Evaluation of Surface Cleaning Regimens on Bond Strength of Resin Cement to Zirconia reinforced Lithium Silicate Ceramic – An in Vitro Study
Silicate Ceramic, In Vitro, Zirconia Reinforced Lithium Silicate (ZLS), Hydrofluoric, Hydrofluoric
AuthorsINTRODUCTIONWith various advancements in dental adhesives and material science , there has been an increased demand and preference to opt for all - ceramic restorations which are considered as an excellent substitute to traditional metal - ceramic crowns due to their durability and good aesthetics. As a result of extensive research in novel restorative materials, Zirconia Reinforced Lithium Silicate (ZLS) ceramics have been introduced with the aim of achieving excellent mechanical and aesthetic properties. [1] This ceramic contains tetragonal zirconia fillers that are added to the crystalline component consisting of a homogenous glassy matrix with round and submicrometric elongated grains of lithium metasilicates and lithium orthophosphates. [1] The grain formation of lithium disilicate follows after a crystallization process. Apart from material properties, it is the appropriate surface treatment of the intaglio surface that will dictate the longetivity of any bonded restoration. The manufacturer recommends the use of hydrofluoric acid followed by silane application, since ZLS ceramics are acid sensitive. [2] However in regard to the cementation of ZLS ceramics, it is still not known as to which surface treatment will offer sufficient bond strength. [3] Further, it is known that the contamination of the intaglio surface of the prosthesis with saliva during the intraoral try in can compromise the bond strength due to components such as proteins, enzymes, microorganisms and food debris, present in the saliva. [4,5] Although conventionally, the intra-oral try-in of the restoration is performed before applying the Hydrofluoric (HF) acid and silane coupling agent, the restoration may occasionally be etched in the laboratory. [4] This is done in order to make it easier for the practitioner or because chairside use of HF is prohibited in some countries due to its potential hazardous effects. [6] Due to the potentially toxic nature of HF acid and its technique sensitivity, its chairside use should be performed with caution or avoided. [2,5,6] It is therefore necessary to have an efficient alternative to HF acid. [4] Many alternative cleaning methods have been proposed, such as 37% phosphoric acid and alkaline based cleaning agents such as Ivoclean (Ivoclar Vivadent, Schaan, Liechtenstein), and have shown good results when tested on lithium disilicate ceramics. [4,7] But the cleaning efficiency of these materials has not been tested on ZLS ceramics. Another material that has been used for the surface treatment of glass ceramics is a self-etching ceramic primer (SECP), available commercially as Monobond Etch & Prime (Ivoclar Vivadent, Schaan, Liechtenstein), that has shown to combine the conditioning effects of hydrofluoric acid and silane, while at the same time offering a safer and less technique sensitive surface treatment compared to HF etching. [2] The manufacturer also claims that the SECP can clear salivary residues from the surface. [8] However, very scarce evidence exists regarding its efficacy. The current study aims to assess how different surface cleaning techniques affected the resin cement's ability to adhere to zirconia-reinforced lithium silicate ceramic. According to the null hypothesis, ZLS and the resin cement have no difference in shear bond strength across all of the variables examined in the study. ••••••••••••••••••••••••••••••• ejprd.org - Published by Riset Publishing Services LLC
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