d e n t a l m a t e r i a l s 2 6 ( 2 0 1 0 ) 44–50

available at www.sciencedirect.com

journal homepage: www.intl.elsevierhealth.com/journals/dema

Influence of air-abrasion on zirconia ceramic bonding using

an adhesive composite resin

B. Yang 1 , A. Barloi, M. Kern ∗

Department of Prosthodontics, Propaedeutics and Dental Materials, Dental School, Christian-Albrechts University at Kiel,
Arnold-Heller-Str. 16, 24105 Kiel, Germany

a r t i c l e i n f o a b s t r a c t

Article history: Objectives. Air-abrasion as bonding conditioning method for zirconia ceramic might com-
Received 18 February 2009 promise the mechanical strength of zirconia restorations. The purpose of this study was to
Received in revised form 9 July 2009 evaluate the influence of surface conditioning parameters, i.e., air-abrasion with reduced
Accepted 21 August 2009 pressure or no air-abrasion and priming with adhesive primers on the long-term resin bond
strength to zirconia ceramic.
Methods. Zirconia ceramic disks were polished with 600 grit abrasive paper. Plexiglas tubes
Keywords: filled with composite resin were bonded with RelyX Unicem luting composite resin to
Air-abrasion the conditioned zirconia disks. Three surface conditions (unconditioned, air-born parti-
Zirconia ceramic cle abrasion at 0.05 or 0.25 MPa) and four priming conditions (no priming, priming with
Bonding Metal/Zirconia Primer, priming with Alloy Primer, priming with Clearfil Ceramic Primer)
Self-adhesive luting resin composite were tested. Sixteen specimens of each combination were bonded. Subgroups of eight
bonded samples were stored in water either for 3 days or 150 days with 37,500 thermo-
cycling. Tensile bond strengths (TBSs) were determined with a universal testing machine at
a crosshead speed of 2 mm/min.
Results. Without priming, RelyX Unicem showed durable bond strength to 0.25 MPa
airborne-particle abraded ceramic. When combined with 10-methacryloyloxy-decyl dihy-
drogenphosphate containing primers, air-abrasion resulted in a durable TBS to zirconia
ceramic even at a reduced abrasion pressure. However, combined with Metal/Zirconia Primer
air-abrasion did not provide a durable TBS to zirconia ceramic.
Significance. Using a self-adhesive luting resin composite (RelyX Unicem), air-abrasion at
0.25 MPa or the combination of low pressure air-abrasion and priming with MDP-containing
primers seems to be useful to achieve durable long-term bonding to zirconia ceramic.
© 2009 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

lowed by silanating has been used on zirconia ceramics with

1. Introduction varying results. It produced durable resin bonding for some zir-
conia ceramics [3–6], while on other zirconia ceramics reduced
Air-abrasion seems to be a prerequisite to achieve high and bond strengths after artificial aging were found [4,5,7–9]. An
durable bond strengths to zirconia ceramics [1,2]. Air-abrasion explanation might be that the silica layer to a large extent
with silica containing particles (named as silica-coating) fol- was not firmly attached to the zirconia surface [8]. How-

∗
Corresponding author. Tel.: +49 431 5972874; fax: +49 431 5972860.
E-mail address: [email protected] (M. Kern).
1
Current address: American Dental Association Foundation, Paffenbarger Research Center, National Institute of Standards and Tech-
nology, Gaithersburg, MD 20899, USA.
0109-5641/$ – see front matter © 2009 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.dental.2009.08.008
 d e n t a l m a t e r i a l s 2 6 ( 2 0 1 0 ) 44–50 45

Fig. 1 – Experimental design of the study.

ever increasing the blasting pressure during silica-coating of zirconia ceramic restorations, the influence of various sur-
from 0.15 MPa to 0.45 MPa increased the bond strength from face conditioning parameters, i.e., air-abrasion and priming,
11.2 MPa up to 30.5 MPa [10] suggesting that tribochemical on the long-term resin bond strength to zirconia ceramic
silica-coating requires a high blasting pressure. with RelyX Unicem was investigated in this study. The null
In several studies on zirconia ceramic bonding, air- hypotheses tested were that there is no influence of prop-
abrasion with 50 ␮m Al2 O3 at 0.25 MPa at 10 mm operation erly reducing air-abrasion pressure on resin–zirconia ceramic
distance was used to condition the ceramic surface in bond durability with RelyX Unicem, that there is no influence
order to increase the surface roughness, as well as to of surface condition with primers on resin–zirconia ceramic
clean and to activate the surface [11–14]. This method can bond, and that there is no influence of the combination of
significantly improve resin–zirconia ceramic bond strength reducing air-abrasion pressure and using different primers on
and its durability by increasing surface roughness, clean- resin–zirconia ceramic bonding durability.
ing and activating the ceramic surface [1,3,7,12,13,15–19]
when combined with adhesive monomer-containing primers
such as 4-methacryloxyethyl-trimellitate-anhydride (4-META) 2. Materials and methods
[20] or 10-methacryloxydecyl-dihydrogenphosphate (MDP)
[17,19,21,22]. Zirconia ceramic disks were made from Cercon ceramic (Cer-
However, air-abrasion might compromise the mechanical con, DeguDent, Hanau, Germany) and polished with 600
strength of ceramic itself by initiating surface defects [23–25] grit abrasive paper. Three surface conditions (polished, air-
although the critical defect size in zirconia ceramic varies abrasion with alumina particles at 0.05 MPa, or at 0.25 MPa)
between 15 and 40 ␮m depending on the nature of the critical and four priming conditions including no priming (NP),
flaw produced in the manufacturing process [26]. Therefore, priming with Metal/Zirconia Primer (MZP, Ivoclar-Vivadent,
reducing the pressure during air-abrasion or omitting air- Schaan, Liechtenstein), priming with Alloy Primer (AP, Kuraray
abrasion completely might be recommended in combination Medical, Osaka, Japan) or Clearfil Ceramic Primer (CCP,
with new ceramic primers in order to improve the bonding Kuraray Medical, Osaka, Japan) according to the manufactur-
durability and reduce the negative influence of high-pressure ers’ instructions were tested (Fig. 1). Air-abrasion was done
air-abrasion on the mechanical properties of zirconia ceramic. with 50 ␮m Al2 O3 particles (Edelkorund weiß 50 ␮m, Pluradent,
Up to now, this assumption has not been investigated or Offenbach, Germany) using a spot blasting unit (P-G 400, Har-
reported. nisch + Rieth, Winterbach, Germany) at a distance of 10 mm
Recently, RelyX Unicem has been recommended as one- from the bonding surface. Then the specimens were cleaned
step self-adhesive luting composite resin for dental materials ultrasonically in 96% ethanol for 2 min to remove the debris of
bonding. Adhesive monomer with phosphoric acid groups and Al2 O3 particles from the ceramic surface.
effective function of initiators in the initially acidic cement
paste bring about to RelyX Unicem self-adhesion and a high 2.1. Tensile bond strength (TBS) testing
degree of cross-linking between the monomers after setting.
For dental oxide ceramics with RelyX Unicem, only 0.25 MPa The protocols of bonding the conditioned zirconia ceramic
air-abrasion pretreatment of ceramic bonding surface with- specimens with RelyX Unicem composite luting resin (3 M
out priming was recommended and proven to contribute to ESPE, Seefeld), aging simulations with water storage and ther-
a durable resin–ceramic bonding [4,5,15]. However, the effects mal cycling, and TBS testing followed the protocol described
of reduced blasting pressure and/or the primer application on by Kern and Thompson [27] which was used as standard
bonding of Unicem to zirconia ceramic are not known. protocol in numerous studies and therefore allows valid com-
In order to find one suitable surface treatment to improve parisons to previously obtained results. Briefly, RelyX Unicem
bonding durability without impairing mechanical properties was bonded in light curing mode according to the manufac-
46 d e n t a l m a t e r i a l s 2 6 ( 2 0 1 0 ) 44–50

turer’s instruction. The bonded specimens were stored in 37 ◦ C

water for 3 days or 150 days with 37,500 thermal cycles from
5 ◦ C and 55 ◦ C prior to TBS testing with a universal testing
machine (Zwick Z010/TN2A, Zwick, Germany) at a crosshead
speed of 2 mm/min (Fig. 1).

2.2. Surface topography examination and

fractographic examination

A scanning electron microscope (SEM, XL 30 CP, Philips, Kassel,

Germany) operating at 10–25 KV was used to observe ceramic
surfaces after mechanical conditions with polishing, air-
abraded with 0.05 MPa and 0.25 MPa and fractographic analysis
of representative debonded ceramic specimens. Failure modes
of debonded ceramic specimens after tensile testing were
classified into [27]: (A) adhesive failure at ceramic surface;
(C) cohesive failure in the RelyX Unicem luting composite
resin or in the tube filling composite resin with or with-
out primer residue on ceramic surface. Failure areas of each
mode were calculated and expressed as a percentage of the
total bonding surface area for each test group. All debonded
ceramic surfaces were examined using a light microscope
at 40× magnification to calculate the area of each failure
mode.

2.3. Statistical analysis

As data was not normally distributed, statistical analysis was

performed using the Wilcoxon rank sum test adjusted accord-
ing to Bonferroni–Holm for multiple testing at ˛ = 5%.

3. Results

SEM photographs of different topographic surface structure

produced by polishing (a), 0.05 MPa (b) and 0.25 MPa (c) air-
abrasion are illustrated in Fig. 2. Air-abrasion of zirconia
ceramic surface created at 0.25 MPa produced a rougher
surface than air-abrasion at 0.05 MPa, while only polishing
resulted in the smallest roughness.
The means and standard deviations of TBS in MPa of
experimental groups after different surface treatments and
different storage conditions are shown in Table 1. In groups
without air-abrasion—although specimens showed accept-
able TBS after 3 days storage—all specimens debonded
spontaneously during water storage and thermal cycling
regardless of primers. In groups 05, no priming and the Fig. 2 – (a) SEM photographs of surface topography without
Metal/Zirconia Primer priming did not result in long-term air-abrasion (polished); (b) SEM photographs of surface
stable TBS, while Alloy Primer and Clearfil Ceramic Primer topography after air-abrasion at 0.05 MPa; (c) SEM
priming led to a durable long-term TBS. For groups 25, only photographs of surface topography after air-abrasion at
Metal/Zirconia Primer priming showed decreased long-term 0.25 MPa.
TBS, no priming, Alloy Primer and Clearfil Ceramic Primer
resulted in long-term stable TBS.
SEM of representative failure modes after TBS testing are between composite resin and primer, leaving primer remain-
shown in Fig. 3a–f. Fig. 3a and b shows a mostly adhesive fail- ing on the ceramic surface (Fig. 3f).
ure mode with a very small area of composite resin residue Mean percentages of areas assigned to the failure modes
on ceramic surface. Fig. 3c and d shows mixed failure modes observed in the bonding groups after TBS testing are shown
with a low percentage of adhesive failure at the ceramic sur- in Fig. 4. After 3 days storage, failure modes were found
face. Fig. 3e and f shows mixed failure modes with cohesive to be mixed with a high percentage of adhesive failure at
failure either in the composite resin or in the bonding interface the ceramic surface in not air-abraded groups. In contrast,
 d e n t a l m a t e r i a l s 2 6 ( 2 0 1 0 ) 44–50 47

Table 1 – Medians of tensile bond strength in MPa to zirconia ceramic after different surface treatments and storage
times (n = 8). Statistically different medians (p < 0.05) are indicated by different superscript upper case letters (within a
row for the same storage time), or by different subscript lower case letters (within a column), or by different superscript
lower case Greece letters (comparing 3 days and 150 days storage within the same test group). *All specimens debonded
spontaneously during storage time, no statistical test conducted.
Priming conditions No Primer (NP) Metal/Zirconia Primer (MZP) Alloy Primer (AP) Clearfil Ceramic Primer (CCP)

Surface conditions 3 days 150 days 3 days 150 days 3 days 150 days 3 days 150 days
No air-abrasion (polished) 17.7B b ␣ 0* * ␤ 19.0B b ␣ 0* b ␤ 29.9A b ␣ 0* b ␤ 24.4B c ␣ 0* b ␤
Air-abrasion with 0.05 MPa 42.1A a ␣ 12.9B * ␤ 42.5A a ␣ 18.8B a ␤ 40.2A a ␣ 37.9A a ␣ 39.3A a ␣ 24.3A a ␤
Air-abrasion with 0.25 MPa 46.0A a ␣ 30.2A * ␤ 38.5A a ␣ 19.4B a ␤ 34.2A,B a ␣ 37.8A a ␣ 32.1B b ␣ 33.2A a ␣

Fig. 3 – SEM of representative failure modes after TBS testing: (a) low magnification of adhesive failure mode; (b) high
magnification of adhesive failure mode with very small piece of composite resin residue on ceramic surface; (c) low
magnification of mixed failure mode with low percentage of adhesive failure at the ceramic surface; (d) high magnification
of (c); (e) low magnification of mixed failure mode with cohesive failure in composite resin or in the bonding interface
between composite resin and primer, leaving primer remaining on the ceramic surface; (f) high magnification of (e).
48 d e n t a l m a t e r i a l s 2 6 ( 2 0 1 0 ) 44–50

Fig. 4 – Mean percentages of assigned failure modes after tensile bonding testing after 3 or 150 days water storage with
thermal cycling.

for groups with air-abrasion at 0.05 MPa and 0.25 MPa, mixed so-called self-adhesive luting resin to zirconia ceramic were
failure modes with primarily cohesive failures in the com- evaluated.
posite resin were found. After 150 days storage, for not In this study, except groups with air-abrasion and priming
air-abraded groups, all ceramic specimens debonded spon- with Alloy Primer or Clearfil Ceramic Primer, water stor-
taneously and presented adhesive failure modes regardless age with thermal cycling significantly decreased the bonding
of using primers. In groups with air-abrasion at 0.05 MPa, no durability of RelyX Unicem to zirconia ceramic (Table 1). Dif-
priming resulted in complete adhesive failure mode with low ferences in conditions of ceramic surface and the chemistry
bond strengths, and Metal/Zirconia Primer resulted in a mixed and physical properties of luting agents will significantly influ-
failure mode with greatly increasing adhesive failures, while ence the nature of the bonding mechanism and resin bonding
Alloy Primer and Clearfil Ceramic Primer resulted in high per- durability to zirconia ceramic [1,29,32]. The chemical bonding
centage of cohesive failures in the composite resin with high forces that occur at the interfaces of heterogeneous sys-
and durable TBS. In groups with air-abrasion at 0.25 MPa, sub- tems is believed to occur between functional monomers and
groups no priming, Alloy Primer and Clearfil Ceramic Primer metal ions on the ceramic surface [1,24]. As zirconia ceramic
showed high TBS with mainly cohesive failures in the com- contains metal oxides, the surface treatment with primers
posite resin except subgroup Metal/Zirconia Primer, which containing adhesive functional monomers such as MDP (Alloy
showed a high percentage of adhesive failures at the ceramic Primer and Clearfil Ceramic Primer in this study), other phos-
surface. phoric acid acrylate monomer (Metal/Zirconia Primer in this
study) and RelyX Unicem composite resin containing adhe-
sive phosphoric acid group monomer are often recommended
4. Discussion to improve the bonding to zirconia ceramic [3–6,24,33]. These
adhesive monomers are believed to have the ability to form
Long-term storage and thermal cycling are often used as the chemical bonds with metal oxides, secondary forces such as
artificial aging methods in vitro bonding testing [18,19,28–30]. van der Waals forces or hydrogen bonds at the resin–zirconia
The combination of these two important parameters to sim- interface. These interfacial forces improve the surface wet-
ulate oral conditions can have effects on the durability of the tability of zirconia ceramic surface and thereby resin bonding
resin bond strength to zirconia ceramic. However often only strength with low percentage of adhesive failure from ceramic
short-term bond strength and/or after short-term thermal surface (Table 1 and Fig. 4).
cycling were used to evaluate the effects of various pretreat- Without air-abrasion after polishing, the three primers
ment and luting resins on the bond to ceramic [29,31]. The in Metal/Zirconia Primer, Alloy Primer, Clearfil Ceramic Primer
vitro bonding testing after long-term oral simulation is nec- and the adhesive monomer in RelyX Unicem obviously pro-
essary to be performed before clinical recommendations can moted initial bonding to zirconia ceramic indicating chemical
be provided. Therefore, in this study, the effects of thermal bonding (Table 1). However, these chemical bonds were not
cycling and long-term storage on the bond durability of one water resistant and bond strengths were reduced to 0 MPa
 d e n t a l m a t e r i a l s 2 6 ( 2 0 1 0 ) 44–50 49

during long-term storage indicated by a complete adhesive but to roughen, to clean and to chemically activate the zir-
failure at the ceramic surface (Fig. 3a and b). If air-abrasion conia surface. Then alumina particles not firmly attached are
was not used after polishing, primers and adhesive monomer removed from the bonding surface in an ultrasonic cleaning
in RelyX Unicem luting composite resin did not promote long- bath. So, the different air-abrasion methods using different
term TBS with almost very high percentage of adhesive failure particles for specific purposes seem to be influenced differ-
mode (Table 1 and Fig. 4), suggesting that the surface activation ently by the blasting pressure.
and cleaning effect of air-abrasion is necessary for hydrolysis Interestingly, without any priming long-term TBS of RelyX
resistant chemical bonding. Unicem after low pressure air-abrasion at 0.05 MPa was sta-
Air-abrasion plays an important role to improve the tistically lower than after regular pressure air-abrasion at
bonding strength of resin cements to oxide ceramics as 0.25 MPa (Table 1). Although the reason for this difference
shown by previous studies [17,34]. This mechanical surface remains unclear, it could be speculated that the low viscosity
condition with air-abrasion can improve the resin–ceramic primers were better capable to wet the surface conditioned
bonding by increasing the surface roughness and bonding with low pressure air-abrasion than the RelyX Unicem lut-
surface area, improving wetting kinetics of adhesives, and ing composite resin itself with a considerable higher viscosity.
removing any organic contaminants from ceramic surface When using regular pressure air-abrasion at 0.25 MPa surface
[18,19,22]. roughness and the bonding area were greater, obviously pro-
Using low pressure air-abrasion at 0.05 MPa without viding a surface topography with better wettability for the
primers resulted in a statistically significant decrease of TBS viscous luting composite resin.
over long-term storage (Table 1). However, when low pres- Therefore, the hypothesis that there is no influence of
sure air-abrasion was combined with MDP-containing primers reducing air-abrasion pressure on resin–zirconia ceramic bond
such as Alloy Primer and Clearfil Ceramic Primer, a durable durability has to be partially rejected. In addition, it can
long-term TBS (Table 1) with very low percentage of adhesive be speculated, that bonding to zirconia ceramic is mainly
failure mode (Fig. 3c and d, Fig. 4) was achieved. This result promoted by chemical bonds and the main functions includ-
indicates that when low air-abrasion pressure is used, primers ing cleaning and chemical activation of the bonding surface,
containing MDP monomer are necessary for durable zirconia which is effectively done by air-abrasion because it removes
ceramic resin bonding using RelyX Unicem. organic contaminants thoroughly [5,19].
In contrast, using air-abrasion at 0.25 MPa without primers So combining air-abrasion and priming, the tested primers
RelyX Unicem achieved a rather durable long-term TBS promoted durable long-term TBS of composite resin to zirco-
to zirconia ceramic (Table 1) with low percentage of nia ceramic, whereas Alloy Primer and Clearfil Ceramic Primer
adhesive failure (Figs. 3c and 4). So while conventional produced significantly higher bond strengths and lower per-
bis-GMA based composite resins without using any adhe- centage of adhesive failure than those of group Metal/Zirconia
sive monomers were not able to create long-term durable Primer (Figs. 3 and 4). This indicates that under same mechani-
bonds to air-abraded zirconia ceramic [7,17], adhesive phos- cal conditions of air-abrasion, different primers show different
phoric acid group-containing monomers in RelyX Unicem effects on the long-term TBS of composite resin to zirconia
luting composite resin obviously were able to promote ceramic and percentage of adhesive failure mode (Fig. 3c and
durable long-term bond to air-abraded zirconia ceramic. In e, Fig. 4). It can be assumed that the phosphate monomer
addition, for groups combining air-abrasion and MDP con- MDP contained in Alloy Primer and Clearfil Ceramic Primer
taining monomers such as Alloy Primer and Clearfil Ceramic produced stronger chemical bonds than the phosphonic acid
Primer, RelyX Unicem produced long-term durable bonding acrylate monomer contained in Metal/Zirconia Primer. There-
(Table 1). fore, the hypothesis that there is no influence of surface
The morphological evaluation in the SEM showed that reg- treatment with primers on long-term zirconia ceramic bond-
ular pressure air-abrasion at 0.25 MPa created greater surface ing has to be rejected. In addition, the hypothesis that there is
roughness and larger bonding surface area than low pres- no influence of the combining air-abrasion pressure reduction
sure air-abrasion at 0.05 MPa or using no air-abrasion (Fig. 2). and the use of various primers on zirconia ceramic bonding
Despite these morphological differences, there were no sta- has to be rejected.
tistical differences in long-term TBS between both blasting In conclusion, when using luting composite resin con-
pressures for any primer group (Table 1). This result sug- taining phosphate adhesive monomers, regular pressure
gests that using adequate adhesive primers the air-abrasion air-abrasion at 0.25 MPa, or the combination of low pressure
pressure can be reduced without affecting long-term TBS neg- air-abrasion and priming with MDP-containing primers pro-
atively. vided durable long-term bonding to dental zirconia ceramic.
In contrast, in a recent study on tribochemical silica- Without air-abrasion no durable bonding to zirconia ceramic
coating of zirconia ceramic higher blasting pressure resulted was achieved regardless of using primers.
in higher bond strengths [10] suggesting that the attachment
of the silica layer to the zirconia surface is influenced by the
blasting pressure. These results differ from the current results, Acknowledgments
which show that the pressure of alumina particle air-abrasion
is not influencing TBS in the range of 0.05–0.25 MPa blasting The tested primers and resins were supplied free of charge
pressure. This difference can be explained by the different by 3M Espe (Seefeld, Germany), Kuraray Medical Inc. (Osaka,
purposes of alumina particle air-abrasion as compared to tri- Japan), and Ivoclar-Vivadent Company (Schaan, Liechten-
bochemical silica-coating which is not to add a surface layer stein). The authors thank for the support.
50 d e n t a l m a t e r i a l s 2 6 ( 2 0 1 0 ) 44–50

references [19] Yang B, Wolfart S, Scharnberg M, Ludwig K, Adelung R, Kern

M. Influence of contamination on zirconia ceramic bonding.
J Dent Res 2007;86:749–53.
[20] Chang JC, Hurst TL, Hart DA, Estey AW. 4-META use in
[1] Blatz MB, Sadan A, Kern M. Resin–ceramic bonding: a review
dentistry: a literature review. J Prosthet Dent 2002;87:216–24.
of the literature. J Prosthet Dent 2003;89:268–74.
[21] Burke FJ, Fleming GJ, Nathanson D, Marquis PM. Are
[2] Kern M. Resin bonding to oxide ceramics for dental
adhesive technologies needed to support ceramics? An
restorations. J Adhes Sci Technol 2009;23:1097–111.
assessment of the current evidence. J Adhes Dent
[3] Blatz MB, Chiche G, Holst S, Sadan A. Influence of surface
2002;4:7–22.
treatment and simulated aging on bond strengths of luting
[22] Quaas AC, Yang B, Kern M. Panavia F 2.0 bonding to
agents to zirconia. Quintessence Int 2007;38:745–53.
contaminated zirconia ceramic after different cleaning
[4] Lüthy H, Loeffel O, Hämmerle CH. Effect of thermocycling on
procedures. Dent Mater 2007;23:506–12.
bond strength of luting cements to zirconia ceramic. Dent
[23] Guazzato M, Albakry M, Quach L, Swain MV. Influence of
Mater 2006;22:195–200.
surface and heat treatments on the flexural strength of a
[5] Piwowarczyk A, Lauer HC, Sorensen JA. The shear bond
glass-infiltrated alumina/zirconia-reinforced dental
strength between luting cements and zirconia ceramics
ceramic. Dent Mater 2005;21:454–63.
after two pre-treatments. Oper Dent 2005;30:382–8.
[24] Uo M, Sjogren G, Sundh A, Goto M, Watari F, Bergman M.
[6] Radovic I, Monticelli F, Goracci C, Vulicevic ZR, Ferrari M.
Effect of surface condition of dental zirconia ceramic
Self-adhesive resin cements: a literature review. J Adhes
(Denzir) on bonding. Dent Mater J 2006;25:626–31.
Dent 2008;10:251–8.
[25] Zhang Y, Lawn BR, Rekow ED, Thompson VP. Effect of
[7] Kern M, Wegner SM. Bonding to zirconia ceramic: adhesion
sandblasting on the long-term performance of dental
methods and their durability. Dent Mater 1998;14:64–71.
ceramics. J Biomed Mater Res B: Appl Biomater
[8] Matinlinna JP, Heikkinen T, Özcan M, Lassila LV, Vallittu PK.
2004;71:381–6.
Evaluation of resin adhesion to zirconia ceramic using some
[26] Kosmac T, Oblak C, Jevnikar P, Funduk N, Marion L. The
organosilanes. Dent Mater 2006;22:824–31.
effect of surface grinding and sandblasting on flexural
[9] Özcan M, Vallittu PK. Effect of surface conditioning methods
strength and reliability of Y-TZP zirconia ceramic. Dent
on the bond strength of luting cement to ceramics. Dent
Mater 1999;15:426–33.
Mater 2003;19:725–31.
[27] Kern M, Thompson VP. Bonding to glass infiltrated alumina
[10] Heikkinen TT, Lassila LV, Matinlinna JP, Vallittu PK. Effect of
ceramic: adhesive methods and their durability. J Prosthet
operating air pressure on tribochemical silica-coating. Acta
Dent 1995;73:240–9.
Odontol Scand 2007;65:241–8.
[28] Bott B, Hannig M. Effect of different luting materials on the
[11] Al-Dohan HM, Yaman P, Dennison JB, Razzoog ME, Lang BR.
marginal adaptation of Class I ceramic inlay restorations in
Shear strength of core-veneer interface in bi-layered
vitro. Dent Mater 2003;19:264–9.
ceramics. J Prosthet Dent 2004;91:349–55.
[29] Özcan M, Nijhuis H, Valandro LF. Effect of various surface
[12] Blatz MB. Cementation of zirconium-oxide ceramic
conditioning methods on the adhesion of dual-cure resin
restorations. Pract Proced Aesthet Dent 2004;16:14.
cement with MDP functional monomer to zirconia after
[13] Oh WS, Shen C. Effect of surface topography on the bond
thermal aging. Dent Mater J 2008;27:99–104.
strength of a composite to three different types of ceramic. J
[30] Roulet JF, Söderholm KJ, Longmate J. Effects of treatment
Prosthet Dent 2003;90:241–6.
and storage conditions on ceramic/composite bond
[14] Valandro LF, Della Bona A, Antonio Bottino M, Neisser MP.
strength. J Dent Res 1995;74:381–7.
The effect of ceramic surface treatment on bonding to
[31] Pisani-Proenca J, Erhardt MC, Valandro LF, Gutierrez-Aceves
densely sintered alumina ceramic. J Prosthet Dent
G, Bolanos-Carmona MV, Del Castillo-Salmeron R, et al.
2005;93:253–9.
Influence of ceramic surface conditioning and resin cements
[15] Blatz MB. Adhesive cementation of high-strength ceramics. J
on microtensile bond strength to a glass ceramic. J Prosthet
Esthet Restor Dent 2007;19:238–9.
Dent 2006;96:412–7.
[16] Wegner SM, Kern M. Long-term resin bond strength to
[32] Kern M. Bond strength of luting cements to zirconium oxide
zirconia ceramic. J Adhes Dent 2000;2:139–47.
ceramics. Int J Prosthodont 2000;13:350.
[17] Wolfart M, Lehmann F, Wolfart S, Kern M. Durability of the
[33] Atsu SS, Kilicarslan MA, Kucukesmen HC, Aka PS. Effect of
resin bond strength to zirconia ceramic after using different
zirconium-oxide ceramic surface treatments on the bond
surface conditioning methods. Dent Mater 2007;23:45–
strength to adhesive resin. J Prosthet Dent 2006;95:430–6.
50.
[34] Kern M, Strub JR. Bonding to alumina ceramic in restorative
[18] Yang B, Lange-Jansen HC, Scharnberg M, Wolfart S, Ludwig
dentistry: clinical results over up to 5 years. J Dent
K, Adelung R, et al. Influence of saliva contamination on
1998;26:245–9.
zirconia ceramic bonding. Dent Mater 2008;24:508–13.