Mechanical and chemical surface treatment enhances bond strength between zirconia and orthodontic brackets: an in vitro study

Objectives To assess the shear bond strength (SBS) between metal orthodontic brackets and zirconia after receiving different mechanical and chemical surface treatments, and different types of resin adhesive. The failure mode of each treatment protocol was also evaluated.Materials and methods The present in vitro experimental study consisted of six surface treatment protocols with two different resin adhesives. One-hundred and forty-four rectangular-shaped 3 mol% yttrium-stabilized tetragonal zirconia polycrystal blocks were milled, sintered, and embedded in acrylic resin. They were randomly divided into three mechanical (none, air abrasion, and bur grinding) and two chemical surface treatment conditions (no primer and Z-primer). The specimens were divided into two groups according to the resin adhesive received: self-cured (RelyX U200) and light-cured adhesives (Transbond XT). The SBS between the metal bracket and zirconia was tested using a universal testing machine (1-mm/min crosshead speed), and the failure mode was evaluated. Differences in SBS and failure mode were analyzed using Welch ANOVA followed by post-hoc comparison and Fisher's Exact test, respectively.Results Bur grinding produced the highest SBS, followed by air abrasion. Z-primer application typically provided a higher SBS regardless of resin adhesive used (p < 0.001). Without primer application, RelyX U200 provided a higher SBS than Transbond XT (p < 0.001). After grinding, using Z-primer and RelyX U200 resulted in a higher SBS than no primer and using Transbond XT (p < 0.001). Adhesive failure at the zirconia-adhesive interface occurred only when Transbond XT was applied without bur grinding, and when using Transbond XT after grinding, but no Z-primer application.Conclusion Bur grinding combined with applying an MDP-containing primer and resin adhesive enhances the SBS between zirconia and metal orthodontic brackets.