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Revue de la littérature / Literature Review

Prothèses Fixées / Fixed Prosthodontics

SELF-ADHESIVE CEMENTS
AND ALL CERAMIC CROWNS: A REVIEW

Foudda Homsy * | Elie Daou ** | Maha Ghotmi *** | Mireille Rahi ***

Abstract Résumé
Adhesive bonding techniques and modern all-ceramic systems Les techniques de collage et les systèmes d’adhésifs modernes
offer a wide range of highly esthetic treatment options. The offrent un large éventail d’options de traitements esthétiques.
inherent brittleness of some ceramic materials and certain clini- Dans certaines situations cliniques, la fragilité inhérente à cer-
cal situations require resin bonding of the restoration to the tooth tains matériaux en céramique exige le collage de la restauration
for long-term clinical success. A surface pretreatment of the à la dent à l’aide d’un ciment à base de résine pour une meilleure
ceramic and the tooth is necessary to obtain a good adhesion. pérennité. Un traitement préalable de la surface de la céramique
The clinician faces many problems when luting restorations et de celle de la dent est nécessaire pour obtenir une bonne
such as the choice of the appropriate agent depending on the adhérence.
restoration material, the technique sensitivity and the necessity Le clinicien est confronté à de nombreux problèmes lors du col-
of applying different luting materials. lage des restaurations tels que le choix de l’agent approprié en
To overcome some of the disadvantages of the conventional fonction du matériau de restauration et la nécessité de procéder
and resin cements, self-adhesive cements were introduced to souvent par étapes.
the market. They do not require any pretreatment of the tooth Pour pallier à certains inconvénients des ciments convention-
surface and their application is accomplished in a single clinical nels, des ciments auto-adhésifs ont été introduits sur le marché.
step. Ces derniers ne nécessitent pas un traitement préalable de la
A wide literature review was conducted, through a MEDLINE surface dentaire et ils sont appliqués en une seule étape.
search. Articles that treat self-adhesives properties were selec- Une revue de la littérature a été réalisée par une recherche sur
ted. According to in vitro studies, self-adhesive cement adhe- MEDLINE. Les articles qui traitent des ciments auto- adhésifs
sion to dentin and to all-ceramic materials is satisfactory and ont été sélectionnés. Selon les études obtenues, l’adhésion
comparable to other multistep resin cements. Randomized clini- du ciment auto-adhésif à la dentine et aux restaurations en
cal trials and long-term in vitro studies are necessary prior to any céramique est satisfaisante et comparable aux autres ciments
recommendation regarding their use. en résine conventionnels. Des essais cliniques randomisés et
de long-terme sont nécessaires avant toute recommandation
Keywords: Self-adhesive cement - bonding all-ceramic res- concernant l’utilisation des ciments auto-adhésifs.
toration - resin cement.
Mots-clés: ciment auto-adhésif - ciment à base de résine.

* BDS, DESS ** DESS, *** BDS, DESS **** BDS, DUA,


Dpt of Prosthodontics Chef de Clinique, Dpt of Prosthodontics DUB in Prosthodontics
Dental Faculty, Dpt of Prosthodontics Dental Faculty,
Lebanese University, Lebanon Dental Faculty, Lebanese University, Lebanon
loubab3@hotmail.com Lebanese University, Lebanon
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Revue de la littérature | Literature Review


IAJD Vol. 5 – Issue 2

Introduction dissimilar materials, possess favorable equivalent bond strength of conven-


compressive and tensile strengths, tional resin cements to dentin [19,
To fulfill patients’ expectations, have sufficient fracture toughness to 23], gold alloy and glass ceramics
dental biomaterials must have a highly prevent dislodgment as a result of [34] and zirconia [35, 36]. Attar et al.
aesthetic appearance comparable to interfacial or cohesive failures [13, 14], [38] demonstrated that resin-based
that of natural teeth as well as good be able to wet the tooth and the resto- cements that rely on the application of
mechanical properties [1]. This explains ration surfaces, exhibit adequate film etch-and-rinse adhesive systems have
the professionals’ growing interest for thickness and viscosity to ensure com- greater flexural strength than conven-
all-ceramic restorations [1, 2]. plete seating [12-15], exhibit minimal tional resin cements; different studies
On the other hand, successful bon- solubility in the oral cavity [13, 14, 16] found lower bond strengths [11, 23].
ding of the luting material to both and demonstrate adequate working Due to its simplified applica-
the restorative material and the tooth and setting times [12-15]. The den- tion technique, the first self-adhe-
structure is imperative for the retention tal adhesive should also enhance the sive cement introduced to the market
and longevity of the restoration [3]. fracture resistance of the full-ceramic (RelyX™ Unicem; 3M ESPE, St. Paul,
Obtaining adhesion between a crowns [2, 13, 17] and ensure adequate Minn) rapidly gained popularity among
luting agent and a ceramic surface marginal adaptation [18]. clinicians [11]. Thus, several brands
requires surface pretreatment [4, 5] Resin cements are composites that developed self-adhesive cements
such as etching, priming and bonding consist of a resin matrix, eg bis-GMA or (RelyX™ Unicem; RelyX™ U100; 3M
[6-9]. urethane dimethacrylate, and a filler of ESPE, St. Paul, Minn; SmartCem® 2
Until recently, resin cements were fine inorganic particles. Dentsply Caulk, Milford; G-Cem™,
divided into two subgroups according Bonding of resin-based composite GC America, Inc, Alsip, Ill; Maxcem
to the adhesive system used to prepare materials to tooth hard tissues has Elite™ (Kerr Corp, Orange, Calif) ; SeT
the tooth prior to cementation. One been simplified recently [11]. Even (SDI Ltd, Bayswater, Australia); SAC-
group utilizes etch-and-rinse adhe- though enamel and dentin bonding H, SAC-A (Kuraray Medical, Tokyo,…)
sive systems (example: RelyX™ ARC, has progressed from the first to the (Table 1).
3M ESPE, St. Paul, Minn). The second current seventh-generation adhesives, Regarding their composition,
group uses self-etch primer (example: bonding to dentin remains less predic- self-adhesive cements are based on
Panavia™ F, Kuraray Medical Inc, table than bonding to enamel [19-21]. phosphoric-acid methacrylates that
Tokyo, Japan) [10, 11]. Multistep luting All luting agents required the demineralize and infiltrate the tooth
materials make the procedure tech- application of one of these adhesive substrate, resulting in micromechani-
nique-sensitive [11]. In-vitro studies on systems to prepare the tooth prior to cal retention. Secondary reactions have
the shear bond, the microtensile bond cementation [6, 19, 22, 23]. This mul- been suggested to provide chemical
and the long-term durability of the tistep procedure and the performance adhesion to hydroxyapatite [10, 32].
resin cement on the tooth substrate of the etch-and-rinse or self-etch adhe- The basic inorganic fillers are able
and the ceramic restoration demons- sive itself can influence the bonding to undergo a cement reaction with the
trated that the bond strength was effectiveness [11, 24]. phosphoric-acid methacrylates. The
impaired when the surface treatment To overcome some of the shortco- dominant setting reaction starts with
was insufficient [12-50]. mings of both conventional and resin free radical polymerization, which can
Bonding to traditional silica-based cements, resin-based self-adhesive be initiated either by light or by a redox
ceramics is a predictable procedure cements were introduced in 2002 as a system (dual-curing composite mate-
yielding durable results when fabri- new subgroup of resin cements. The rials) [3, 32].
cants ’guidelines are respected [51-63]. goal was to present the favorable cha- The purpose of this literature
However, the composition and physi- racteristics of different classes (total review is to evaluate the reliability of
cal properties of high-strength ceramic etch, self-etch) in a single product [10]. self-adhesive luting agents when used
materials, such as aluminum oxide This new category of cements does with all-ceramic crowns and compare
(Al2O3) [64-72] and zirconium oxide not require any surface treatment of them to the conventional etch-and-
(ZrO2) ceramics [73-76] differ substan- the teeth or restorations and provides rinse and self-etching luting agents.
tially from silica-based ceramics and effective bond strength [3, 8, 13, 26, 27].
require alternative bonding techniques Self-adhesive cements aim to Materials and Methods
to achieve a strong and durable resin combine the favorable properties
bond [28, 29, 54, 61]. of conventional (zinc phosphate, A broad systematic search of
An ideal dental adhesive must be glass ionomers and polycarboxylate English dental litterature was initia-
biocompatible and resistant to micro- cements) and resin luting agents [10, ted. Keywords or phrases included:
leakage [2, 12]. The cement should 16]. In fact, it is reported that self- silica-based ceramics, aluminum
also provide a durable bond between adhesive resin cements provide the oxide ceramics, zirconium oxide cera-
67

Prothèses Fixées / Fixed Prosthodontics

mics, dental cements, composite resin cement in the microporosities forms a and infiltrating the substrate simulta-
cements, adhesives, total-etch adhe- well-accepted micromechanical bond neously [10]. According to the manu-
sives, self-etch adhesives, self-adhe- [20, 38]. facturers, the self-etching capacity is
sives, RelyX™ Unicem, BisCem®, The bond between the cementing attributed to the presence of different
Breeze™, G-Cem®, Maxcem Elite™, agent and the dentinal hard tissue is monomers in the luting agent formula-
Monocem®, Clearfil, Embrace, compromised by the tubular micros- tion, such as the hydrophilic monomer
Multilink® Sprint, SmartCem®, SeT tructure, the higher content of organic 4-MET in SmartCem® and methacryla-
and iCEM®. material, and the intrinsic humidity of ted phosphoric esters in SeT [11]. An
Peer-reviewed articles published in the dentinal substrate [28]. increase in pH from 1 to 7 is obser-
English between 1976 and 2010 were Finish lines placed below the ved as a consequence of the reaction
identified through a MEDLINE search cemento-enamel junction result in a between phosphate groups and both
(Pubmed and Elsevier) as well as a significant loss of adhesion [40], since alkaline filler particles and hydroxyapa-
hand search of relevant textbooks and cementum cannot be infiltrated by tite from enamel and dentin, to neutra-
annual publications. resin to the same extent as the dentin lize resin acidity [13, 22]. Han et al. [13]
[41]. reported low pH values for G-Cem™,
Results The favorable bond strength obser- Maxcem Elite™, SmartCem® and
ved for RelyX™ Unicem has been RelyX™ Unicem a few seconds after
Of the retrieved articles, articles on attributed to the micromechanical manipulation. However, after 48 hours,
the bonding to silica-based ceramics retention and chemical interaction only RelyX™ Unicem presented a neu-
[22, 44, 76], on the bonding to alumi- between monomer acidic phosphate tral pH (pH=7.0).
nium oxide ceramics [34, 58, 76] and groups and dentin/enamel hydroxya- Unlike conventional cements, resin
on the bonding to zirconium oxide patite [9, 19, 31, 35, 42, 43]. The smear materials designed for adhesive use
ceramics [30, 34-36, 72] were selected. layer is partially removed or incorpora- are anhydrous and have silanized,
Additional references were included to ted by acidic monomers that promote unreactive fillers [32]. The pH neu-
accompany statements of facts [1, 21, micromechanical retention to the tralization results in water formation
23-71, 73-76]. tooth structure [19]. and a more hydrophilic cement, which
RelyX™ Unicem was the most The quality of the dentin-adhesive- enhances the cement’s wetting ability
thoroughly investigated self-adhe- cement interface is closely related to on the dentin surface and the cement
sive while one article investigated the extension of monomers infiltra- tolerance to water. Water is crucial for
other currently marketed self-adhesive tion into the demineralized collagen self-adhesive luting agents to release
cements. network [46] and to their ability to che- hydrogen ions required for smear
Two main subjects were treated: mically interact with dentin hydroxya- layer demineralization [20] and is also
bonding to tooth structure and bon- patite [24, 31]. Despite the low initial reused in the reaction between mul-
ding to ceramics. pH of RelyX™ Unicem (pH<2 in the tifunctional acidic phosphate mono-
first minute, according to the manu- mers and alkaline filler particles.
Bonding to tooth structure facturer), almost no demineralization Shear bond strength of RelyX™
Dental cement acts as a barrier and no true hybrid layer formation was Unicem to enamel was evaluated prior
against microbial leakage, sealing the observed on the dentin surface [19, 27, to and after thermocycling [3]. Before
interface between the tooth and the 31]. It was found that RelyX™ Unicem thermocycling, this cement produced
restoration [16, 33]. This attachment applied to fractured dentin only inte- bond strength of 14.5 MPa, which
may be mechanical, chemical, or a racts very superficially without any was significantly lower than the bond
combination of both [15, 34]. Research evidence of a smear layer or resin tags strengths of other resin luting systems
has also shown that leakage may occur (irregular interaction zone ranging from investigated, which range between 17
even with successful bonding, or that nearly 0 to 2µm [21]). This may explain and 32 MPa. Moreover, its shear bond
shrinkage may cause cohesive fracture the low bond strengths recorded [19, strength to enamel was significantly
of tooth structure although the bond 47] and the high number of adhesive lower after thermocycling, in contrast
is preserved [36]. However, it is well failures for the self-adhesive materials to other resin cements that were not
established that the cementing agent [24, 31]. This finding might be attribu- influenced by the same aging condi-
used for bonding influence microlea- ted to the high cement viscosity, which tion [3]. The author concluded that
kage [35]. hinders the wetting and infiltrating of RelyX™ Unicem might not be the ideal
Enamel and dentin are dissimi- the dentin surface by the luting agent material for luting if a considerable
lar in composition and structure. The [19]. enamel surface area is present [3] and
resin tags mainly determine the adhe- The multifunctional monomers is contraindicated for veneers.
sive performance of the enamel bond having acidic phosphate groups are Similar results in terms of ena-
[37] and the penetration of the resin supposedly capable of demineralizing mel bond strengths were reported in
68

Revue de la littérature | Literature Review


IAJD Vol. 5 – Issue 2

Working/set-
Product Delivery system Shades Composition
ting time
Paste/paste dual
Bis (hydroxyethyl methacrylate) phosphate
BisCem® (Bisco; syringe; direct 1min/6min at Translucent
(base), tetraethylene glycol dimethacrylate,
Schaumburg, IL, USA) dispensing through 22ºC Opaque
dental glass
a mixing tip
Mixture of Bis-GMA, UDMA, TEGDMA, HEMA,
Paste/paste dual A2
Breeze™ (Pentron and 4-MET resins, silane-treated barium borosili-
syringe; direct 1min/4min at Translucent
Clinical Technologies, cate glasses, silica with initiators, stabilizers and
dispensing through 22ºC Opaceous
Wallingford, CT,USA) UV absorber, organic and/or inorganic pigments,
a mixing tip White
opacifiers
Clearfil SA (Kuraray, A2 Bis-GMA, TEGDMA, MDP, barium glass, silica,
Dual-barrel syringe 1min/5min
Tokyo, Japan; SL) White sodium fluoride
Embrace WetBond Completely Di-, tri-, and multi-functional acrylate monomers
Automix or standard
resin cement (Pulpdent; autocures in One shade into a hydrophilic, resin acid-integrating network
syringe packaging
Watertown, MA, USA) 7min (RAIN).
Powder: fluoroaluminosilicate glass, initiator,
A2,
pigment.
G-Cem™ (GC; Tokyo, AO3,
Capsules 2min/4min Liquid: 4-Met, phosphoric acid ester monomer,
Japan) Translucent,
water, UDMA, dimethacrylate, silica powder,
BO1
initiator, stabilizer

iCEM® (Heraeus Kulzer) Double syringe     No information available

GPDM (glycerol dimethacrylate dihydrogen phos-


Clear phate), comonomers (mono,di, and tri-functional
Paste/paste dual
White methacrylate monomers), proprietary self-curing
Maxcem Elite ™(Kerr; syringe;
2min/3min White opaque redox activator, photo-initiator (camphorquinone),
Orange, CA, USA) direct dispensing
Yellow stabilizer, barium glass fillers, fluoroaluminosili-
through a mixing tip
Brown cate glass filler, fumed silica (filler load 67%wt,
particle size 3.6µm
Paste/paste dual Unlimited wor-
Monocem™ (Shofu
syringe; king time (7min Translucent
Dental; San Marcos, No information available
direct dispensing in anaerobic Bleach white
CA, USA)
through a mixing tip conditions)
Powder: glass fillers, silica, calcium hydroxide,
A1
self-curing initiators, pigments, ligth-curing
RelyX™ Unicem (3M Capsules A2 Universal
2min/5min at initiators.
ESPE; St Paul, MN, (Aplicap: 0.001ml; Translucent
22ºC Liquid: methacrylated phosphoric esters,
USA) Maxicap: 0.36ml) White opaque
dimethacrylates, acetate, stabilizers, self-curing
A3 Opaque
initiatirs, ligth-curing initiators
Translucent,
UDMA, phosphate, fluoroaluminosilicate glass,
SeT (SDI, Australia; SE) Capsules 5min A1, A2, OA3
silica
White opaque
Urethane dimethacrylate; di- and tri-methacrylate
resins; phosphoric acid modified acrylate resin;
Translucent
barium boron fluoroaluminosilicate glass; organic
Light
SmartCem® (Dentsply- Dual-barreled peroxide initiator; camphorquinone photoinitia-
2min/6min Medium
Caulk- Germany) syringe tor; phosphene oxide photoinitiator; accelera-
Dark
tors; butylated hydroxy toluene; UV stabilizer;
Opaque
titanium dioxide; iron oxide; hydrophobic amor-
phous silicon dioxide
Working time:
self 100 – 140s,
dual100 – 140s Transparent Dimethacrylates, ytterbium trifluoride, co-poly-
SpeedCEM™ (Ivoclar,
Double syringe Setting time: Opaque mer, glass filler, silicon dioxide, adhesive mono-
Vivadent)
(37 °C) Yellow mer initiators, stabilizers and pigments
self150 – 220s,
dual150 – 220s

Table 1: Characteristics of self-adhesive cements of different brands.


69

Prothèses Fixées / Fixed Prosthodontics

microtensile bond strength investi- Silica-based ceramics the contact angle between the ceramic
gations. Enamel microtensile bond Silica-based ceramics, such as surface and the resin cement [53, 54].
strengths of RelyX™ Unicem ranged feldspathic porcelain (Vita Mark II, VITA Several studies have demonstrated
between 10.7 MPa [27] and 19.6 MPa Zahnfabrik, Bad Sackingen, Germany) that RelyX™ Unicem can achieve high
[19] and were significantly lower than and glass ceramic Empress, Empress or comparable bond strength to other
the bond strengths of the self-etching II and Emax (Ivoclar, Vivadent, Schaan, investigated cements without any pre-
cement Panavia™ F 2.0 and other resin Liechtenstein) [50] are used to veneer treatment steps such as etching, pri-
cements which ranged between 25 and metal frameworks or high-strength ming or bonding [53, 63]. However,
49 MPa [19, 27]. ceramic copings for all-ceramic resto- other studies observed higher shear
The majority of the results obtai- rations. In spite of the inherent britt- bond strength values after etching with
ned are consistent and demonstrate leness and limited flexural strength of HF acid and silanized [22, 28, 50, 53].
that in contrast to enamel adhesion, silica-based ceramics, final adhesive In a study of Kumbuloglu et al. [55],
RelyX™ Unicem performs comparably cementation with composite increases RelyX™ Unicem showed lower shear
to other multistep systems on coronal the fracture resistance of the ceramic bond strengths than the other resin
dentin. Comparable bond strength with restoration and the abutment tooth cements investigated, but no pretreat-
Panavia™ F was obtained [3, 19, 27]. [50]. ment of the ceramic surface was per-
In contrast to the positive effect Surface preparation of ceramic formed. In the study of Reich et al.,
observed on enamel, de Munck Jan [19] material is important for a strong resin only the RelyX™ Unicem, in contrast
found that acid etching was detrimen- bond [51]. To achieve this bond, the to Variolink (Ivoclar, Vivadent) and
tal to RelyX™ Unicem dentin adhe- porcelain surface may be chemically Calibra (DeTrey Dentsply, Konstanz,
sion. However, in a recent study, Pavan or mechanically modified to promote Germany), was able to survive the
et al. [16] proposed, as for glass iono- surface roughness and/or reactivity of whole thermocycling procedure in the
mer materials, that the use of poly- the porcelain to the luting agent [52]. case of no pretreatment. This indicates
acrylic acid (Ketac Conditioner; 3M Several authors have described various that besides mechanical interlocking,
ESPE, Seefeld, Germany) might have surface treatment procedures to allow additional bonding mechanisms with
enhanced the dentin bond strength of adhesion of all-ceramic restorations RelyX™ Unicem to the ceramic surface
self-adhesive cement [16]. [22, 28, 52-56]. Bonding to silicate- are possible.
In terms of marginal adaptation, based ceramics is usually obtained The specific phosphoric acid
Frankenberger and al. [49] reported by two simultaneous mechanisms: 1) methacrylates have the ability to pro-
that RelyX™ Unicem offers a tight seal micromechanical retention provided vide physical interactions with the
at dentin margins, while self-adhesive by acid-etching of the ceramic surface, ceramic surface and are able to provide
cements cannot compete with cements and 2) chemical coupling by the appli- strong hydrogen bonding with hydroxyl
which utilize etch-and-rinse adhesives cation of a silane coupling agent [50, groups present on the ceramic surface
in terms of bonding performance [49]. 53, 54, 57-59]. [22]. An increase in the bond strength
On the other hand, it should be The hydrofluoric (HF) acid reacts after pretreatment with hydrofluoric
noted that with the latest generation of with the glassy matrix that contains acid and silane was also observed [22].
dental adhesives, in pull and shear tes- silica, dissolving the surface to the This is in agreement with the study of
ting adhesion, values are so high that depth of a few micrometers [53]. This Piwowarczyk [28] who reported that,
fracturing no longer occurs at the inter- glassy matrix is selectively removed in comparison with 10 cements from
face (adhesive failure), but directly in and the crystalline structure is exposed different classes, only RelyX™ Unicem
dentin (cohesive failure) [32]. [54]. The silane coupling agent pre- exhibited high shear bond strength
sents bifunctional characteristics, after 14 days of water storage followed
Bonding to ceramics promoting a chemical interaction by thermal cycling. In the same study, it
Ceramics fall into three main cate- between the silica in the glass phase of was reported that the light polymeriza-
gories that differ by their composition ceramics and the methacrylate groups tion of the self-adhesive resin cements
and their physical properties: silica- of the resin through siloxane bonds enhances shear-bond strength in com-
based ceramics, aluminium oxide- [53, 60, 61]. It has been demonstrated parison to autopolymerization [28].
based ceramics and zirconium oxide- that silane primers may confer a resis-
based ceramics. The ability of the tance to the degradation of the cera- Aluminium oxide ceramics
combination of resin cement/adhesive mic-resin bond exposed to moisture The aluminium oxide serves as
system to adhere to dental ceramics and intraoral thermal changes [62]. reinforcement of the glassy matrix
depends on the microstructure of the Etching and silanization increase the [50]. In general, ceramics containing
esthetic restoration and the applied surface energy and the wettability of less than 15% silica are not regarded
surface treatment [9]. the ceramic substrate, which decrease as silica-based or silicate ceramics
[50]. Glass-infiltrated aluminium oxide
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IAJD Vol. 5 – Issue 2

ceramic (In-Ceram, Vita Zahnfabrik, Other authors confirmed this result vior [73]. Full coverage zirconium oxide
Bad Sackingen, Germany) and densely- [50, 59]. may not require adhesive cementa-
sintered high-purity aluminium oxide Airborne particle abrasion with a tion [73]; however, some authors
ceramic (Procera® All-Ceram, Nobel micro-etcher (50μm Al2O3) is neces- concluded that adhesive cementation
Biocare, Goteborg, Sweden) are widely sary to create porosities which improve is preferable for ensuring better reten-
used representatives of this group. microretention of the luting agents by tion, marginal adaptation and fracture
interlocking [58, 70, 72]. Borges et al. resistance of the restoration and the
Glass-infiltrated aluminium oxide [70] found in his study that airborne- abutment tooth [75].
ceramic particle abrasion of the material with Neither the application of HF acid
In-Ceram is made of a high-content 50μm aluminium oxide caused flatte- nor the silanization resulted in a satis-
aluminium oxide opaque core that is ning of the alumina rather than creating factory resin bond to zirconia [63]
glass-infiltrated to achieve its final microretentive features. SEM revealed because of the high crystalline content
strength [50, 66]. Because of its low only an irregular surface texture [70]. and the limited vitreous phase (below
silica content, neither acid etching Hummel [72] reported that the phos- 1%) of this high strength core ceramic
nor adding a silane resulted in an ade- phate monomer containing composite [73, 75]. Conventional silanes are not
quate resin bond to the alumina-based resin Panavia™21 showed the highest as effective on zirconia as on silica-
In-Ceram ceramic [58, 62]. However, bond strength to sandblasted Procera based ceramics. Airborne particle
other authors recommended a surface which did not decrease significantly abrasion with Al2O3 abrasive particles
treatment of etching and/or sandblas- over storage time. The same study has proven to be effective [50, 56]. It
ting followed by silanization [68, 69]. revealed that the use of Variolink II increases surface energy and, there-
Silanization of glass-infiltrated alumi- after priming the sandblasted ceramic fore, wettability [56].
nium oxide ceramic does not provide showed high bond strength. It has been reported that the
a chemical bond but may have a rewet- The silane might increase the wet- 10-MDP (10-methacryloxydecyl dihy-
ting effect on air-particle-abraded alu- tability, which allows flow of the bon- drogen phosphate) containing luting
mina surfaces [50]. ding resins into the undercuts and system (Clearfil™ Esthetic cement)
Air abrasion with Al2O3 abrasive porosities [72]. Blixt et al. [50] found seems to be the most suitable to bond
particles is effective and practical for tribochemical surface treatment with zirconia ceramic surfaces and it does
creating a roughened surface for alu- the Rocatec™ system (to bis-GMA not require any pretreatment of the
minium oxide ceramics [58]. Silica coa- based resin cement) to be superior to ceramic surface before luting [75]. The
ting with silanization can increase the other treatments; however, this study adhesive potential of MDP to zirco-
bond strength significantly compared was limited to short-term observations nia may depend on the presence of a
to that of airborne-particle abrasion [50]. passive coating of zirconium oxide on
alone [67]. The adhesive functional Piwowarczyk et al. [28] demonstra- the ceramic surface. Chemical reac-
phosphate monomer 10-methacrylo- ted that among 12 cementing agents, tions involving the hydroxyl groups
loxydecyl dihydrogen phosphate only RelyX™ Unicem and Panavia™ F of the layer and the phosphate ester
(MDP) chemically bonds to metal exhibited strong bond strengths to air- monomers of the MDP may occur at
oxides such as aluminium and zirco- borne particle-abraded pure aluminum the interfacial level [76]. Therefore, the
nium oxides [50, 70]. These results are oxide ceramic after 14 days of water MDP containing self-adhesive resin
confirmed by Baldissara who revealed storage followed by thermal cycling. cement Clearfil SA luting (Kuraray,
that MDP-based resin cement with Tokyo, Japan) is more suitable to bond
sandblasting with Al2O3 particles and Zirconium oxide ceramics the zirconia surface than other self-
bis-GMA-based resin cement with tri- Polycristalline ZrO2 is typically adhesive resin cements when no pre-
bochemical silica coating were the used in a tetragonal crystalline phase treatment of the ceramic was done
best luting protocols for the alumina [73]. A number of zirconia-oxide cera- [76]. Blatz [74] found that the appli-
ceramic [71]. mic systems have been recently intro- cation of a MDP-containing bonding/
duced, such as Cercon® (Dentsply, silane coupling agent is the key factor
Procera All-Ceram Amherst, N.Y.), DCS® system (DCS® for a reliable resin bond to airborne
Procera uses a high-purity alumi- Dental AG, Allschwil, Switzerland), particle-abraded Procera AllZirkon
nium oxide ceramic with an aluminium Lava™ (3M ESPE) and Procera all- (NobelBiocare, Goteborg, Sweden)
oxide content of 99.9%. Borges et al. Zirkon (NobelBiocare, Goteborg, and is not influenced by the resin
[70] showed that the ceramic surface Sweden). Each of the commercial zir- luting agent used. Jie Lin [76] found
of densely sintered alumina was not conia systems has unique material that silica coating and tribochemical
etched by hydrofluoric acid because properties due to the specific fabrica- treatment improved the bond strength
it does not contain a silica phase [70]. tion process, creating a unique intaglio of the self-adhesive cements (RelyX™
surface that influences bonding beha- Unicem, Maxcem Elite™, Smartcem®,
71

Prothèses Fixées / Fixed Prosthodontics

Breeze™, Biscem™, Clearfil SA) to zir- References


conia compared to untreated ceramic.
1. Höland W, Rheinberger V, Appel C, Ritzberger C, Rothbrust F,
Furthermore, De Oyague [75] found Kuppert H, et al. Future perspectives of biomaterials for dental
that RelyX™ Unicem bonded to zir- restoration. Journal of the European Ceramic Society, 2009;
conia, regardless of the ceramic sur- 29:1291-1297.
face treatment and without additional 2. Rosenstiel SF, Crispin BJ. Dental luting agents: A review of the
coupling agent application. According current literature. J Prosthet Dent 1998;80:280-31.
to Kumbuloglu [56], RelyX™ Unicem 3. Abo-Hamar, Jung H, Federlin M, Friedl K-H, Schmalz G. Bond
showed higher bond strength than strength of a new universal self-adhesive resin luting cement to
the Panavia™ F in both water-storage dentin and enamel. Clin Oral Invest 2005;9:161-167.
and thermocycling when used with 4. Ozcan M. Effect of surface conditioning methods on the bond
a zirconium oxide (DCS Dental AG) strength of luting cement to ceramics. Dent Mater 2003;19:725-
[56]. Panavia™ F and RelyX™ Unicem 31.
contain phosphoric-acid methacrylates 5. Atsu S, Kucukesmen C, Aka S. Effect of zirconium-oxide ceramic
that provide a strong physical interac- surface treatments on the bond strength to adhesive resin. J
Prosthet Dent 2006;95:430-6.
tion, such as hydrogen bonding, with
the air abraded ceramic surface [28]. 6. Mak YF, Cheung GS, Chan AW, Tay FR, Pashley DH. Microtensile
bond testing of resin cements to dentin and an indirect resin
composite. Dent Mater 2002;18:609-21.
Conclusion
7. Stewart G, Hodges J. Shear bond strength of resin cements
to both ceramic and dentin. J Prosthet Dent 2002;88:277-284.
Based on the published articles,
RelyX™ Unicem - the most investiga- 8. Nakamura T, WK, Kinuta S, Nishida H, Miyamae M, Yatani
H. Mechanical properties of new self-adhesive resin-based
ted self-adhesive cement- proved to be cement. J Prosth Res 2010;54:59-64.
satisfactory and comparable to other
9. Pegoraro T, Carvalho R. Cements for use in esthetic dentistry.
multistep resin cements. However, Dent Clin North Am 2007;51:453-471.
RelyX™ Unicem bonding performance
10. Radovic I, Goracci C, Vulicevic ZR, Ferrari M. Self-adhesive resin
was found to be better on dentin than cements: A literature review. J Adhes Dent 2008;10:251-8.
on enamel. On the other hand, this
11. Viotti R G, Pena C E, Alexandre R S, Arrais C A, Reis A.
product can bond to the silica-based
Microtensile bond strength of new self-adhesive luting
ceramics, aluminium oxide ceramics, agents and conventional multistep systems. J Prosthet Dent
zirconium oxide ceramics regardless of 2009;102:306-312.
the ceramic treatment. 12. De Suza Costa CA, Lopes do Nascimento AB, Hebling J.
Self-adhesive cements seem to be Biocompatibility of resin-based dental materials applied as
promising in indirect restorative pro- liners in deep cavities prepared in human teeth. J Biomed Mater
Res B Appl Biomater, 2007;87:175-84.
cedures because they offer a simplified
technique, reduce the occurrence of 13. Han L, Fukushima M, Okiji T. Evaluation of physical properties
postoperative sensitivity and are sui- and surface degradation of self-adhesive resin cements. Dent
Mater 2007;26:906-14.
table for a wide range of applications.
Prospective, long-term studies 14. White SN, Kang SK, Caputo AA. Microleakage of new crown
and fixed partial denture luting agents. J Prosthet Dent
are necessary to evaluate self-adhe- 1992;67:156-61.
sives introduced in the market prior to
15. Diaz-Arnold Ana M, Haselton debra R. Current status of luting
making any general recommendation
agents for fixed prosthodontics. J Prosthet Dent 1999;81:135-
regarding their use. 41.
16. Pavan S, Berger S, Bedran-Russo AKB. The effect of dentin
pretreatment on the microtensile bond strength of self-adhesive
resin cements. J Prosthet Dent 2010;104:258-64.
17. Gemalmaz D. Clinical evaluation of all-ceramic crowns. J
Prosthet Dent 2002;87:189-96.
18. Mota CS, Camacho GB, Powers JM. Microleakage in ceramic
inlays luted with different resin cements. J Adhes Dent
2003;5:63-70.
19. De Munck J, Van Landuyt K, Hikita K, Lambrechts P, Van
Meerbeek B. Bonding of an auto-adhesive luting material to
enamel and dentin. Dent Mater 2004;20:963-971.
72

Revue de la littérature | Literature Review


IAJD Vol. 5 – Issue 2

20. Knobloch Lisa A, Azer S, Johnston w, Clelland N, Kerby R. Bond 38. Buonocore MG, Matsui A, Gwinnett AJ. Penetration of resin
strengths of one- and two-step self-etch adhesive systems. J dental materials into enamel surfaces with reference to
Prosthet Dent 2007;97:216-22. bonding. Arch Oral Biol, 1968;13:61-70.
21. Wassell RW, Steele G. Crowns and other extra-coronal 39. Lam CW, Wilson P. Crown cementation and pulpal health. Int
restorations: Try-in and cementation of crowns. Brit D J Endod J 1999;32:249-256.
2002;193(1):17-28.
40. Peumans M, Van Meerbeek B, Lambrechts P. Porcelain
22. Reich SM, Frankenberger R, Zajc D. Effect of surface veneers: a review of the literature. J Dent 2000;28:163-77.
treatment on the shear bond strength of three resin cements
41. Federlin M, Schmidt S, Hiller KA, Thonnemann B, Schmalz G.
to a machinable feldspatic ceramic. J Biomed Mater Res Appl
Partial ceramic crowns: influence of preparation design and
Biomater 2005;74:740-6.
luting material on internal adaptation. Oper Dent 2004;29:560-
23. Hikita K, De Munck J, Ikeda T, van Landuyt K, Maida T. Bonding 70.
effectiveness of adhesive luting agents to enamel and dentin.
42. Schenke F, Hiller K, Schmalz G, Federlin M. Marginal integrity
Dent Mater 2007;23:71-80.
of partial ceramic crowns within dentin with different luting
24. Yoshida Y, Nagakane K, Fukuda R, Nakayama Y, Okazaki M, techniques and materials. Oper Dent 2008;33:516-25.
Shintani H. Comparative study on adhesive performance of
43. Ibarra G, Johnson G, Geurtsen W, Vargas MA. Microleakage
functional monomers. J Den Res 2004;83:454-8.
of porcelain veneer restorations bonded to enamel and dentin
25. Van Meerbeek B, Yoshida Y, Inoue S, Vargas M, Vijay P, Van with a new self-adhesive resin-based dental cement. J Den Res
Landuyt K et al. Adhesion to enamel and dentin: current status 2007;23:218-25.
and future challenges. Oper Dent 2003;28:215-235.
44. Zicari F, Couthino E, De Munck J, Poitevin A, Scotti R, Naert
26. Behr M, Rosentritt M, Regnet T, Lang R, Handel G. Marginal I, et al. Bonding effectiveness and sealing ability of fiber-post
adaptation in dentin of a self-adhesive universal resin cement bonding. Dent Mater 2008;24:967-77.
compared with well-tried systems. Dent Mater 2004;20:191-7.
45. Mazitelli C, Monticelli F, Osorio R, Casucci A, Toledano M,
27. Goracci C, Curry A, Cantoro A, Papachini F, Tay FR, ferrari M. Ferrari M. Effect of simulated pulpal pressure on self-adhesive
Microtensile bond strength and interfacial properties of self- cements bonding to dentin. Dent Mater 2008;24:1156-63.
etching and self-adhesive resin cements used to lute composite
46. Hashimoto M, De Monk J, Ito S, Sano H, Kaga M , Ogushi H,
onlays under different seating forces. J Adhes Dent 2006;8:327-
et al. In vitro effect of nanoleakage expression on resin-dentin
35.
bond-strengths analyzed by microtensile bond test, SEM/EDX
28. Piwowarczyk A, Lauer H-C, Sorensen J. In vitro shear bond and TEM. Biomaterials 2004;25:5565-74.
strength of cementig agents to fixed prosthodontic restorative
47. Goracci C, Sadek F, Fabianelli A, Tay FR, Ferrari M. Evaluation of
materials. J Prosthet Dent 2004;92:265-73.
the adhesion of fiber posts to intraradicular dentin. Oper Dent
29. Palacios RP, Johnson GH, Philips KM, Raigrodski AJ. Retention 2005;30:627-35.
of zirconium oxide ceramic crowns with three types of cement.
48. Wang VJ, Chen Y, Yip KH, Smales RJ, Meng QF, Chen L. Effect
J Prosthet Dent 2006;96:104-14.
of two fiber post types and two luting cement systems on
30. Attar N, Tam L, Mc Comb D. Mechanical and physical regional post retention using the push-out test. Dent Mater
properties of contemporary dental luting agents. J Prosthet 2008;24:372-7.
Dent 2003;89:127-34.
49. Frankenberger R, Lohbauer U, Schaible RB, Nikolaenko SA,
31. Gerth H, Zuchner H, Schafer E. Chemical analysis and bonding Naumann M. Luting of ceramic inlays in vitro: Marginal quality
reaction of RelyX™ Unicem and Bifix composites- a comparative of self-etch and etch-and-rinse adhesives versus self-etch
study. Dent Mater 2006;22:934-941. cements. Dent Mater 2008;24:185-191.
32. Technical data sheet: Expertise RelyX™ Unicem (3M ESPE), 50. Blatz M, Sadan A, Kern M. Resin-ceramic bonding: a review of
S.G., 2002. the literature. J Prosthet Dent 2003;89:268-74.
33. Pameijer CH. Long term clinical evaluation of three luting 51. Kamada K, Yoshida K, Atsuta M. Effect of ceramic surface
materials. Swed Dent J 1994;18:59-67. treatments on the bond of four resin luting agents to a
ceramic material. J Prosthet Dent 1998;79:508-13.
34. Bergenholtz G. Evidence for bacterial causation of adverse
pulpal responses in resin-based dental restorations. Crit Rev 52. Ayad M, Fahmi N, Rosenstiel S. Effect of surface treatment
Oral Biol Med, 2000;11:467-80. on roughness and bond strength of a heat-pressed ceramic. J
prosthet dent 2008;99:123-130.
35. Piwowarczyk A, L.H-C, Sorensen John A. Microleakage of
various cementing agents for full cast crowns. Dent Mater 53. Pisani-Proenca J, Erhardt G, Valandro F. Influence of ceramic
2005;21:445-453. surface conditioning and resin cements on microtensile bond
strength to a glass ceramic. J Prosthet Dent 2006;96:412-7.
36. Bouillaget S, Gysi P, Wataha JC. Future directions in bonding
resins to the dentine-pulp complex. Journal of Oral Rehabilitation 54. Chaiyabutor Y, Mc Gowan S, Phillips K, Giordano R. The effect
2004;31:385-392. of hydrofluoric acid surface treatment and bond strength of a
zirconia veneering ceramic. J Prosthet Dent 2008;100:194-202.
37. Heng-Liang L, Chun-Li L, Ming-Tsung S, Yen-Hsiang C.
Numerical investigation of macro- and micro-mechanics of a 55. Kumbuloglu O, Lassila LVJ, User A, Toksavul S, Vallittu P.K.
ceramic veneer bonded with various cement thicknesses using Shear bond strength of composite resin cements to lithium
the typical and submodeling finite element approaches. J Dent disilicate ceramics. J Oral Rehab 2005;32:128-133.
2009;37:141-148.
73

Prothèses Fixées / Fixed Prosthodontics

56. Kumbuloglu O, Lassila LVJ, User A, Vallitu PK. Bonding of resin 74. Blatz M, Sadan A, Martin J, Lang B. In vitro evaluation of
composite luting cements to zirconia oxide by two air-particle shear bond strengths of resin to densely-sintered high-purity
abrasion methods. Oper Dent 2006;31(2):248-255. zirconium-oxide ceramic after long-term storage and thermal
cycling. J Prosthet Dent 2004;91:356-62.
57. Addison O, Marquis P, Fleming G. Resin strengthening of
dental ceramics- the impact of surface texture and silane. J 75. De Oyague R, Monticelli F, Toledano M, Osorio E, Ferrari M,
Dent 2007;35:416-424. Osorio R. Influence of surface treatments and resin cement
selection on bonding to densely-sintered zirconium-oxide
58. Blatz M, Sadan A, Arch G, Lang B. In vitro evaluation of long- ceramic. Dent Mater 2009;25:172-179.
term bonding of Procera Allceram alumina restorations with a
modified resin luting agent. J Prosthet Dent 2003;89:381-7. 76. Lin J, Shinya A, Gomi H, Shinya A. Effect of self-adhesive resin
cement and tribochemical treatment on bond strength to
59. Kato H, Matsumura H, Tanaka T, Atsuta M. Bond strength zirconia. Int J Oral Sci 2010;2(1):28–34.
and durability of porcelain bonding systems. J prosthet Dent
1996;75:163-8.
60. Matinlinna J, Vallittu P. Silane based concepts on bonding resin
composite to metals. The Journal of Contemporary Dental
Practice 2007;8(2):1-8.
61. Bottino M, Valandro LF, Scotti R, Buso L. Effect of surface
treatments on the resin bond to zirconium-based ceramic. Int J
Prosthodont 2005;18:60-65.
62. Owen A, Marquis PM, Fleming G. Adhesive luting of all-ceramic
restorations- The impact of cementation variables and short-
term water storage on the strength of a feldspathic dental
ceramic. J Adhes Dent 2008;10:285-294.
63. Technical product profile: 3M ESPE RelyX UnicemSelf-Adhesive
Universal Resin Cement.
64. Trajtenberg CP, Caram SJ, Kiat-amnuay S. Microleakage of All-
Ceramic Crowns using self-etching luting agents. Oper Dent
2008;33(4):392-399.
65. Ferrari M. Marginal integrity of ceramic inlays luted with a self-
curing resin system. Dent Mater 2003;19(4):270-276.
66. Al-Wahadani A, Hussey D, Grey N, Hatamieh M. Fracture
resistance of aluminium oxide and lithium disilicate-based
crowns using different luting cements: an in vitro study. The
Journal of Contemporary Dental Practice 2009;10(2):51-58.
67. Kern M, Thompson P. Bonding to glass infiltrated alumina
ceramic: Adhesive methods and their durability. J Prosthet
Dent 1995;73:240-9.
68. Begazo C, de Boer H, Kleverlaan C, Van Waas M, Feilzer A.
Shear bond strength of different types of luting cements to an
aluminium oxide-reinforced glass ceramic core material. Dent
Mater 2004;20:901-907.
69. Madani M, Chu F, McDonald A, Smales R. Effects of surface
treatments on shear bond strengths between a resin cement
and an alumina core. J Prosthet Dent 2000;83:644-7.
70. Borges G, De Goes MF, Platt J, Moore K, Hueb de Menezes
F, Vedovato E. Extrusion shear strength between an alumina-
based ceramic and three different cements. J Prosthet Dent
2007;98:208-215.
71. Baldissara P, Valandro LF, Monaco C, Ferrari M, Bottino MA,
Scotti R. Fatigue resistance of the bond of a glass-infiltrated
alumina ceramic to human dentin. J Adhes Dent 2006;8(2):97-
104.
72. Hummel M, Kern M. Durability of the resin bond strength to the
alumina ceramic Procera. Dent Mater 2004:20;498-508.
73. Blatz M G, Chiches H, Sadan A. Influence of surface treatment
and simulated aging on bond strengths of luting agents to
zirconia. Quintessence Int 2007;38:745-753.