Statement of problem. Surface treatment methods used for resin bonding to conventional silica-based dental ceramics are not reliable for zirconium-oxide ceramics. Purpose. The aim of this study was to compare the effects of airborne-particle abrasion, silanization, tribochemical silica coating, and a combination of bonding/silane coupling agent surface treatment methods on the bond strength of zirconium-oxide ceramic to a resin luting agent. Material and methods. Sixty square-shaped (5 X 5 X 1.5 mm) zirconium-oxide ceramic (Cercon) specimens and composite resin (Z-250) cylinders (3 X 3 mm) were prepared. The ceramic surfaces were airborne-particle abraded with 125-mu m aluminum-oxide (Al2O3) particles and then divided into 6 groups (n=10) that were subsequently treated as follows: Group C, no treatment (control); Group SIL, silanized with a silane coupling agent (Clearfil Porcelain Bond Activator); Group BSIL, application of the adhesive 10-methacryloyloxydecyl dihydrogen phosphate monomer (MDP)-containing bonding/silane coupling agent mixture (Clearfil Liner Bond 2V/Porcelain Bond Activator); Group SC, silica coating using 30-mu m Al2O3 particles modified by silica (CoJet System); Group SCSIL, silica coating and silanization (CoJet System); and Group SCBSIL, silica coating and application of an MDP-containing bonding/silane coupling agent mixture (Clearfil Liner Bond 2V/Porcclain Bond Activator). The composite resin cylinders were bonded to the treated ceramic surfaces using an adhesive phosphate monomer-containing resin luting agent (Panavia F). After the specimens were stored in distilled water at 37 degrees C for 24 hours, their shear bonding strength was tested using a universal testing machine at a crosshead speed of 0.5 mm/min. Debonded specimen surfaces were examined with a stereomicroscope to assess the mode of failure, and the treated surfaces were observed by scanning electron microscopy. Bond strength data were analyzed using 1-way analysis of variance and the Duncan test (alpha=.05). Results. The bond strengths (mean +/- SD; MPa) in the groups were as follows: Group C, 15.7 +/- 2.9; Group SIL, 16.5 +/- 3.4; Group BSIL, 18.8 +/- 2.8; Group SC, 21.6 +/- 3.6; Group SCSIL, 21.9 +/- 3.9; and Group SCBSIL, 22.9 +/- 3.1. The bond strength was significantly higher in Group SCBSIL than in Groups C, SIL, and BSIL (P<.001), but did not differ significantly from those in Groups SC and SCSIL. Failure modes were primarily adhesive at the interface between zirconium and the resin luting agent in Groups C and SIL, and primarily mixed and cohesive in Groups SC, SCSIL, and SCBSIL. Conclusion. Tribochemical silica coating (CoJet System) and the application of an MDP-containing bonding/silane coupling agent mixture increased the shear bond strength between zirconium-oxide ceramic and resin luting agent (Panavia F).
