Repair Bond Strength of Composite Resin to Dental Ceramic Using Various Surface Treatments: An In Vitro Study

Aim: This research aims to evaluate and compare the effect of various surface treatments and adhesive types on the bond strength between composite resin and two types of ceramic materials. Materials and Methods: A total of 98 disk-shaped of 10 mm diameter and 4 mm thickness were fabricated for each of the zirconia (H. C. Starck) and lithium disilicate (IPS E-Max computer-aided design), which were implanted individually in the acrylic resin mold leaving one surface exposed. The disks in each group were sub-divided according to the surface treatments into seven groups (n = 14): [hydrofluoric acid (HF, 9.5%), air abrasion, bur, laser, HF + bur, HF + air abrasion, HF + laser]. Each sub-group was further divided into two groups (n = 7) according to the type of adhesive used for the repairing procedure [G-Premio Bond universal adhesive group and intraoral repair kit (BISCO) group]. Each adhesive was applied depending on manufacturer instructions and, then, the composite cylinder (4 mm in diameter and 4 mm in height) was built on the pre-determined treated ceramic surface area by the addition of rubber mold. Then the samples were stored in distal water for 24 h. After that, all groups were submitted to a shear bond test using an Instron testing machine (TSTM 02500; Elista Ltd., Istanbul, Turkey) at 0.5 mm/min a crosshead speed. The data were analyzed by three-way analysis of variance and Tukey post hoc test at (P <= 0.05). Results: The HF + air abrasion groups registered the higher bond strength but with no statistically significant difference from groups of HF + bur. While the laser groups showed the lowest mean bond strength. Generally, E-Max registered significantly higher bond strength in comparison to zirconia. Finally, the BISCO repair system registered a significantly higher bond strength value in comparison to G-Premio. Conclusion: Combined surface treatment of HF + air abrasion with an intraoral repair kit can provide a promising method for repairing cracked ceramic restorations. However, repairing lithium disilicate is more predictable and successful than zirconia.