Bond Strength of CAD/CAM Restorative Materials Treated with Different Surface Etching Protocols

To evaluate the effect of different surface treatments on the surface morphology of CAD/CAM ceramics and on their bond strength to cement.

Sixty cubic sections were cut from each of three materials (lithium disilicate glass-ceramic [DL], leucite-based glass-ceramic [LC], resin-matrix ceramic composite [RMCC]) and were treated as follows (n = 10): 1. no treatment (C); 2. 5% hydrofluoric acid applied for 20 s plus silane (HF5% 20 s); 3. 5% hydrofluoric acid applied for 60 s plus silane (HF5% 60 s); 4. 10% hydrofluoric acid applied for 20 s plus silane (HF10% 20 s); 5. 10% hydrofluoric acid applied for 60 s plus silane (HF10% 60 s); 6. Self-etching ceramic primer (MBEP). Ceramic cubes were bonded to pre-polymerized composite resin cubes with a composite cement. Each set was cut into stick-shaped specimens (1 ± 0.3 mm2). After 24-h water storage, microtensile bond strength (µTBS) was measured. Data were analyzed using two-way ANOVA and Tukey's test (α = 0.05). Failure pattern and surface morphology were assessed using scanning electron microscopy (SEM).

Both factors significantly influenced µTBS, while no interaction between factors was found. RMCC presented statistically higher µTBS values than LC and DL, while the surface treatments HF5% 20 s, HF5% 60 s, HF10% 20 s, HF10% 60 s and MBEP, did not show statistical differences between them, although they resulted in statistically significantly higher bond strengths than did C groups. A high number of pre-test failures were detected in the control groups for all materials. MBEP produced less extensive surface alterations than did all HF treatments.

All of the hydrofluoric acid treatments tested showed similar cement-ceramic bonding efficacy. The self-etching ceramic primer produced less surface alterations and comparable bonding efficacy compared to separate hydrofluoric acid/silane primer application.