Long-term Bond of Glass Ceramic and Resin Cement: Evaluation of Titanium Tetrafluoride as an Alternative Etching Agent for Lithium Disilicate Ceramics

Purpose: To evaluate in vitro the effect of using titanium tetrafluoride as an alternative etchant prior to the silanization of the bonding surface on the long-term resin bond strength to lithium disilicate ceramic. Materials and Methods: Disk-shaped specimens made of lithium disilicate ceramic were ground with abrasive paper, then etched with aqueous solutions (2.5% and 5%) of titanium tetrafluoride for 60 s, 120 s and 240 s. Positive control specimens were etched with 5% hydrofluoric acid for 20 s and negative control specimens were not etched. Afterwards, bonding surfaces of all specimens were silanized. Plexiglas tubes filled with a composite resin were bonded to the specimens using an alignment apparatus and a composite luting resin. After storage in 37 degrees C tap water for three days (n = 8) and after storage in 37 degrees C tap water for 150 days interrupted by 5 x 7500 thermal cycles (n = 8), tensile bond strength (TBS) was measured in a universal testing machine at a crosshead speed of 2 mm/min. Results: After artificial aging, all specimens etched with titanium tetrafluoride debonded spontaneously resulting in a TBS of 0 MPa. Therefore, statistical analysis revealed a highly significant difference between the positive control and the test groups after 150 days storage. Conclusion: Etching the bonding surface of lithium disilicate ceramic restorations with hydrofluoric acid is still a "gold standard" and cannot be replaced by titanium tetrafluoride.