Effect of Surface Treatment and Resin Cement on the Bond Strength of an Advanced Lithium Disilicate

The aim of the study was to evaluate the effect of surface treatment and resin cement on the bond strength of conventional and advanced lithium disilicates (ALDs).

Ceramic slices (2 × 13 × 15 mm) of conventional lithium disilicate (LD) (IPS e.max CAD) and ALD (CEREC Tessera) were sectioned, polished, and divided into 16 groups (n = 10) according to the factors: ceramic, surface treatment, and resin cement (Panavia V5 and Variolink Esthetic DC). Surface treatments consisted of hydrofluoric acid 4.9% etching for 20 seconds (Hf20) or 30 seconds (Hf30), self-etching ceramic primer (Se), and sandblasting (Sb). Then, a resin cement cylinder (Ø = 2.5 mm) was manufactured on each specimen's surface. The specimens were then submitted to a shear bond strength (SBS) test. Surface roughness was evaluated through a contact profilometer, and surface morphology was evaluated under scanning electron microscopy for qualitative analysis.

Two-way analysis of variance (ANOVA) was used to analyze the data of SBS and surface roughness. For bond strength, the effects of surface treatment, resin cement, and the interaction were analyzed for each ceramic. For roughness, analyzed factors include ceramic and surface treatment.

ANOVA revealed that ceramic (p = 0.047) and surface treatment (p < 0.001) factors affected the bond strength, while the cements performed similarly. Both materials showed adequate bond strength (ALD 19.1 ± 7.7 MPa; LD 17.1 ± 7.9 MPa). Sb protocol showed the lowest mean value (9.6 ± 2.9 MPa) compared with Hf20 (22.0 ± 7.1 MPa), Hf30 (21.7 ± 7.4 MPa), and Se (19.3 ± 6.0 MPa).

For both ceramics, the highest performance was obtained after applying Se and Hf20 or Hf30. Therefore, longer etching time is unnecessary. Sb protocol must be avoided.