title: Durable bonding to mechanically and/or chemically pre-treated dental zirconia.
abstract: OBJECTIVE
  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 sandblasting (CoJet, 3M ESPE) or not mechanically pre-treated. Next, the zirconia samples 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 randomly exposed to one of three ageing protocols: (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 (6m). 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 sandblasting (CoJet, 3M ESPE) or not, sandblasting 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.
  
  
  CONCLUSIONS
  As a standard procedure to durable bond zirconia to tooth tissue, both mechanical (tribochemical silica coating) and chemical (silane/MDP-combined ceramic primers) is clinically highly recommended.
authors.affiliation: KU Leuven BIOMAT, Department of Oral Health Sciences, KU Leuven (University of Leuven), & Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, blok a bus 7001, B-3000 Leuven, Belgium.
authors.forename: Masanao
authors.initials: M
authors.lastname: Inokoshi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kameyama
authors.forename: Jan
authors.initials: J
authors.lastname: De Munck
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Minakuchi
authors.forename: Bart
authors.initials: B
authors.lastname: Van Meerbeek
mesh_terms: D000268:Adhesiveness; D000537:Aluminum Oxide / Q000737:chemistry; D017438:Bisphenol A-Glycidyl Methacrylate / Q000737:chemistry; D003188:Composite Resins / Q000737:chemistry; D001840:Dental Bonding; D003738:Dental Cements / Q000737:chemistry; D045662:Dental Etching / Q000379:methods*; D003776:Dental Porcelain / Q000737:chemistry*; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D008689:Methacrylates / Q000737:chemistry; D008855:Microscopy, Electron, Scanning; D019279:Resin Cements / Q000737:chemistry*; D012821:Silanes / Q000737:chemistry; D012822:Silicon Dioxide / Q000737:chemistry; D013314:Stress, Mechanical; D013499:Surface Properties; D013696:Temperature; D013718:Tensile Strength; D013997:Time Factors; D014867:Water / Q000737:chemistry; D015019:Yttrium / Q000737:chemistry*; D015040:Zirconium / Q000737:chemistry*
chemical_list: D003188:Composite Resins; D003738:Dental Cements; D008689:Methacrylates; C076808:Monobond S; C438843:Panavia-Fluoro; D019279:Resin Cements; D012821:Silanes; C530542:clearfil esthetic cement; C499362:yttria stabilized tetragonal zirconia; D014867:Water; D003776:Dental Porcelain; D017438:Bisphenol A-Glycidyl Methacrylate; D015019:Yttrium; D012822:Silicon Dioxide; C069749:methacryloyloxydecyl dihydrogen phosphate; D015040:Zirconium; D000537:Aluminum Oxide