Impaction-modified densely sintered yttria-stabilized tetragonal zirconium dioxide: methodology, surface structure,...

The objectives of the study were to describe a novel method for producing zirconium dioxide specimens with a cementation surface that allows adhesive cementation techniques, to describe the surface structure and to evaluate the bond strength. Forty-eight pairs of specimens were fabricated and adhesively luted together. Three different surfaces were tested: impaction-modified surfaces created by using glass granules (G), impaction-modified surfaces created by using polymer granules (P) and a nonmodified control surface (C). Two bonding systems were used, Variolink(®)II (VA) or Panavia™F 2.0 (PA). During the different fabrication steps, the surfaces were examined under light microscope and analyzed with an optical interferometer. All groups were thermocycled and subjected to shear bond strength test. The groups with modified cementation surfaces showed significantly higher shear bond strength: 34.9 MPa (VA-G), 30.9 MPa (VA-P), 29.6 MPa (PA-P), and 26.1 MPa (PA-G) compared with the relevant control group: 20.5 MPa (VA-C) and 17.8 MPa (PA-C). The groups with surface modification showed a rougher surface structure and significantly fewer fractures between the cement and the zirconium dioxide surfaces compared to the control groups where all failures were adhesive. Impaction modification with an impaction medium pressed into the cementation surface of zirconium dioxide-based reconstructions can be used in combination with an additive production technique to increase bond strength. Both modification techniques described in the study result in a rougher surface structure and higher shear bond strength compared to the control groups.