Er,Cr:YSGG Laser Surface Modification Effect on Dentin Bonding to Zirconia: An In Vitro Study

This study investigated the effect of dentin surface treatment with the erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser on the bond strength of zirconia to dentin. Although it is well-known that resin cement (RC) provides adequate bond strength of zirconia restorations to the tooth structure, many clinicians were not convinced in bonding reliability to zirconia materials. So, they preferred cementing their crowns with glass-ionomer cement (GIC). Pretreating the dentin surface is recommended to improve the adhesion of crowns cemented with GIC or RC. Recently, the Er,Cr:YSGG laser has been widely used for a cavity preparation, conditioning the tooth structure. However, there is not enough research on the bond strength of zirconia crowns cemented on a Er,Cr:YSGG laser-treated dentin. Forty-eight molars were cut horizontally at the crest of curvature. The flat dentin surface of 24 molars was left untreated, whereas the dentin surface of the other half was treated using an Er,Cr:YSGG laser 2.78 μm (4.5 W, 8.18 J/cm², 90 mJ, 60 μs, 50 Hz, 60% air and 80% water). In addition, 48 plates of zirconia were prepared to be cemented with GIC or RC on the dentin surface. So, the molars were divided into four groups as follows: GIC+untreated dentin; GIC+treated dentin; RC+untreated dentin; and RC+treated dentin. All the specimens were subjected to shear bond strength test. The mode of failure was determined and additional samples were prepared to evaluate the cement-dentin interface using a scanning electron microscope. Data were analyzed with two-way analysis of variance accompanied by univariate analyses. The bond strength of zirconia cemented with GIC or bonded with RC significantly increased on a Er,Cr:YSGG laser-treated dentin surface (p < 0.05). Dentin preconditioning with an Er,Cr:YSGG laser significantly improved the bond strength of zirconia plates to dentin as compared with untreated dentin.