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Optimizing adhesive protocols for CAD-CAM restorations: Is simplification a reliable alternative to conventional

Soner Sismanoglu¹

¹Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University-Cerrahpasa, Istanbul, Turkey.

The Journal of Advanced Prosthodontics

|May 6, 2026

Summary

The conventional three-step silane protocol offers the most durable bond for CAD-CAM materials. Simplified strategies provide acceptable alternatives, though bond strength varies by material type and aging.

Keywords:

Ceramics Computer-aided design Dental bonding Shear strength Silane coupling agents

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Area of Science:

Dental Materials Science
Biomaterials Engineering
Restorative Dentistry

Background:

Computer-Aided Design/Computer-Aided Manufacturing (CAD-CAM) restorations require durable bonding to tooth structure.
Optimizing silane-based surface treatments is crucial for enhancing the bond strength of various CAD-CAM materials.
Understanding the impact of aging on bond durability is essential for clinical longevity.

Purpose of the Study:

To compare the bond strength and surface morphology of five CAD-CAM materials.
To evaluate the efficacy of different silane-based bonding strategies.
To assess the influence of artificial aging on bond durability.

Main Methods:

Five CAD-CAM materials (leucite-reinforced glass ceramic, lithium disilicate, zirconia-reinforced lithium silicate, polymer-infiltrated ceramic network, resin nanoceramic) were tested.
Specimens were subjected to five bonding protocols: conventional silane, universal adhesive, single-step cement, ceramic primer, and no silane.
Bond strength was measured via micro-shear testing before and after 10,000 thermal cycles; failure modes and surface morphology were analyzed.

Main Results:

Material type, bonding strategy, and aging significantly impacted bond strength (P < .001).
The conventional silane protocol yielded the highest bond strength across all materials.
Simplified strategies showed intermediate, clinically acceptable bond strengths, though reduced by thermal cycling.

Conclusions:

The conventional three-step silane protocol ensures the most reliable and durable bonding for CAD-CAM restorations.
Simplified bonding strategies can be acceptable alternatives, contingent upon the specific CAD-CAM material used.
Artificial aging consistently reduced bond strength, highlighting the importance of robust bonding protocols.