Effectiveness of universal adhesive bonding agents on the shear bond strength to lithium disilicate ceramics

Abstract

Background: All-ceramic restorations have excellent esthetic outcomes compared with other restorative materials. Lithium disilicate is classified as one of many silica-based all-ceramic materials. Currently, companies have provided single-step adhesives, known as universal adhesives, compatible with different restorative materials including lithium disilicate. Many studies have reported greater bond strengths when using a silane to treat the lithium disilicate before applying the bonding agent. Moreover, few studies were published comparing the bond strength when using the universal adhesive alone. Purpose: The objective of this study was to evaluate and compare shear bond strength of three universal adhesives to lithium disilicate ceramic restorative material. Materials and Methods: Three universal adhesive bonding agents were selected from commercially available adhesives. 408 IPS e.max CAD ceramic discs were processed, fired, and etched for 20s. The specimens were divided into six groups. The first three groups used the universal adhesive directly. The remaining three groups were treated with silane. Then, a composite resin cylinder was placed on top of the adhesive using a bonding jig. Each group was subdivided into four equal subgroups (n = 17), subjected to different aging simulation procedures: 24 h, one month with 5000 thermocycles, two months with 5000 cycles, and three months with 5000 cycles. Then, specimens were debonded using shear force by a universal testing machine (MTS). Results: Shear bond strength was greater with silane than without silane (p < 0.0001), regardless of the levels of adhesive or time. Shear bond strength was significantly greater at 24h and 1m than at 2m (p < 0.0001) or 3m (p < 0.0001) regardless of the adhesive or the presence of silane. Debonded specimens were examined under a stereomicroscope at X45 magnification to evaluate the fracture pattern. SEM was used to prove the results were considered as mixed failure. Conclusion: The optimal bonds to lithium disilicate are achieved by application of silane prior to application of a universal adhesive. Although the constituent silane in the universal adhesive was not effective in optimizing the resin to ceramic bond, silane should always be applied to lithium disilicate prior to bonding.