The poor bonding strength of zirconia to different dental substrates is one of the challenging issues in restorative dentistry. Hydroxyapatite is an excellent biocompatible material with fine bonding properties. In this study, it was hypothesized that hydroxyapatite coating on zirconia would improve its bond strength. Forty-five zirconia blocks were prepared and randomly divided into three groups: hydroxyapatite coating, sandblasting, and no preparation (control). The blocks were bonded to cement and the micro-shear bond strength was measured following load application. The bond strength values were analyzed with the Kruskal-Wallis test in 3 groups and paired comparisons were made using the Mann-Whitney U test. The failure patterns of the specimens were studied by a stereomicroscope and a scanning electron microscope and then analyzed by the chi-square test (significance level = 0.05). Deposition of hydroxyapatite on the zirconia surface significantly improved its bond strength to the resin cement in comparison with the control specimens (p < 0.0001). Also, the bond strength was similar to the sandblasted group (p = 0.34). The sandblasted and control group only showed adhesive failure, but the hydroxyapatite coated group had mixed failures, indicating the better quality of bonding (p < 0.0001). As a final point, hydroxyapatite coating on the zirconia surface improved the bond strength quality and values.

Objectives: This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers.Materials and Methods: Based on the PICO question and the search terms, an electronic search was performed in Google Scholar, PubMed (MEDLINE), Scopus, Cochrane Library, Web of Science, Science Direct, Wiley, Ovid, and SAGE for articles published up to July 2022. After including English in vitro studies that evaluated posterior ceramic occlusal overlays at the posterior with ceramic restorations by following the PRISMA statement, the extracted data was tabulated. The methodological quality of the included studies was evaluated. Risk of bias assessment was done independently by two authors using the modified MINORS scale.Results: About 3138 search results were screened, of which 22 were selected due to their titles. Twenty-one full-text articles were assessed for eligibility. Seventeen invitro studies were finalized for the extraction of quantitative data. All 17 articles had a low risk of bias and were retained. The influencing items for evaluating the research were different in most studies; therefore, qualitative synthesis of the results was feasible. They generally included preparation design, material thickness, depth of preparation in the tooth, internal divergence angle, and finish line. Metaanalysis was not done due to heterogeneity of preparation types and evaluation methods. Results revealed that fracture resistance of occlusal veneers is higher than normal mastication force, and it is sufficient to prepare the occlusal surface, use a self-etching primer for bonding, and an acceptable minimum ceramic thickness. The marginal discrepancy of occlusal veneers is clinically acceptable. However, this systematic review faces some limitations due to the lack of in vivo studies, different preparation designs in included studies, different follow-ups, and lack of comprehensive explanations in articles.

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Objectives: Endocrown restorations were introduced for endodontically treated teeth as a conservative treatment. However, data about the effect of preparation design on marginal integrity and fracture resistance of endocrowns are lacking. The purpose of this systematic review was to investigate the effect of preparation design of endocrown restorations on marginal integrity and fracture resistance. Materials and Methods: Based on PICO question and the search terms, PubMed, Embase, Scopus, and the Cochrane Library were searched. After including studies matched to predefined inclusion and exclusion criteria, the extracted data were tabulated in a table provided by the authors. Two reviewers assessed the methodological quality of each included study independently. Ten articles were selected for extracting the quantitative data. All included studies were in vitro. The potential risk of bias of the selected studies was assessed using the modified MINORS scale. Results: Four studies assessed the marginal adaptation, five studies evaluated the fracture resistance and just one investigated both the marginal integrity and fatigue resistance of the specimens. The evaluated influencing items in preparation design were as follows: cavity depth, occlusal thickness, ferrule effect, internal divergence angle, type of finish line, and adding vents inside pulp chamber. Meta-analysis could not be done due to heterogeneity of preparation designs and evaluation methods. Conclusion: Marginal discrepancy of endocrowns is intensified with adding preparation features, higher cavity depth and increasing the divergence. Fracture resistance of endocrowns is increased with more occlusal reduction and cavity depth. However, it is still beyond the normal clinical force range.

Objectives: This study aimed to compare the color and fluorescence of five dentin ceramic systems with human dentin to enhance shade matching.Materials and methods: Five dentin ceramic systems, including Vita, GC, Creation, Noritake, and Ivoclar in 16 shades, and 12 human dentins, were prepared. The fluorescence and color coordinates were measured at 380-780 nm. A light source including a visible and a ultraviolet (UV) complemented with a geometry 45 illumination and 0 observer was used. The mean minimum difference in color coordinates and fluorescence efficiency was statistically analyzed before and after UV excitation by one-way ANOVA (p < 0.05). Post-hoc multiple comparisons were performed using the LSD test (p < 0.05).Results: While the fluorescence efficiency of Noritake and Ivoclar ceramics displayed no significant difference with natural dentin, Vita, GC, and Creation ceramics presented a lower fluorescence compared to the natural dentin (p < 0.05). Noritake and Ivoclar had a better color match with human dentin than the other ceramics. Studying the color differences under UV showed that just Creation offers statistically worse performance than the other ceramic. Conclusions:The color and fluorescence of the used different brands of dentin ceramic are not the same as the human dentin. However, Noritake and Ivoclar presented the most similarity.Clinical Significance: Knowledge of ceramic and natural teeth fluorescence is essential for acceptable reproduction of optical properties in esthetic restorations.

BackgroundZirconia has been used as a reliable core material in dental restorations for years, however, its bonding to resin cement is a matter of challenge. Physical, chemical, and a combination of these techniques have been investigated to boost the properties of zirconia surface bonding. The objective of this work was to evaluate the effect of hydroxyapatite coating as a chemical therapy in combination with physical modifications on micro-shear bond strength of the resin cement over zirconia.MethodsIn the present research, 60 sintered zirconia blocks (4×4×4 mm) were randomized into four groups of 15, including Al2O3 particle abrasion (group 1), HA coating (group 2), Al2O3 particle abrasion + HA coating (group 3), and Er, Cr:YSGG laser irradiation + HA coating (group 4). The micro-shear bond strength was determined by bonding the blocks to the resin cement. ResultsBond strength (mean ±standard deviation) of modified zirconia surfaces were 16.93±4.94 MPa, 16.14±5.4 MPa, 19.4±5.27 MPa and 16.21±3.7 MPa in the group 1 to 4, respectively. ANOVA tests results clarified no significant difference regarding bond strength values of zirconia surfaces to the resin cement between studied preparation modalities. (P>0.05) ConclusionObservations of the present study showed that HA coating can be as effective as airborne-particle abrasion technique in the improvement of bond strength to zirconia surface. Moreover, sandblasting by aluminum oxide or Er,Cr:YSGG laser irradiation prior to HA coating of zirconia showed no significant effect on the reinforcement of bond strength values when comparing with HA coating alone.

Background. Today, various methods are used to increase the bond strength of zirconia in layering ceramics. This study evaluated the effects of nonthermal argon plasma on zirconia shear bond strength to layering porcelain. Materials and Method. In this experimental study, 42 square blocks of zirconia were prepared and randomly divided into three groups (n = 14) according to the applying surface treatment: (1) the control group (without any surface treatment), (2) the plasma-treated group with argon nonthermal plasma, and (3) the air abrasion group with 50 µm Al2O3 particles. All samples were layered with porcelain. One sample from each group was evaluated by electron microscopy (SEM) to examine the cross-sectional area of the zirconia–ceramic bond. The rest of the specimens were subjected to thermocycling with 5,000 baths to imitate the aging process in the mouth and then were tested for shear bond strength. The failure pattern of the samples was examined by stereomicroscope. Bond strength data were analyzed by one-way ANOVA test in three groups and Tamhane post hoc test in pairs. The significance level of p-value was considered 0.05. Results. The shear bond strength of the plasma-treated group was significantly higher than the control group ( p = 0.032 ) but the shear bond strength between the sandblast and the plasma-treated group was not significantly different ( p = 0.656 ). The shear bond strength between the sandblast and the control group was also not significant ( p = 0.202 ). Regarding the mode of failure, failures were mostly adhesive and then mixed. Examination of the samples under SEM showed that the bond area is the thickest in the sandblast group and also the surface roughness is the highest in the sandblast group and the lowest in the control group. Conclusion. This study demonstrated that the use of nonthermal argon plasma treatment is an effective way to enhance the quality and quantity of shear bond strength between layering porcelain and zirconia.

Background: Considering the potential of translucent zirconia for application in esthetic restorations, it is necessary to find effective methods with the least adverse effects to increase its bond strength to resin cement. Aims: This study aimed to test if different conservative surface treatments and cement types could affect the micro-shear bond strength (μSBS), failure mode, and bonding interface between resin cement and translucent zirconia. Materials and Methods: In this in vitro experimental study, translucent zirconia blocks were divided into four groups based on the surface treatment they received: no treatment, argon plasma, primer (Pr), and Pr + plasma. Each group was further divided into two subgroups based on the applied cement: PANAVIA F2 and Duo-Link cement. Fourteen cement columns with a diameter of 1 mm were placed on each block ( n = 14); all the specimens were immersed in 37°C water for 24 h. Afterward, μSBS was evaluated ( P < 0.05), and the mode of failure was determined by a stereomicroscope (×10). The cement–zirconia interface and the surface hydrophilicity (contact angle) were also evaluated. Statistical Analysis: Two-way analysis of variance (ANOVA) was used to evaluate the effect of surface preparation, cement types, and incubator, simultaneously ( P < 0.05). The bond strengths after incubation were analyzed by one-way ANOVA ( P < 0.05). Failure mode, contact angle, and cement–zirconia interface were analyzed descriptively. Results: The highest bond strength was seen in Pr surface treatment for Duo-Link cement; however, this group was not significantly different from Pr and PANAVIA F2 cement and Pr + plasma and Duo-Link cement ( P = 0.075) groups. All plasma specimens in the incubator failed prematurely. The mode of failure in all specimens was adhesive. The lowest and highest contact angles were seen in Pr + plasma and the control groups, respectively. Conclusion: The use of Pr could successfully improve the bond strength of resin cement to translucent zirconia while plasma was not an acceptable and durable substitute.