Shear bond strength of resin cements to both ceramic and dentin☆☆☆★★★

Abstract 

Statement of Problem. All ceramic restorations benefit from resin cement bonding to the tooth. However, the literature is unclear on which cement, ceramic conditioning treatment, and dentin bonding agent produce the highest and longest-lasting bond strength. Purpose. This in vitro study evaluated immediate and 6-month shear bond strengths between a feldspathic ceramic and 4 different resin cements with the use of 6 different surface-conditioning treatments. Shear bond strengths between the 4 resin cements and dentin also were measured. Material and Methods. Four hundred eighty discs (10 mm in diameter and 4 mm thick) of Ceramco II porcelain were randomly divided into 6 main groups (n = 80). The ceramic specimens received 6 different surface conditioning treatments before the application of resin cement. These surface treatments were sanding with 600-grit silicon carbide paper, microetching with aluminum oxide, sanding followed by silane application, microetching followed by silane application, hydrofluoric acid-etching, and hydrofluoric acid-etching followed by silane application. Each group then was subdivided into 4 subgroups (n = 20) for the application of 1 of 4 cements: Nexus, Panavia 21, RelyX ARC, and Calibra. All cemented specimens were tested under shear loading until fracture on a universal testing machine; the load at fracture was reported in MPa as the bond strength. Bond strengths were determined at 24 hours and after 6 months of specimen storage in a saline solution. For dentin-resin cement shear bond strength testing, dentin specimens were treated with dentin bonding agents, and a thin layer of resin cement was applied according to the manufacturer's directions. Prodigy composite was bonded to the cement. Shear bond strengths were determined as above and reported in MPa at fracture. Data were analyzed with 3-way analysis of variance (P<.01). Results. Hydrofluoric acid-etching followed by silane application produced bond strengths (15.0 ± 7.4 to 21.8 ± 5.8 MPa) in the highest statistical group with all 4 cements at both 24 hours and 6 months (P<.01). Sanding with 600-grit silicon carbide paper and microetching with aluminum oxide produced the lowest bond strengths (0.0 to 4.0 ± 3.5 MPa). At 24 hours and 6 months, there were no significant differences among the 4 cements when hydrofluoric acid-etching was followed by silane application. Both auto- and light-polymerized dentin bonding agents bonded better to dentin than dual-polymerized bonding agents. Conclusion. Within the limitations of this study, hydrofluoric acid-etching followed by silane application produced the best bonds at 24 hours and 6 months with all 4 cements. Auto- and light-polymerized adhesives were associated with higher bond strengths to dentin than dual-polymerized adhesives. (J Prosthet Dent 2002;88:277-84.)