Bonding of resin-based luting cements to zirconia with and without the use of ceramic priming agents

Purpose: This study evaluated and compared bonding characteristics of resin-based luting agents and special ceramic primers to zirconia. Materials and Methods: Disk specimens (n = 242) were fabricated from zirconium dioxide ceramics (Katana) and bonded with four resin-based luting agents without priming. In addition, zirconia was bonded with 7 bondingsystem combinations of three priming agents and three resin-based luting agents. Two of the resin-based luting agents and two ceramic priming agents contain an identical adhesive monomer, 10-methacryloyloxydecyl dihydrogen phosphate (MDP), either in the material itself or in the priming agent. Shear bond strength was determined after 20,000 cycles of thermocycling. The Kruskal-Wallis test was performed for both pre- and post-thermocycling groups to evaluate the difference among primer and luting agent variations. On the basis of the Kruskal-Wallis test, Steel-Dwass multiple comparisons were further performed to compare the difference among four luting agents and seven conbinations of three primers and three luting agents for both pre- and post-thermocycling conditions. Results: Within the four unprimed groups, Clearfil SA Cement (5.8 MPa) and Panavia F 2.0 (6.7 MPa) showed statistically higher post-thermocycling bond strength than the other materials (0.1 MPa) (p < 0.05). Among the seven primer/cement combinations, Clearfil Ceramic Primer combined with Clearfil Esthetic Cement exhibited the highest post-thermocycling bond strength (7.5 MPa), followed by two groups primed with Monobond Plus (4.0-4.6 MPa) (p < 0.05). Conclusion: Application of resin-based luting and priming agents containing the adhesive monomer MDP provide better bond strength to zirconia than do other systems.