Critical appraisal. Resin bonding to zirconia

Research has focused on adhesion and bond strengths to zirconia, but the question is "what is the gold standard--what is the bond strength we are trying to achieve?" Clinical data are needed to further understand adhesion issues--and studies are just now being published. Preliminary clinical research indicates that some failures are due to loss of adhesion but more are due to chipping of veneer porcelain. Commercial adhesion products are continuously being developed and optimized for clinical use. It is anticipated that the use of zirconia in dentistry will increase in the future, so reliable clinical adhesion solutions are needed. Based on the literature and the commercial products available to clinicians today, using novel primers (e.g., Z-PrimePlus) coupled with low pressure air-abrasion would be more than sufficient for adequate bonding of resin cement.