Bonding durability between zirconia and different types of tooth or implant abutments-a systematic review. Part I: outcomes of in vitro studies.

Abstract

PURPOSE\nTo systematically review all in vitro studies focusing on the durability of different bonding protocols applied to zirconia restorations with different types of tooth or implant abutments.\n\n\nMATERIALS AND METHODS\nEnglish-language articles published in dental journals up to March 2020 were searched using a combination of free text words and MeSH terms, as follows: zirconia; Y-TZP; zirconium; zirconia restoration; enamel; dentin; titanium abutment; titanium base; ceramic abutment; dental core; ceramic or metal post and core; composite build-up; bonding; adhesive cement; resin cement; adhesion; cementation; test; material testing; laboratory; and in vitro. Studies were identified for review based on certain inclusion and exclusion criteria.\n\n\nRESULTS\nA total of 3,339 titles were identified. After a successive filtering process, a final total of 28 studies were included. The included studies featured different types of surface pretreatment methods, primers, resin cements, tooth and implant abutments, laboratory test outcomes, and designs. The relatively limited number of the identified studies and the heterogeneity of the extracted data did not allow for meta-analysis.\n\n\nCONCLUSIONS\nZirconia surface pretreatment is an essential step in the bonding protocol. Airborne-particle abrasion surface pretreatment had a positive influence on zirconia resin bonding to most types of tooth and implant abutments identified. Chemically activating the treated zirconia surfaces with an MDP monomer-based primer, along with an MDP monomer or phosphate ester monomer-based resin cement, seems to be a durable bonding protocol. Type of resin cement seems to be a less influential factor.