Purpose To evaluate resin cement bond strength after removal of salivary contamination from a zirconia surface using different cleaning solutions and air‐borne particle abrasion. Materials and methods One‐hundred and twenty zirconia specimens (KATANA STML, Noritake) were prepared and divided into 12 groups (n = 10). Groups were subjected to a notched‐edge shear bond strength test (ISO 29022) to analyze the bonding efficiency of a resin cement (Panavia V5, Kuraray Noritake Dental Inc.) before and after contamination with saliva. Group 1 (control) was prepared and cemented without salivary contamination. Group 2 was coated with ceramic primer (Clearfil Ceramic Primer Plus, Kuraray Noritake Dental Inc.) then subjected to salivary contamination then tested. Group 3 was contaminated, cleaned by air‐borne particle abrasion, ceramic primer and resin cement applied, and tested. Groups 4 to 12 were contaminated, and then different cleaning solutions (water, 4.5% hydrofluoric acid, 35% phosphoric acid, Ivoclean, KATANA cleaner, Zirclean, sodium hypochlorite 4%, and 7.5%) were used to decontaminate the zirconia surface, followed by ceramic primer, resin cement application, and tested. One‐way ANOVA and Tukey post‐hoc analysis was used to analyze the data. Results One‐way ANOVA showed statistical differences among cleaning procedures (p < 0.001, F = 13.48). Air‐borne particle abrasion was the only group which provided a bond strength (21 ± 2.8 MPa) that was not statistically different than the control group in which no contamination occurred (25.3 ± 3.3 MPa) (p = 0.247). The use of hydrofluoric acid and zirconia cleaning solutions resulted in bond strengths values which were not statistically different from each other (17.5‐19.1 MPa). Conclusion Air‐borne particle, zirconia cleaning solutions and hydrofluoric acid are feasible to decontaminate the zirconia surface from saliva prior to bonding the restoration.

Purpose To evaluate the survival rate (fatigue resistance), bonding efficiency and marginal integrity of monolithic zirconia partial and full coverage single restorations adhesively bonded to the tooth structure using air‐particle abrasion, a primer with 10‐methacryloyloxydecyl dihydrogen phosphate and a composite‐resin cement (APC) protocol. Materials and Methods Extracted human premolars (N = 32) were randomly divided into four groups of eight specimens each. Premolars were prepared for the following restorations: full crown (group 1, control), mesial‐occlusal‐distal‐facial onlay (MODF, group 2) preserving 2 mm facio‐lingual functional cusp width, mesial‐occlusal‐distal‐lingual onlay (MODL, group 3) preserving 2 mm facio‐lingual nonfunctional cusp width, mesial‐occlusal‐distal‐buccal‐lingual onlay (MODBL, group 4), overlay preparation. All restorations were milled from monolithic 3 mol% yttria (3Y) zirconia blocks (ZirCad, A1 LT, Ivoclar Vivadent) with CAD/CAM software presets at minimum occlusal and axial thicknesses of 1 mm. The intaglio surface of the restorations was air‐particle abraded (50 µm Al2O3, 2‐Bar pressure, 15 s, 10 mm distance) and primed. An adhesive cement system was used to bond the restorations. Each group was subjected to thermomechanical loading for 1.2 million cycles (force = 70 N, 1.4 Hz) with simultaneous thermocycling (5‐55°C, 30 s dwell time) using a mastication simulator. All specimens were examined under scanning electron microscope (SEM) analysis (30, 100, and 150×) to evaluate cracks and marginal defects. Fracture of restoration and/or fracture within tooth structure, and debonding were considered modes of failure. Results One specimen from group 2 debonded at 632,000 cycles. None of the specimens failed due to fracture. SEM analysis at 30× indicated marginal integrity issue of the remaining seven intact specimens of group 2 in the area of antagonist contact. No specimens from group 1, 3, and 4 demonstrated marginal integrity issue at 30×. None of the specimens demonstrated any microcrack at 100× and150×. Conclusions Due to its fatigue resistance, 3Y‐zirconia is a viable option for partial and full coverage single restorations. Following a strict bonding protocol, zirconia demonstrated durable adhesion to the tooth structure. Occlusal contact on restoration margins should be avoided.

Purpose: To assess the effect of yttria mol% concentration and material thickness on the biaxial fracture load (N) of zirconia with and without mastication simulation. Materials and methods: Disk-shaped specimens (N = 120) of 3 mol% yttriapartially stabilized zirconia, 3Y-PSZ (Katana High Translucent, Kuraray Noritake), 4 mol% yttria-partially stabilized zirconia, 4Y-PSZ (Katana Super Translucent Multi Layered) and 5 mol% Yttria-partially stabilized zirconia, 5Y-PSZ (Katana Ultra Translucent Multi Layered) were prepared to thicknesses of 0.7 and 1.2 mm. For each thickness, the biaxial fracture load (N) was measured with and without mastication simulation with 1.2 million cycles at a 110-N load and simultaneous thermal cycling at 5°C to 55°C. The data were analyzed by three-way Analysis of Variance (α = 0.05) and Tukey-Kramer adjusted multiple comparison test. Results: Yttria mol% concentration and material thickness had a statistically significant effect on the mean biaxial fracture load (F = 388.16, p < 0.001 and F = 714.33, p < 0.001 respectively). The mean biaxial fracture load ranged from the highest to the lowest; 3Y-PSZ, 4Y-PSZ, and 5Y-PSZ (p = 0.012). The mean biaxial fracture load of the 1.2 mm thickness groups was significantly higher than 0.7 mm thickness at any given condition (p = 0.002). Not all specimens survived the mastication simulation protocol. Fifty percent of the 0.7-mm-thick 4Y-PSZ specimens, 70% of the 0.7-mm-thick 5Y-PSZ specimens and 20% of 1.2-mm-thick 5Y-PSZ specimens fractured during mastication simulation. Mastication simulation had no statistically significant effect on the biaxial fracture load (F = 1.24, p = 0.239) of the survived specimens. Conclusions: Lowering yttria mol% concentration and increasing material thickness significantly increases the fracture load of zirconia. At 0.7 mm thickness, only 3Y-PSZ survived masticatory simulation. A minimum material thickness of 1.2 mm is required for 4Y-PSZ or 5Y-PSZ.

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