VOLUME 44 NUMBER 8 SEPTEMBER 2013 591

QUI NTESSENCE I NTERNATI ONAL

PROSTHODONTICS
Inuence of silanes on the shear bond
strength of resin cements to zirconia
Figen Akyelken Gkkaya, Med Dent
1
/Bogna Stawarczyk,
Dipl Ing MSc
2
/Christoph H.F. Hmmerle, Prof Dr med dent
3
/
Irena Sailer, PD Dr med dent
4
Objective: To test the shear bond strength of self-adhesive and conventional resin
cements to zirconia after the application of different types of silanes with/without aging.
Method and Materials: Three hundred and sixty zirconia specimens were randomized
into 10 groups (n = 36). Five groups were assigned to the self-adhesive resin cement
RelyX-Unicem (RXU) and ve groups to the conventional resin cement Panavia 21 (PAN).
The groups were further assigned to the following pretreatments: Monobond-S (M), Alloy
Primer (AP), Clearl (C), Experimental Universal Primer (EUP), or without silane (control
group). Twelve specimens of each of the cements were tested after water storage for 24
hours (initial shear bond strength). The remaining 24 samples were aged (1,500 cycles,
n = 12; or 13,500 cycles, n = 12). The shear bond strength was measured (Universal
Testing Machine; 1 mm/min, Zwick Roell Z010). Data were analyzed with one-way ANOVA
followed by post-hoc Scheff tests. Students t test was applied to test the differences
between the two cements (P < .05). Results: The initial bond strength of RXU was
increased by the application of the different silanes. The silanes had less inuence on the
initial bond strength of PAN. Aging reduced the bond strength of RXU signicantly in com-
bination with two of the silanes (AP, 0 0 MPa; C, 4.1 0.9 MPa; P < .05). Aging led to a
signicant reduction of the bond strength values of PAN with the primers AP (2.9 0.4
MPa) and EUP (2.5 0.5 MPa; P < .05). Conclusion: The present study indicates that the
bond strength of the self-adhesive resin cement was positively inuenced by the pretreat-
ment of the zirconia surface with different silanes. Aging led to a decrease of the bond
strength of both types of cements, irrespective of most of the silanes used. (Quintessence
Int 2013;44:591600; doi:10.3290/j.qi.a29754)
Key words: aging, pretreatment, resin cements, self-adhesive resin cement, shear
bond strength, silane, universal silane, zirconia
1
Private Practitioner, Dental School Clinic, Stacherholzstr. 32,
CH-9320 Arbon, Switzerland.
2
Dental Technologist, Center of Dental Medicine, Clinic of Fixed
and Removable Prosthodontics and Dental Material Science,
Zurich, Switzerland.
3
Head of Clinic, Center of Dental Medicine, Clinic of Fixed and
Removable Prosthodontics and Dental Material Science, Zurich,
Switzerland.
4
Senior Lecturer, Center of Dental Medicine, Clinic of Fixed and
Removable Prosthodontics and Dental Material Science, Zurich,
Switzerland.
Correspondence: PD Dr Irena Sailer, Clinic of Fixed and Remov-
able Prosthodontics and Material Science, Center of Dental
Medicine, University of Zurich, Plattenstrasse 11, CH-8032
Zurich, Switzerland. Email: irena.sailer@zzm.uzh.ch
The high-strength ceramic zirconia exhibits
promising clinical performance as a frame-
work material for all-ceramic crowns and
xed dental prostheses (FDPs).
1,2
Few frac-
tures of zirconia frameworks have been
reported.
1,2
These good results are associ-
ated with the excellent mechanical and
physical properties of zirconia when com-
pared to other ceramics.
3,4
Zirconia is a polycrystalline high-
strength ceramic which does not contain a
silica glass matrix. Due to its specic chem-
ical composition the adhesive cementation
of zirconia can only be accomplished with
specic resin cements.
5-7
Zirconia cannot be roughened by hydro-
uoric acid etching used for the pretreat-
ment of glass-ceramics.
8,9
Additionally, the
conventional silanes used for glass-ceram-
ics do not chemically bond to zirconia.
These silanes improve the bond strength
between the ceramic and the resin cement
by forming a siloxane that cross-links with
592 VOLUME 44 NUMBER 8 SEPTEMBER 2013
QUI NTESSENCE I NTERNATI ONAL
Gkkaya et al
the silica in the glass-ceramic.
9
Since zirco-
nia is free of silica, different types of silanes
and resin cements are needed as for glass-
ceramics.
5,10
The clinical procedures asso-
ciated with the cementation of zirconia-
based reconstructions can be complicated
due to the fact that clinicians need to be
aware of the chemical composition of zirco-
nia and the suitable resin cements for its
adhesive cementation. Recently, a number
of different resin cements and new silanes
were introduced to improve the adhesive
xation of zirconia-based reconstructions.
In order to provide chemical bonding to
zirconia, the silanes and/or resin cements
need to contain acidic monomers such as
phosphate monomer 10-methacryloyloxy-
decyl dihydrogen phosphate (MDP).
5-7,11

Recent studies showed that resin cements
with acidic monomers led to signicantly
higher bond strength values compared to
conventional resin cements without acidic
monomers.
4-7,9,11
Furthermore, the applica-
tion of MDP-containing silanes (eg, Clearl
New Bond and Clearl Porcelain Bond Acti-
vator, Kuraray Europe) significantly
increased the shear bond strength of resin
cements (eg, Panavia 21 [PAN], Kuraray
Europe) to zirconia.
12
Owing to the fact that resin cements are
hydrophobic, numerous pretreatment prim-
ing and bonding steps are needed for the
chemical bonding to dentin. As a conse-
quence, adhesive cementation is a very
technique-sensitive procedure in clinical
practice. Clinical problems like the contami-
nation
13
of the surface with saliva or blood,
14

or errors at application of the pretreatment
solutions or the cements
15
lead to a signi-
cant decrease of the bond strength values.
In addition, the chemical compatibility of
the resin cements and the different restora-
tive materials needs to be considered, as
indicated above.
Recently developed self-adhesive resin
cements aim for a simplication of the
adhesive cementation. These resin cements
bond to both tooth substance and other
materials without a specic pretreatment.
16

Self-adhesive resin cements with acidic
monomers, such as RelyX Unicem (RXU;
3M ESPE), exhibit promising results in
laboratory and clinical studies.
16
Interest-
ingly, good bonding performance of this
cement was observed with zirconia.
17,18
It
has been demonstrated that the initial bond
strength of resin cements generally is
reduced by aging in the humid oral environ-
ment. However, the application of silanes
leads to a stabilization of the bond strength
values and, hence, to less inuence of
aging.
4
In order to simplify the silanization, uni-
versal silanes that chemically bond to differ-
ent types of materials were recently intro-
duced. These universal silanes and/or resin
cements could signicantly simplify the clin-
ical procedures for the cementation of zir-
conia-based reconstructions and would be
very desirable from a clinical perspective,
provided that the materials are compatible.
No reports of the inuence of these silanes,
or their interaction with different types of
resin cements and materials are available.
The aim of the present study, therefore,
was to test whether or not the shear bond
strength of conventional and self-adhesive
resin cements to zirconia is inuenced by
the application of different types of silanes.
Furthermore, the effect of the silanes on the
bonding performance of the cements with
aging was analyzed.
The following hypotheses were tested:
(1) the shear bond strength of self-adhesive
and conventional resin cements to zirconia
is improved by the application of conven-
tional and/or universal silanes; and (2) the
shear bond strength of the two types of
cements is less prone to aging through the
application of the respective silanes.
METHOD AND MATERIALS
The shear bond strength of two resin
cements, one self-adhesive resin cement
(RXU) and one conventional resin cement
(PAN), to zirconia was tested in combina-
tion with the application of the following
silanes and primers, respectively: one
methacrylate-acid-containing silane (Mono-
bond S [M], Ivoclar Vivadent), two phos-
phate-monomer-containing silanes (Clearl
Porcelain Bond Activator [C]; Alloy Primer
[AP], Kuraray Europe) and one universal
silane (Experimental Universal Primer
[EUP], Ivoclar Vivadent). (Note that EUP
was a prototype silane, and was a rst ver-
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Gkkaya et al
sion of the further developed and currently
available silane Monobond Plus, Ivoclar
Vivadent. At time of the study EUP was not
approved for clinical application.)
The detailed information on the chemical
composition, lot numbers, and brands of
the silanes and primers is given in Table 1.
Specimen preparation
Densely sintered zirconia blanks (Cercon,
DeguDent) were used for the fabrication of
the zirconia specimens. The blanks were
cut into 360 disk-shaped specimens with a
diameter of 20 mm and a thickness of
2 mm. The specimens were embedded in
acrylic resin, exposing the top surface of
the ceramic. The exposed zirconia surface
of specimens was polished to high gloss
(Abramin).
The 360 polished zirconia specimens
were divided into 10 groups of 36 speci-
mens each. Five of these groups were
assigned to the self-adhesive resin cement
RXU. The remaining five groups were
assigned to the conventional resin cement
PAN. For both resin cements the groups
were further assigned to the pretreatment
methods described in Table 2 (test). For
both resin cements, untreated specimens
acted as control groups (Table 2).
The zirconia surface of the specimens
was cleaned with alcohol. Subsequently,
Table 2 Assignment of pretreatment groups
Cement Test/control Pretreatment No. of specimens
RXU
Test
RXUM 36
RXUAP 36
RXUC 36
RXUEUP 36
Control RXU 36
PAN
Test
PANM 36
PANAP 36
PANC 36
PANEUP 36
Control PAN 36
Table 1 Summary of products used
Product Abbreviation Manufacturer LOT No.
Cement
RelyX Unicem RXU 3M ESPE 300136/290546/287407
Panavia 21 PAN Kuraray Europe 00406C UNI TC/ 00647C CAT
Adhesive
Monobond S M Ivoclar Vivadent J23960
Alloy Primer AP Kuraray Europe 239AA
Clearl Porcelain
Bond Activator
C Kuraray Europe 00201B/Primer:00653A
Experimental
Universal Primer
EUP Ivoclar Vivadent R38-082-2
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the specimens were pretreated with the
respective silanes following the manufactur-
ers instructions (Table 3), and the resin
cements were applied to the pretreated sur-
faces. The specimens of the control groups
were cleaned, and the resin cements were
directly applied to the untreated surfaces.
The specimens were mounted in a cus-
tomized holding device (Fig 1) with the
exposed zirconia surface on the top. For
the standardized application of the resin
cements, acrylic cylinders with an inner
diameter of 2.9 mm (DR-TEC) were
mounted on the zirconia surface by means
of the holding device, thus dening the
bonding area for the resin cements at
6.605 mm
2
. The procedures used for the
standardized application of the resin
cements and the shear bond strength test
were published in detail elsewhere
19
and
are only briey summarized herein.
The cements were applied into the cylin-
ders according to the manufacturers rec-
ommendations (Table 3), and a steel screw
(inner hexagon, outer diameter 2.8 mm)
was inserted into the cylinder applying a
standardized load on the cements of 100 g
(Fig 2). With this procedure the thickness of
the resin cement layers was set at 0.5 mm
for all specimens. The excess resin cement
was carefully removed with cotton pellets.
All specimens cemented with RXU
(n = 36) were light cured with a light-emit-
ting diode (LED) polymerization lamp
(Elipar Freelight 2, 3M ESPE) for 20 sec-
onds as recommended by the manufactur-
ers. The 36 PAN specimens were chemi-
cally cured for 10 minutes at 37C. After the
setting of the cements the specimens were
stored in distilled water (37C) for 24 hours.
Twelve samples of each of the cements
were tested straight after the storage in
water (initial shear bond strength). The
remaining 24 samples of each cement were
aged by means of thermocycling (Thermo-
cycler, Willitec). Twelve specimens of each
group were aged with 1,500 thermocycles
(TC; 5C and 55C, 30 seconds dwell time).
The remaining specimens (n = 12) were
tested after 13,500 TC.
Table 3 Detailed information on the application of the resin cements and silanes
Name Application steps
RXU Activate the Aplicap capsule in the Aplicap Activator (3M ESPE) for 24 s. Mix the capsule for 10 s in
the RotoMix (3M ESPE). Apply cement to the substrate surface with the Aplicap Applier (3M ESPE).
PAN Mix the catalyst and universal pastes for 2030 s, creating a homogenous paste. Apply cement to the
substrate with a spatula. Apply Oxyguard II (Kuraray Europe) to all margins for 3 min; remove by rins-
ing with water.
M Apply the liquid with a brush. Leave for 1 min and dry with a gentle airow.
AP Apply a thin layer on the surface. Leave for 5 s.
C Mix Clearl SE Primer (Kuraray Europe) and Clearl Porcelain Bond Activator with one another 1:1.
Apply the liquid on the surface. Leave for 20 s. Blow the solvents with a gentle airow.
EUP Apply a thin layer with a brush and leave for 60 s. Blow with air thoroughly.
Fig 1 Bonding device (A, xed specimen; B, holder).
A
B
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Shear bond strength test
The shear bond strength test was carried
out in a universal testing machine (Zwick
Roell Z010) with load applied at a cross-
head speed of 1 mm/min. For this, the
specimens were positioned by means of a
special sample device (Fig 3) with the zir-
conia surface parallel to the loading piston,
and the chisel of the loading piston was
adjusted. The load was applied to the cylin-
der with a 300 m distance between the
piston and the surface of the specimen. The
load at debonding of the cylinders was
recorded in N. For further analysis the load
values were converted to MPa by dividing
the failure load (N) by the bonding area
(mm
2
).
Statistical analysis
Statistical analysis was performed using
SPSS version 19 (SPSS). Descriptive statis-
tics were computed. Within each pretreat-
ment and aging group, differences between
mean shear bond strength values of the
groups were analyzed by one-way ANOVA,
followed by a post-hoc Scheff test. Addi-
tionally, Students t test was applied to test
the differences between the two resin
cements. P values smaller than 5% were
considered to be statistically signicant in
all tests.
RESULTS
Detailed information on the respective shear
bond strength values of the groups with and
without application of silanes and the differ-
ences between groups are given in Table 4.
Infuence of silanes on the
initial shear bond strength
At all time points, the application of the
silanes increased the initial shear bond
strength (0 TC) of the self-adhesive resin
cement RXU as compared to the samples
without pretreatment. In contrast, the appli-
cation of most of the silanes did not have an
inuence on the initial shear bond strength
of the conventional cement PAN. For this
resin cement only the silane C had a posi-
tive effect (Table 4).
Infuence of aging on shear
bond strength
Aging (1,500 TC and 13,500 TC) had a sig-
nicant effect on the bond strength of RXU
to the zirconia samples that were pretreated
with C and AP. A signicant reduction of the
bond strength values was observed for
these samples. No reduction of the bond
strength was found for the samples pre-
treated with the other silanes and for the
Fig 2 Bonding device (A, xed specimen; B, holder;
C, load simulating nger pressure [100 g]).
Fig 3 Test device for shear bond strength.
B
C
A
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specimens without pretreatment (Table 4
and Fig 4).
Aging also had a signicant inuence on
the conventional resin cement PAN. In gen-
eral, the bond strength was reduced after
aging (Fig 5). For the samples pretreated
with AP, C, and EUP the decrease was sig-
nicant as compared to the initial bond
strength (Table 4).
Comparison of the shear bond
strength of the two cements
No signicant difference of the initial shear
bond strength values was found when the
conventional cement PAN and the self-
adhesive resin cement RXU were com-
pared. Furthermore, aging did not exhibit a
pronounced inuence on the comparison of
the two resin cements. Only in two of the
tests was a statistically signicant differ-
ence between PAN and RXU found
(Table 5).
DISCUSSION
The rst part of this study tested the effect
of different silanes on the shear bond
strength of the self-adhesive resin cement
RXU and the conventional resin cement
PAN to zirconia. The shear bond strength of
RXU was increased by the application of
the silanes. In contrast, the application of
most of the silanes did not have any inu-
ence on the conventional resin cement
PAN. Hence, the rst hypothesis could only
be accepted for the self-adhesive resin
cement RXU.
The second part of this study investi-
gated the inuence of aging on the shear
bond strength of RXU and PAN after pre-
treatment of zirconia with the respective
silanes. Aging had a highly variable inu-
ence on the bond strength of the tested
silanes and cements. For RXU, aging
reduced the bond strength signicantly in
combination with two of the silanes (AP and
C). No inuence, however, was found for
the specimens without silane pretreatment
or for the specimens pretreated with M and
EUP. For PAN, a signicant reduction of the
bond strength was observed in combination
with the silanes AP and EUP after aging.
Aging, however, had no inuence on the
specimens treated with the other pretreat-
ment methods. Thus, the second hypothe-
sis was rejected.
The results of the present study are of
signicance for everyday clinical practice.
They indicate that the newly developed uni-
versal resin cements and silanes are not
necessarily compatible with conventionally
Table 4 Shear bond strength results for each resin cement with different silanes
No. of thermocycles Control M AP C EUP
RXU
0 TC
P (mean difference) 1.4 (0.7)
A
a
5.3 (0.9)
A
ab
5.2 (0.8)
B
ab
8.1 (1.1)
B
b
4.7 (0.8)
A
ab
95% CI -0.23.1 3.27.4 3.47.0 5.710.6 2.96.6
1,500 TC
P (mean difference) 2.6 (0.7)
A
a
3.2 (0.9)
A
a
4.1 (1.1)
B
ab
7.7 (0.5)
B
b
3.9 (0.7)
A
a
95% CI 1.14.2 1.25.3 1.76.6 6.58.9 2.35.6
13,500 TC
P (mean difference) 2.4 (0.7)
A
ab
5.3 (1.4)
A
b
0 (0)
A
a
4.1 (0.9)
A
ab
5.3 (1.4)
A
b
95% CI 0.84.0 2.18.4 00 2.16.1 2.18.6
PAN
0 TC
P (mean difference) 4.0 (0.4)
A
a
4.2 (0.4)
A
ab
5.0 (0.5)
B
ab
6.0 (0.5)
B
b
5.4 (0.3)
B
ab
95% CI 3.04.9 3.45.1 3.96.0 4.97.1 4.86.1
1,500 TC
P (mean difference) 7.5 (1.0)
B
b
4.8 (0.3)
A
a
5.3 (0.4)
B
ab
4.2 (0.3)
A
a
4.0 (0.6)
AB
a
95% CI 5.29.9 4.25.4 4.36.3 3.54.9 2.75.4
13,500 TC
P (mean difference) 3.3 (0.6)
A
a
3.9 (0.4)
A
a
2.9 (0.4)
A
a
3.2 (0.4)
A
a
2.5 (0.5)
A
a
95% CI 1.94.6 3.04.8 1.33.3 2.24.2 1.43.5
A/B, ANOVA, inuence of aging within a pretreatment; a/b, ANOVA, inuence of the primer at one time; Aa indicates statis-
tically different from Bb; ABab indicates not signicantly different from Aa or Bb; CI, condence interval; TC, thermocycles.
VOLUME 44 NUMBER 8 SEPTEMBER 2013 597
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used adhesive materials, and in contrast to
improving the bonding quality, can even
lead to a reduction of the bond strength if
combined inappropriately. It is, therefore, of
great importance for good long-term stability
of the bonding that only specic combina-
tions are used for the adhesive cementation.
In the present study, pretreatment with
MDP-containing silanes or primers (C and
AP) increased the shear bond strength
between the zirconia and the self-adhesive
resin cement RXU. The increase of the
shear bond strength was also shown in a
study by de Souza et al.
20
Kern et al
21
indi-
cated that this increase is most likely
caused by a chemical interaction between
MDP and zirconia. This assumption is sup-
ported by the results of several studies. The
phosphate ester monomer of MDP was
shown to bond directly to the oxides of alu-
mina and zirconia.
21-23
This chemical inter-
action also lead to higher shear bond
strength of MDP-containing resin cements
to zirconia.
4,9,16,18,24-27
Blatz et al
4
showed
that the phosphate ester monomer of MDP
exhibited a positive inuence irrespective of
whether the monomer was part of the silane
or of the resin cement.
Fig 5 Mean values and standard deviations of the
shear bond strength of the conventional resin
cement Panavia 21 with dierent pretreatments and
aging (0 TC, 1,500 TC, 13,500 TC).
Fig 4 Mean values and standard deviations of the
shear bond strength of the self-adhesive resin
cement RXU with dierent pretreatments and aging
(0 TC, 1,500 TC, 13,500 TC).
10.0
9.0
8.0
7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
0 1,500 13,500
No. of thermocycles
S
h
e
a
r

b
o
n
d

s
t
r
e
n
g
t
h

(
M
P
a
)
without silane
M
AP
C
EUP
10.0
9.0
8.0
7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
0 1,500 13,500
No. of thermocycles
S
h
e
a
r

b
o
n
d

s
t
r
e
n
g
t
h

(
M
P
a
)
without silane
M
AP
C
EUP
Table 5 Results of the comparison between RXU and PAN
RXU vs PAN Control M AP C EUP
0 TC
P (mean difference) .005* .315 .832 .780 .418
95% CI -4.26 -0.83 -1.093.17 -1.692.09 -0.264.62 -2.591.14
1,500 TC
P (mean difference) .001* .123 .332 < .001* .945
95% CI -7.48 -2.34 -3.590.48 -3.711.33 2.204.74 -2.021.89
13,500 TC
P (mean difference) .349 .360 < .001* .371 .080
95% CI -2.831.04 -1.774.54 -3.23 -1.35 -1.132.97 -0.396.15
*, signicant difference (P < .05). CI, condence interval; TC, thermocycles.
598 VOLUME 44 NUMBER 8 SEPTEMBER 2013
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In most studies,
9,23,28,29
the silane C
increased the shear bond strength between
PAN and zirconia. However, this nding
was not supported by the results of the
present study. The differences in the results
might be caused by the different study pro-
tocols. In the present study no airborne-par-
ticle abrasion of the zirconia was per-
formed, while in other investigations the
zirconia surface was roughened by air-
borne-particle abrasion.
30
Numerous stud-
ies have shown that airborne-particle abra-
sion positively inuences the shear bond
strength between resin cement and zirco-
nia.
24,30-34
Future studies are needed to test
the inuence of a combination of airborne-
particle abrasion and application of silanes
on the bond strength of resin cements to
zirconia.
Aging had a negative inuence on the
shear bond strength of both types of resin
cements to the zirconia. This observation is
supported by numerous studies.
6,7,10,12,18
In
contrast, Lindgren et al
35
reported no signif-
icant inuence of aging on the shear bond
strength of RXU with the metal primer. In
the present study, aging was performed by
means of storage in water and/or thermocy-
cling. In general, the shear bond strength
values decreased after 1,500 thermocycles
and also after 13,500 thermocycles.
The experimental universal silane EUP
that was tested in the present study had no
inuence on the shear bond strength values
compared to the other silanes. This result
was discouraging and indicated that this
prototype silane needed signicant further
improvement prior to introduction to the
clinical practice. Since no further investiga-
tions testing this specic silane were avail-
able, the present results are difcult to
judge. Future studies of the commercially
available version of the prototype EUP are
needed to conrm its application in the
presently tested combinations for the adhe-
sive xation of zirconia-based reconstruc-
tions.
One of the reasons for the differences
between the results of the present study
and other studies might be the different
testing procedure. In a recent review of the
literature by Heintze et al,
36-38
the different
in-vitro testing procedures were compared.
In most of the shear bond strength tests,
resin composite cylinders were bonded to
at polished surfaces, and the shear bond
strength test was performed with a specic
testing machine. The authors concluded
that the shear bond strength test was easy
and fast; however, the results were highly
inuenced by the operator and the specic
settings of the testing machines. Factors
such as the positioning of the shearing
blade on the specimens or high forces
applied by the blade greatly affected the
bond strength values. Furthermore, the way
the specimens were aged (ie, whether or
not thermocycling was performed), had a
signicant impact on the bond strength val-
ues. The reviews showed that in most of the
studies solely storage in water for 24 hours
was used for aging. The authors concluded
that for the analysis of the long-term bond
strength of silanes and/or resin cements to
various materials, aging for a minimum of 3
months should be performed.
39
Hence, in
the present as well as in other studies the
simulation of the oral conditions by means
of thermocycling had an important effect on
the durability of the resin bond strength to
zirconia, and this might be the reason for
the differences in the results.
4,5,25,40
CONCLUSION
In conclusion, the present study indicated
that the shear bond strength is affected by
the pretreatment of the zirconia surface with
different silanes. This nding is of specic
interest to daily clinical practice, since new
simplified resin cements and adhesive
agents (eg, silanes) are constantly being
introduced in order to improve the bonding
to zirconia. Hence, clinicians need to take
care of the chemical compatibility of the
components used.
Interestingly, in the present study no dif-
ference was found between the self-adhe-
sive and the conventional resin cements.
This indicates that even with simplied
adhesive luting procedures using self-
adhesive resin cements, good bond
strength to zirconia can be achieved. The
additional application of compatible silanes
increases the bonding capacity of the self-
adhesive cement.
VOLUME 44 NUMBER 8 SEPTEMBER 2013 599
QUI NTESSENCE I NTERNATI ONAL
Gkkaya et al
However, since the presently applied
shear bond strength test is critical in the
abovementioned reasons, studies using
more standard procedures like the micro-
tensile test
41,42
should be performed to test
the present observations in more detail.
ACKNOWLEDGMENTS
The authors gratefully thank the companies ESPE and
Ivoclar Vivadent for supporting this study. We also thank
Mrs Gisela Mller for the support with the preparation of
this manuscript.
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