Effect of Non-Thermal Atmospheric Plasma Treatment on Bonding Performance of Customized Ceramic Post-and-Cores

To evaluate the impact of non-thermal atmospheric plasma (NTAP) treatment on the bonding performance of different digital methods (full-digital vs. semi-digital) fabricated customized ceramic post-and-core.

Ceramic blocks treated with NTAP in different configurations were bonded with resin cement and tested by shear bond strength (SBS) and tensile bond strength (TBS) tests: on the ceramic surfaces (X-Pl-Pr-C), on primer-applied surfaces (X-Pr-Pl-C), on cement-applied surfaces (X-Pr-C-Pl), and on both ceramic and cement-applied surfaces (X-Pl-Pr-C-Pl). Contact angle and FTIR-ATR analyses were performed to examine the effects of NTAP on the selected zirconia-resin interface. The precision of full-digital and semi-digital fabrication methods was evaluated by comparing the linear discrepancy during the fabrication of zirconia post-and-cores. Push-out bond strength (PBS) testing was then used to assess the influence of NTAP treatment on zirconia post-and-cores bonded to extracted single root canals.

Appropriate NTAP treatment parameters/procedures significantly improved the immediate TBS and SBS of all ceramic samples, except for the primer-treated group (X-Pr-Pl-C), with the most pronounced enhancement observed for zirconia. Semi-digital fabrication exhibited a smaller linear discrepancy at the apical third of the root compared to the full-digital method. NTAP treatment increased the PBS to both immediate and aged zirconia post-and-cores fabricated via semi-digital or full-digital bonded to root canals.

NTAP treatment enhanced ceramic's wettability and resin polymerization, thereby improving surface bonding. Semi-digital fabrication demonstrated better precision at the apical third of the root. Overall, appropriate NTAP treatment significantly improved the bonding performance of customized ceramic post-and-cores with root canals, with optimal efficacy achieved through concurrent application on both ceramic surfaces and cement-applied surfaces.

NTAP treatment improves customized ceramic post-and-core bonding, overcoming its surface inertness and reducing debonding risks, ensuring long-term stability.