Is there a potential for durable adhesion to zirconia restorations? A systematic review (original) (raw)

To achieve the best possible bond quality for the long-term survival of a prosthesis, the intaglio should adhere to the luting agent. Zirconia cores are almost unaffected by any processing because of their high hardness and crystallinity. 1 Because zirconia is not etchable, the advantage of stronger adhesion using resin cements may be lost. 2,3 However, under appropriate conditions, resin cements provide stronger bonding for zirconia restorations with better mechanical properties than conventional cements. Particularly in restorations in which mechanical retention by the abutment is limited, reliable bonding of resin cements with zirconia improves the application limits, reduces microleakage, and increases retention. In single retainer ceramic resin-bonded partial fixed dental prostheses (FDPs) and in inlay-retained FDPs, improved adhesion would minimize the possibility of decementation. In single zirconia crowns, the loss of retention has been shown to be significantly higher than that for other etchable ceramic crowns. Most information about adhesion has come from laboratory studies, and their conclusions may well be useful in guiding randomized clinical trials (RCTs). As-produced zirconia surfaces show low bond strengths even with adhesive resin cements. 20 Laboratory experiments have limitations, and the results of different techniques are not always comparable. Each different zirconia material has different surface features and internal structure, grain size, shape, composition, and hardness so that the effect of any surface treatment and the consequent bond strength with different materials may vary, 22 making it inappropriate to generalize findings from one type of material to another. 3 However,