Bonding to new CAD/CAM resin composites: influence of air abrasion and conditioning agents as pretreatment strategy
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Because of their industrially standardized process of manufacturing, CAD/CAM resin composites show a high degree of conversion, making a reliable bond difficult to achieve.
The purpose of this experiment was to investigate the tensile bond strength (TBS) of luting composite to CAD/CAM resin composite materials as influenced by air abrasion and pretreatment strategies.
Material and methods
The treatment factors of the present study were (1) brand of the CAD/CAM resin composite (Brilliant Crios [Coltene/Whaledent], Cerasmart [GC Europe], Shofu Block HC [Shofu], and Lava Ultimate [3M]); (2) air abrasion vs. no air abrasion; and (3) pretreatment using a silane primer (Clearfil Ceramic Primer, Kuraray) vs. a resin primer (One Coat 7 Universal, Coltene/Whaledent). Subsequently, luting composite (DuoCem, Coltene/Whaledent) was polymerized onto the substrate surface using a mold. For each combination of the levels of the three treatment factors (4 (materials) × 2 (air abrasion vs. no air abrasion; resin) × 2 (primer vs. silane primer)), n = 15, specimens were prepared. After 24 h of water storage at 37 °C and 5000 thermo-cycles (5/55 °C), TBS was measured and failure types were examined. The resulting data was analyzed using Kaplan–Meier estimates of the cumulative failure distribution function with Breslow–Gehan tests and non-parametric ANOVA (Kruskal–Wallis test) followed by the multiple pairwise Mann–Whitney U test with α-error adjustment using the Benjamini–Hochberg procedure and chi-square test (p < 0.05).
The additional air abrasion step increased TBS values and lowered failure rates. Specimens pretreated using a resin primer showed significantly higher TBS and lower failure rates than those pretreated using a silane primer. The highest failure rates were observed for groups pretreated with a silane primer. Within the Shofu Block HC group, all specimens without air abrasion and pretreatment with a silane primer debonded during the aging procedure.
Before fixation of CAD/CAM resin composites, the restorations should be air abraded and pretreated using a resin primer containing methyl-methacrylate to successfully bond to the luting composite. The pretreatment of the CAD/CAM resin composite using merely a silane primer results in deficient adhesion.
For a reliable bond of CAD/CAM resin composites to the luting composite, air abrasion and a special pretreatment strategy are necessary in order to achieve promising long-term results.
KeywordsTensile bond strengths Failure type CAD/CAM Resin composite Air abrasion
We are grateful to Coltene/Whaledent for providing the tested materials.
Marcel Reymus: performed experiments, wrote manuscript.
Malgorzata Roos: performed statistical analyses, approval of final manuscript.
Marlis Eichberger: assistance by experiments.
Daniel Edelhoff: provision of the infrastructure, approval of final manuscript.
Reinhard Hickel: provision of the infrastructure, approval of final manuscript.
Bogna Stawarczyk: idea, experimental design, hypothesis, performed statistical analyses, and wrote manuscript.
The work was supported by the Department of Prosthodontics, Ludwig-Maximilians-University Munich.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any authors.
Informed consent was obtained from all individual participants in the study.
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