Effect of Cleaning Methods After Reduced-pressure Air Abrasion on Bonding to Zirconia Ceramic

Purpose: To evaluate in vitro the influence of different cleaning methods after low-pressure air abrasion on the bond strength of a phosphate monomer-containing luting resin to zirconia ceramic. Materials and Methods: A total of 112 zirconia ceramic disks were divided into 7 groups (n = 16). In the test groups, disks were air abraded at low pressure (L) 0.05 MPa using 50-µm alumina particles. Prior to bonding, the disks were ultrasonically (U) cleaned either in isopropanol alcohol (AC), hydrofluoric acid (HF), demineralized water (DW), or tap water (TW), or they were used without ultrasonic cleaning. Disks air abraded at a high (H) pressure of 0.25 MPa and cleaned ultrasonically in isopropanol served as positive control; original (O) milled disks used without air abrasion served as the negative control group. Plexiglas tubes filled with composite resin were bonded with the adhesive luting resin Panavia 21 to the ceramic disks. Prior to testing tensile bond strength (TBS), each main group was further subdivided into 2 subgroups (n=8) which were stored in distilled water either at 37°C for 3 days or for 30 days with 7500 thermal cycles. Statistical analyses were conducted with two- and one-way analyses of variance (ANOVA) and Tukey's HSD test. Results: Initial tensile bond strength (TBS) ranged from 32.6 to 42.8 MPa. After 30 days storage in water with thermocycling, TBS ranged from 21.9 to 36.3 MPa. Storage in water and thermocycling significantly decreased the TBS of test groups which were not air abraded (p = 0.05) or which were air abraded but cleaned in tap water (p = 0.002), but not the TBS of the other groups (p > 0.05). Also, the TBS of air-abraded groups were significantly higher than the TBS of the original milled (p 0.01). Cleaning procedures did not significantly affect TBS either after 3 days or 30 days storage in water and thermocycling (p > 0.05). Conclusion: Air abrasion at 0.05 MPa and ultrasonic cleaning are important factors for improving bonding to zirconia ceramic. Keywords: zirconia ceramic-resin cement, bonding, cleaning methods