Bonding Efficiency of Recent Adhesive-resin-cement Systems to Metal-free Restoratives

Objectives: The purpose of this study was to examine the bonding efficiency of recent adhesive-resin-cement systems to metal-free restoratives.
Methods: Three recent adhesive-resin-cement systems; a dual-cure system with a chemical-cure-multipurpose resin-adhesive, ESTECEM II(EC; Tokuyama Dental), a dual-cure system with primers, PANAVIA V5(PV; Kuraray Noritake Dental), a dual-cure system with a light-cure-multipurpose resin-adhesive, RelyX Ultimate(RU; 3M ESPE) were used. Seven types of restoratives; feldspathic ceramic(VB; VITABLOCS Mark II, VITA), lithium disilicate ceramic(EM; IPS e.max CAD, Ivoclar vivadent), zirconia(LZ; Lava Zirconia, 3M ESPE), hybrid-ceramic(ES; Estenia C&B, Kuraray Noritake Dental), resin-infiltrated ceramic(EN; VITA ENAMIC, VITA), resin-composite block(CS; CERASMART, GC) and human dentin(D; as control) were selected. All restoratives were ground with a series of SiC paper up to 800grit and then covered by an aluminum-sheet with a 2.4mm-diameter-hole. Each specimen was pretreated following the manufacturer’s instructions prior to cementation. Cylindrical resin-composite was bonded to the pretreated substrates with three cement systems. Tensile-bond-strengths(TBS) of the bonded specimens(n=5) were measured. The data were analyzed using two-way ANOVA and Tukey’s test.
Results: The mean values of TBS(SD) in MPa with EC/PV/RU were VB:14.3(3.0)/8.2(1.4)/14.5(3.5),EM:14.2(4.3)/3.7(2.1)/10.1(2.9),LZ:18.4(3.7)/16.6(4.6)/18.3(5.6), ES:15.5(2.8)/6.0(2.0)/23.0(3.7),CS:13.1(2.1)/3.7(1.9)/13.6(2.8),EN:13.6(3.0)/9.1(1.9)/14.3(1.3),D:5.1(1.8)/17.0(2.1)/18.7(5.5). The values of TBS were influenced by cement systems and restoratives. The TBS of three cement systems did vary with the restorative. The TBS of EC to all restoratives were significantly greater than the value to D. The PV-value to D was significantly greater than those to other restoratives except LZ. The RU-value to ES was significantly greater than the values to other substrates except LZ and D.
Conclusions: The TBS of recent three adhesive-resin-cement systems decreased in the order RU>EC>PV. The RU-value to each restorative was similar to or greater than EC-value and PV-value. The TBS of EC to all restoratives were significantly greater than that to dentin. The PV-value to dentin was greater than those to other restoratives except zirconia.