Bonding Leucite Reinforced Ceramics: Descriptive Analysis of In Vitro Studies

Introduction: Contemporary bonding protocols are crucial to achieve micromechanical interlocking and chemical bonding in ceramics. These steps are taken to ensure clinical longevity Objectives: Report the in vitro studies which varied the adhesive protocol in leucite reinforced ceramic samples, and to identify gaps in the scientific evidence regarding this topic. Methods: A research strategy was employed in the PubMed/Medline database, with the following search terms: "leucite ceramics", "leucite reinforced", "leucite porcelain", "bonding", "adhesion", "luting", "dental composite" "resin composite". This review included bond strength test studies, both tensile and shear bond, which varied the adhesive protocol and included leucite reinforced ceramic samples bonded/luted to resin. Only studies published after 2000 were considered. The selection process followed the PRISMA method, having been carried out by two reviewers independently. Results: After the preliminary research, 98 studies were found. Of these, only 8 met the inclusion criteria. Microtensile bond strength testing was the preferred method of bond tests in leucite ceramics, followed by shear and microshear. Most of these laboratory studies focused on the etching and silane coupling agent application. Conclusion: The etching step with hydrofluoric acid and application of a silane coupling agent are well established in the literature as mandatory steps in bonding leucite reinforced ceramics. Variables such as the silanization time, drying method or ceramic bonding with flowable resin composites are some of the identified gaps. Clinical Implications: The correct preparation of the ceramic sample will allow favorable clinical outcomes long term, and the contribution to the normalization of a technique allows future reproductability. Keywords: leucite ceramics, leucite porcelain, bonding, adhesion, luting, dental composite, resin composite