranged from 25.19 ± 1.73 MPa (MKZ Primer) to 27.69 ± 2.37 MPa (Clearfil Ceramic Primer Plus). On a zirconia base, after 24 h, the bond strengths values ranged from 22.63 ± 2.28 MPa (Reliance Primer) to 29.96 ± 2.37 MPa (MKZ Primer) and from 23.77 ± 3.86 MPa (Metal Primer Z) to 28.88 ± 3.09 MPa (Monobond Plus) after thermocycling. While no significant difference in bond strength was found between the primers on the BMA base, five primer combinations differed significantly from each other on zirconia (p = 0.002-0.043). All primers achieved a bond strength greater than 23 MPa on both framework materials after thermocycling. Thus, all primers tested can be applied to both framework materials with comparable results.