Evaluation Of The Internal Surface Treatment Type Of Zirconia On The Shear Bond Strength Of Different Patternsofresin Cements (In Vitro Study)
Ibrahem Abu shanab1, Eyad Swed2, Muaaz Alkhouli3*
1 MSc in fixed prosthodontics, Faculty of Dentistry, Damascus University, Syria.
2 Professor in fixed prosthodontics, Faculty of Dentistry, Damascus University, Syria.
3 MSc in Pediatric Dentistry, Faculty of Dentistry, Damascus University, Syria.
*Corresponding Author
Muaaz Alkhouli,
MSc in Pediatric Dentistry, Faculty of Dentistry, Damascus University, Syria.
E-mail: Muaaz.Alkhouli@outlook.com
Received: September 10, 2021; Accepted: October 01, 2021; Published: October 13, 2021
Citation: Ibrahem Abu shanab, Eyad Swed, Muaaz Alkhouli. Evaluation Of The Internal Surface Treatment Type Of Zirconia On The Shear Bond Strength Of Different Patterns of resin Cements (In Vitro Study). Int J Dentistry Oral Sci. 2021;8(10):4746-4752. doi: dx.doi.org/10.19070/2377-8075-21000963
Copyright: Muaaz Alkhouli©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Aim: to evaluate the shear bond strength of zirconia bonded with two dual cure adhesive resin cements PANAVIA F 2.0 and
PERMAFLO DC using two surface treatment techniques: sand blasting and silica coating using Cojet system.
Materials and Methods: 60 cubes samples with dimensions (10×10×10mm) and 60 cylinders samples with dimensions
(3mm diameter, 2mm height ) were cut from three zirconia ceramic blocks. Sandblasting was done using air blasting machine
with 110 µm AL2O3 particles and Silica coating surface treatment was done using Cojet system with 30 µm SiO2 particles.
Half of the cylinders sandblasted zirconia samples were cemented to half the sand blasted cubic samples using PANAVIA F
2.0 adhesive resin cement and the rest were cemented using PERMAFLO DC adhesive resin cement. Also, half of the small
silica coated zirconia samples were cemented to half the silica coated large samples using both cements. Thermocycling were
done for 5000 thermal cycles. The shear bond strength was tested using a computerized universal testing machine.
Results: Zirconia specimens cemented with PANAVIA F 2.0 showed higher shear bond strength than specimens cemented
with PERMAFLO DC with silica-treated zirconia surfaces and sandblasted surface treatments.
Conclusion: PANAVIA F 2.0 resin cement and silica coating surface treatment could be the best cement and surface treatment
for zirconia and sand blasting could be a promising alternative surface treatment.
2.Introduction
3.Materials and Methods
3.Results
4.Discussion
5.Conclusion
5.References
Introduction
A need for non-metallic restorative materials with optimal esthetics
and characteristics such as biocompatibility, color stability, high
wear resistance and low thermal conductivity is often stated as a
reason for the use of ceramics in dentistry. Various materials can
be used as all-ceramic core materials such as leucite-reinforced
ceramics, glass-infiltrated ceramics, lithium disilicate, alumina and
zirconia [1].
The use of zirconia in restorative dentistry has grow exponentially
over the past decade [2, 3].
In clinical dentistry, zirconia is used for construction of orthodontic
brackets, posts and cores, implants and implants abutments,
crown substructure and frameworks for fixed partial dental
prostheses [4].
In addition to its favorable mechanical properties and chemical
and dimensional stability, zirconia substructure exhibits good radio-
opacity, enhancing radiographic evaluation of marginal integrity
and detection of recurrent caries. Zirconia offers several advantages
including high flexural strength and metal free structure.
It also demonstrates excellent optical properties, biocompatibility
and low heat conductivity making it one of the most efficient
material both for anterior and posterior restoration [5].
Establishing a strong bond with zirconia is only one part of the
problem. A more crucial aspect would be maintaining this bond
under the influence of fatigue conditions, in presence of saliva
and temperature changes for a clinically acceptable time.
To enhance the bond strength of luting cement to the ceramic
surface, a number of techniques have been reported which mechanically
facilitate resin ceramic bonding. Etching the inner
surface of a restoration with hydrofluoric acid followed by the
application of a silane coupling agent is a well-known and recommended method to increase bond strength. Although hydrofluoric
acid is efficient in roughening feldspathic ceramic for bonding
composite resin [6-8], neither etching with these solutions nor
adding silane resulted in an adequate resin bond to some new
ceramics [9-12]. Particularly high-alumina [13, 14] or zirconia ceramics
[15-17] cannot be roughened by hydrofluoric acid etching
since such ceramics do not contain a silicon dioxide (silica) phase.
For this reason, special conditioning systems are indicated for
these types of ceramics.
Advances in adhesive dentistry have resulted in the recent introduction
of modern surface conditioning methods that require
airborne particle abrasion of the surface before bonding in order
to achieve high bond strength. One such system is silica coating.
In this technique, the surfaces are air abraded with aluminium
trioxide particles modified with silica [18, 19]. The blasting pressure
results in the embedding of these silica coated alumina particles
on the ceramic surface, rendering the silica-modified surface
chemically more reactive to the resin.
There has been no concensus in the literature regarding the best
surface conditioning method for optimum bond strength depending
on the luting cements or ceramics used [20]. Therefore, the
objectives of this study were to evaluate the effect of current surface
conditioning methods on the bond strength of a resin luting
cement bonded to ceramic surfaces and to identify the optimum
method to be used for conditioning the ceramics prior to cementation.
Materials and Methods
60 cubes samples with dimensions (10×10×10mm) and 60 cylinders
samples with dimensions (3mm diameter, 2mm height),
picture (1.2) were cut from three zirconia ceramic blocks using
low speed precision saw machine. Sandblasting was done using air
blasting machine with 110 µm AL2O3 particles for 30 samples of
each (cubes & cylinders). The abrasive was applied to the zirconia
surface samples at a distance of 10 mm between the surface of
the samples and the blasting tip at 2.5 bar pressure for 10 seconds.
Silica coating surface treatment was done using an extra oral
blaster with 30 µm SiO2 particles for the remaining 30 samples of
each (cubics & cylinders). The abrasive was applied perpendicular
to the surface of the zirconia surface samples at 3 bar pressure for
15 seconds at a 10 mm distance.
Cementation of the samples:
Zirconia specimens were divided into 2 groups according to surface
treatment: Group 1: The specimens were sandblasted with
(110µm) Al2O3 (30 specimens cubes & cylinders).
Group 2: The specimens were silica coated with high purity
(30µm) SiO2 using COJET system(3m ESPE AG. ESPE Platz.
Seefield. Germany) (30 specimens cubes & cylinders).
The zirconia samples were sanded and coated with silica using a
dimension adjuster that was designed so that the distance between
the sanding grip head and the sanded surface was 10 mm.picture
(3)
Each group was subdivided into 3 subgroups (10 specimens each)
according to the type of adhesive resin cements (n = 10).
Subgroup A1: The specimens were sandblasted and cemented
with PANAVIA F2.0 (PANAVIA F2 F2:0 Kuraray, Okayama, Japan)
adhesive resin cement (10 Specimens).
Subgroup A2: The specimens were sandblasted and cemented
with PERMAFLO DC (PERMAFLO DC ultradent,salt lak
city,UT,USA) adhesive resin cement (10 Specimens).
Subgroup A3: The specimens were sandblasted and cemented
with PERMAFLO DC adhesive resin cement after conditioning
the zirconia surfaces with CLEARFIL(CLEARFIL Ceramic
Primer, Kuraray, Okayama, Japan) ceramic primer (containing
MDP) (10 Specimens).
Subgroup C1: The specimens were silica coated with and cemented
with PANAVIA F2.0 adhesive resin cement (10 Specimens).
Subgroup C2: the specimens were silica coated with and cemented
with PERMAFLO DC adhesive resin cement (10 Specimens).
Subgroup C3: the specimens were silica coated with and cemented
with PERMAFLO DC adhesive resin cement after conditioning
the zirconia surfaces with CLEARFIL ceramic primer (containing
MDP) (10 Specimens).
The cylinders zirconia samples were seated on the center of surface
of the cubes zirconia samples and a standardized load (3kg)
was applied using a Using the force application device located in
the Department of Fixed Prosthodontics, Damascus University
picture (2), after which the curing was done first for 5 seconds and
then the appendages were removed with a small brush to complete
the final curing for 20 seconds on each side of the cube and
then the application of Oxyguard glycerine gel; (Kuraray Co Ltd)
for ten minutes. The samples were then washed with a stream of
air and water and thermocycled at 37°C in a water bath for 24
hours before being tested.
Evaluation of shear bond strength of the cemented specimens:
The shear strength test (it is the ISO approved test in international
scientific research to test the bonding strength between two materials)
was carried out by the General Mechanical Testing Device
at the Industrial Research Center in Damascuspicture 4, where a
cubic zirconia was installed between the jaws of the device so that
the device head was as close as possible to The interface (cylinder
- cube) at speed of 0.5 mm/min and the forces were applied to
the samples, then the applied forces were calculated by the computer
of the device, where the forces continued to be applied until
the zirconia cylinders were debonded from the cubic zirconia,
then the values of the shear forces in Newtons were recorded.
The load at failure was divided by interfacial bonding area to express
the bond strength in Mpa.
Statistical analysis
The collected data were tabulated and statistically analyzed to
evaluate shear bond strength of different adhesives to zirconia.
Data were collected and recorded on Excel from Microsoft. Then,
statistical tests were conducted using SPSS v.25 (IBM, USA) program
with a significance level of 0.05.
Two-way ANOVA was used to study the effect of sanding and
luting material on the shear strength resistance of zirconia cylinders
with cubic zirconia. One-Way ANOVA with Games-Howell
test was used to study the simple main effect of adhesive. The independent
samples t-test was used to study the simple main effect
of surface treatment and their interaction on shear bond strength
for all groups.
Results
Shear bond strength
The mean shear bond strength of silica-coated zirconia specimens
cemented with PANAVIA F2.0 cement (C1) (21.8) was higher
than that of sandblasted zirconia specimens cemented with PANAVIA
F2.0 cement (A1) (20.5) and the difference was NOT
significant (p=0.669) as shown in Table (1). The mean shear bond
strength of sand blasted zirconia specimens cemented with PERMAFLO
DC cement (A2) (6) was higherthan that of silica-coated
zirconia specimens cemented with PERMAFLO DC cement (C2)
(2.4) and the difference was significant (p= 0.009) as shown in
Table (2). The mean shear bond strength of silica-coated zirconia
specimens cemented with PERMAFLO DC cement after conditioning
with CLEARFIL primer (C3) (16.8) was higherthan that of sandblasted zirconia specimens cemented with PERMAFLO
DC cement after conditioning with CLEARFIL primer (A3)
(12.2) and the difference was not significant (p=0.103).
Figure 1. The Samples (cubes & cylinders).
Figure 2. The force application device.
Figure 3. Dimension Adjustment Tool.
Figure 4. Universal mechanical Testing Device.
Figure 5. Cementation of cylinder on a cube.
Figure 6. Electron microscope image showing the effect of coating on the surface of zirconia (CoJet system).
Figure 7. An electron microscope image showing sandblasting on the surface of zirconia with 110µm aluminum oxide particles.
Table 1.
Table 2.
Discussion
A durable and stable bond between dental tissue, luting cements
and ceramics is fundamental for the long-term performance of all
ceramic restoration.
In this study it was done using (twin sample technique) as bonding
cylinderszirconia samples with dimensions (3mm diameter, 2mm height) to cubes zirconia samples with dimensions (10×10×10
mm) The dimensions of the sample were chosen in this way in
order to match the shape and size of the holders of the General
Mechanical Testing Device (Testometric (M350-10)) located in
the Center for Industrial Research and Tests in Damascus, also
which is in the range of sample dimensions of most previous
studies to give same change after surface treatment and thermocycling
procedure [21, 22].
As zirconia is resistant to traditional ways of surface treatments
like acid etching due to its silica and glass-free polycrystalline
structure, the current study used sandblasting to increase surface
roughness and allow formation of zirconium oxide layer to improve
bond strength between zirconia and adhesive resin cement
by chemical bond.
Zirconia samples received airborne particle abrasion with 110µm
aluminum oxide (Al2O3) particles at 2.5 bar pressure using an air
abrasion device for 10 sec from a distance of 10mm perpendicularly
to the surface [23, 24].
The current study selected 110µm as a sample size because big
size powder produce higher surface roughness than small size
particles (50 µm) thereby produce higher micromechanical retention
[25, 26].
Duration of sandblasting was selected in this study for 10 sec because
sandblasting for long period of time causes sharp margins
in surface topography that acts as stress points lead to formation
and propagations of cracks that can adversely affect the fracture
resistance of zirconia [7].
Due to lack of silica in zirconia, silica coating techniques have
been explored to utilize the chemical bonding provided by MDP
monomer. The use of tribochemical silica coating is a common
practice for coating zirconia-based dental ceramics with silica [27].
Using the CoJet system being the most heavily favored commercial
products utilized for applying the coating. The tribochemical
technique air-abrades particles is appropriate to produce surface
treatment with nano- particles than do with large particles size
[28].
The bonding was done using dual-curing resin cements (PANAVIA
F2 F2:0, PERMAFLO ) because the curing begins with
photoactivation in the light-reached places and the curing process
continues chemically in the far-unreached places [29].
Also, PERMAFLO DC dual-curing resin cement that does not
contain functional phosphate monomers (MDP) was used to
compare its effectiveness with PANAVIA F2:0 cement containing
(MDP) and study the effect of surface treatment and thermal
cycles on the bond strength of each of them [30].
Methacryloyloxyde Dihydrogen Phosphateext monomers in adhesive
cements have been proven to be effective for adhering to
the non-silica-based polycrystalline materials of zirconia. Numerous
studies have shown that phosphate monomers are promising
chemical agents for improving zirconia bonding [10]. The possible
mechanism is the ability of phosphate monomers to form
chemical bonds with zirconia oxide layer on the surface, and have
polymerizable resin terminal end groups (eg, methacrylate), which
enable cohesive bonding to appropriate resin cements [11, 31].
Cementation of the samples was done using the force application
device located in the Department of Fixed Prosthodontics, Damascus
Universitythat allowed application of standardized load
of 3 kg for all samples. This load was chosen in many studies to
avoid the risk of damaging the zirconia samples [32].
Aging by thermocycling was undertaken in this study to examine
the effect of simulated in vivo temperature variations on the
strength of the bond at the resin/ceramic interface [33].
Shear bond strength not only evaluate the bond strength of adhesive/
substrate combination, but also the effectiveness of the
surface treatment of the substrate on the bond. It also provides a
means of comparing different bonding material [16].
The result of the current study showed that shear bond strength
of silica-coated zirconia specimens cemented with PANAVIA
F2.0 cement (21.8 Mpa) was higher than that of sandblasted zirconia
specimens (20.5 Mpa) and the difference was not significant.
The higher bond strength values for the silica coated zirconia
specimens may be explained as silica coating leave a physically and
chemically active outer surface layer (oxide layer) that produced by
silica coating more than sand-blasting surface treatment, this silica
coating promotes a chemical bonding with phosphate monomer
(MDP) which is an ingredient of a composition of PANAVIA
F2.0 [17]. This result in agreement with previuos studies that reported
silica coating treatment with PANAVIA F2.0 provides a
strong and long lasting resin zirconia bond [13].
Also the result of this study recorded that the shear bond strength
of silica-coated zirconia specimens cemented with PERMAFLO
DC cement after conditioning the zirconia surface with CLEARFIL
primer (16.8 Mpa) higher than that of sand blasted zirconia
specimens cemented with PERMAFLO DC cement after conditioning
the zirconia surface with CLEARFIL primer (12.2 Mpa)
and the difference was not significantThis result can be explained
in the same way as the previous one, except that the difference
between this group and the previous one is that the MDP is separate
from the cement structure within the CLEARFIL ceramic
primer group [17].
finally the result of this study recorded that the shear bond
strength of sand blasted zirconia speci¬mens cemented with
PERMAFLO DC cement (6 Mpa) was higher than that of silicacoated
zirconia specimens cemented with PERMAFLO DC cement
(2.4 Mpa) and the difference was significant. The reason
may be due to the Cojet system (30µm Sio2) lead to Si deposition
that might tend to produce a surface with lower roughnessand
consequently lowers the possibility of mechanical interlocking
with PERMAFLO DC adhesive resin cement [34].
Sand blasting surface treatment with (110µm AL2O3) particles
produces more roughness on zirconia surface than silica coatingpicture
(6.7) and obtains micromechanical retention on the
zirconia surface more than silica coating with PERMAFLO DC
adhesive resin cement [35].
Likewise, high viscosity of the PERMAFLO DC causes poor
penetration of the cement to the small pores caused by silica
coating and good penetration to the large pores caused by sand
blasting [36].
This result is in agreement with the finding of several studies
which reported that bond strength to zirconia was not improved
after silica coating compared to airborne paricle abrasion. However,
this result was contradicting to the results of other studies
which reported that silica coating improved bond strength to zirconia
ceramics compared to sand blasting [37].
According to the results of this study the shear bond strength of
sand blasting zirconia specimens cemented with PANAVIA F2.0
cement (20.5 Mpa) was higher than that of sand blasting zirconia
specimens cemented with PERMAFLO DC cement after conditioning
the zirconia surface with CLEARFIL primer (12.2 Mpa)
which was higher than that of sand blasting zirconia specimens
cemented with PERMAFLO DC cement (6 Mpa) with significant
difference. This high bond of PANAVIA F2.0 group &CLEARFIL
primer group can explained here by the (MDP) monomer
present either within the structure of (PANAVIA F2.0) or in the
ceramic primer (CLEARFIL) separated from the risen structure
of PERMAFLO DC, which forms a chemical bond with the surface
of zirconia, MDP is a functional group with a long hydrophobic
chain molecule with two ends. One end has a vinyl group
that reacts with the monomer of the resin cement when polymerized.
At the other end, hydrophilic phosphate ester groups bond
strongly with zirconia oxide layer [38].
It was also noticed that also the shear bond strength of silica
coated zirconia specimens cemented with PANAVIA F2.0 cement
(21.8 MPa) was higher than that of silica-coated zirconia
specimens cemented with PERMAFLO DC cement after conditioning
the zirconia surface with CLEARFIL primer (16.8 MPa)
which was higher than that of silica-coated zirconia specimens
cemented with PERMAFLO DC cement (2.4 MPa) and the difference
was significant.
This high bond of (PANAVIA F2.0) can be explaine by its content
of MDP that produces chemical bond with oxide layer created
by silica coating in zirconia surface in addition to mechanical
bond created by the roughness of silica coating while PERMAFLO
DC cement depends only on mechanical bond created by
silica coating on zirconia surface [39].
Another reason may be due to low viscosity of PANAVIA F2.0
that increases surface wettability and in¬creases penetration of
PANAVIA F2.0 cement to the small pores that caused by silica
coating that leads to high bond strength than PERMAFLO DC
which is more viscous [40].
Tribochemical silica coating is a type of surface treatment in
which zirconia surface is abraded with aluminium-oxide particles
modified by silica and the blasting pressure results in embedding
of silica particles on zirconia surface which results in chemical
bond between zirconia surface and PANAVIA F2.0 adhesive resin
cement as phosphate ester group of MDP binds directly to zirconia
oxide. The efficacy of this surface treatment has been demonstraded
in previous studies [41].
Conclusion
Within the limitations and conditions of this in vitro study, it
could be concluded that:
1. Silica coating surface treatment improved Shear bond strength
of PANAVIA F2.0 as the CoJet system promotes surface roughness
and provides micromechanical retention and also a chemical
bond.
2. Silica coating surface treatment of zirconia specimens showed
inferior bond strength for PERMAFLO DC in comparison with
the sand blasting surface treatment.
3. Sand blasting surface treatment of zirconia specimens showed
high result of shear bond strength than silica coating with PERMAFLO
DC as sand blasting with 110 µm AL2O3 obtains micromechanical
retention on zirconia surface more than silica coating.
4. PANAVIA F2.O produced high bond strength in the zirconia
specimens treated with silica coat¬ing and sand blasting more
than PERMAFLO DC.
5. zirconia/resin bond strength could be significantly improved
using sandblasting & silica coating techniques in combination
with MDP monomer.
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