International Journal of Prosthodontics and Restorative Dentistry

Register      Login

VOLUME 14 , ISSUE 2 ( April-June, 2024 ) > List of Articles


Evaluation of Shear Bond Strength of CAD/CAM Ultra-translucent Zirconia and Lithium Disilicate Ceramics Bonded to Enamel: An In Vitro Study

Ibrahim A Elsisi, Omnia Nabil, Shereen A Amin

Keywords : Enamel substrate, Lithium disilicate, 10-methacryloyloxydecyl dihydrogen phosphate-based cement, Shear bond strength, 5-mol% yttria-stabilized tetragonal zirconia polycrystal

Citation Information : Elsisi IA, Nabil O, Amin SA. Evaluation of Shear Bond Strength of CAD/CAM Ultra-translucent Zirconia and Lithium Disilicate Ceramics Bonded to Enamel: An In Vitro Study. Int J Prosthodont Restor Dent 2024; 14 (2):86-93.

DOI: 10.5005/jp-journals-10019-1449

License: CC BY-NC 4.0

Published Online: 29-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Purpose: The purpose of this in vitro study was to compare the efficacy of bonding 5-mol% yttria-stabilized tetragonal zirconia polycrystal (5Y-PSZ) zirconia (Zr) to enamel relative to lithium (Li) disilicate glass-ceramic. Materials and methods: A total of 36 disk-shaped samples (4 × 2 mm2) were produced by milling process from two groups—Li disilicate (Li group) (IPS e.max CAD, n = 18) and 5Y-PSZ (Zr group) [KATANA Ultra-Translucent Multi-layered (UTML), (n = 18)]. All samples were subjected to a surface conditioning protocol for optimal bonding with a total-etch methacryloyloxydecyl dihydrogen phosphate (MDP) containing adhesive resin cement (Variolink Esthetic DC). Subsequently, a shear bond strength test was performed. The evaluation of failure modes and analysis of the surface was conducted using a light microscope. Failure modes were categorized into adhesive, cohesive, and mixed. The Mann–Whitney U test was utilized to assess statistically significant differences between the two groups. Qualitative data were presented as frequencies and percentages. The Chi-squared test was utilized for all comparative analyses. Results: There was no statistically significant difference in shear bond strength between the two groups (36.57 ± 30.81 MPa for the Li group and 34.11 ± 22.88 MPa for the Zr group). The failure modes varied between adhesive (40, 50%), mixed (30, 40%), and cohesive (30, 10%) in the Li and Zr groups, respectively, with insignificant differences between them (p = 0.53). Conclusion: A 5-mol% yttria-stabilized tetragonal Zr polycrystal showed high shear bond strength similar to Li disilicate glass-ceramic. Air blasting of Zr followed by primers and resin cements based on 10-MDP monomer has proven its efficiency in Zr-resin bonding. Both ultra-translucent 5Y-PSZ Zr and Li disilicate offer viable options for esthetic restorations on anterior teeth.

PDF Share
  1. Scaminaci Russo D, Cinelli F, Sarti C, et al. Adhesion to zirconia: a systematic review of current conditioning methods and bonding materials. Dent J (Basel) 2019;7:74. DOI: 10.3390/dj7030074
  2. Winter A, Schurig A, Odenthal AL, et al. Impact of different layers within a blank on mechanical properties of multi-layered zirconia ceramics before and after thermal aging. Dent Mater 2022;38(5):e147–e154. DOI: 10.1016/
  3. Liu X, Aarts JM, Ma S, et al. The influence of polishing on the mechanical properties of zirconia—a systematic review. Oral 2023;3(1):101–122. DOI: 10.3390/oral3010010
  4. Peterson GR, Carr RE, Marinero EE. Zirconium carbide for hypersonic applications, opportunities and challenges. Materials 2023;16(18):6158. DOI: 10.3390/ma16186158
  5. Sivasankar MV, Chinta ML, Rao PS. Zirconia based composite scaffolds and their application in bone tissue engineering. Int J Biol Macromol 2024;265(Pt 1):130558. DOI: 10.1016/j.ijbiomac.2024.130558
  6. Souza R, Barbosa F, Araújo G, et al. Ultrathin monolithic zirconia veneers: reality or future? Report of a clinical case and one-year follow-up. Oper Dent 2018;43(1):3–11. DOI: 10.2341/16-350-T
  7. Munoz A, Zhao Z, Paolone G, et al. Flexural strength of CAD/CAM lithium-based silicate glass–ceramics: a narrative review. Materials 2023;16(12):4398. DOI: 10.3390/ma16124398
  8. Kursoglu P, Motro PFK, Yurdaguven H. Shear bond strength of resin cement to an acid etched and a laser irradiated ceramic surface. J Adv Prosthodont 2013;5(2):98–103. DOI: 10.4047/jap.2013.5.2.98
  9. Guarda GB, Correr AB, Gonçalves LS, et al. Effects of surface treatments, thermocycling, and cyclic loading on the bond strength of a resin cement bonded to a lithium disilicate glass ceramic. Oper Dent 2013;38(2):208–217. DOI: 10.2341/11-076-L
  10. Abduljabbar T, AlQahtani MA, Al Jeaidi Z, et al. Influence of silane and heated silane on the bond strength of lithium disilicate ceramics-an in vitro study. Pak J Med Sci 2016;32(3):550–554. DOI: 10.12669/pjms.323.9851
  11. Morimoto S, Albanesi RB, Sesma N, et al. Main clinical outcomes of feldspathic porcelain and glass-ceramic laminate veneers: a systematic review and meta-analysis of survival and complication rates. Int J Prosthod 2016;29(1):38–49. DOI: 10.11607/ijp.4315
  12. Salem R, Naggar GE, Aboushelib M, et al. Microtensile bond strength of resin-bonded hightranslucency zirconia using different surface treatments. J Adhes Dent 2016;18(3):191–196. DOI: 10.3290/j.jad.a36034
  13. Matsuzaki F, Sekine H, Honma S, et al. Translucency and flexural strength of monolithic translucent zirconia and porcelain-layered zirconia. Dent Mater J 2015;34(6):910–917. DOI: 10.4012/dmj.2015-107
  14. Güth JF, Stawarczyk B, Edelhoff D, et al. Zirconia and its novel compositions: what do clinicians need to know? Quintessence Int 2019;50(7):512–520. DOI: 10.3290/j.qi.a42653
  15. Jerman E, Lümkemann N, Eichberger M, et al. Evaluation of translucency, Marten's hardness, biaxial flexural strength and fracture toughness of 3Y-TZP, 4Y-TZP and 5Y-TZP materials. Dent Mater 2021;37(2):212–222. DOI: 10.1016/
  16. Zhang Y, Lawn BR. Novel zirconia materials in dentistry. J Dent Res 2018;97(2):140–147. DOI: 10.1177/0022034517737483
  17. Kim HE, Lim MJ, Yu MK, et al. Changes in bond strength and topography for Y-TZP etched with hydrofluoric acid depending on concentration and temperature conditions. Medicina 2020;56(11):568. DOI: 10.3390/medicina56110568
  18. Zhang Q, Yao C, Yuan C, et al. Evaluation of surface properties and shear bond strength of zirconia substructure after sandblasting and acid etching. Mater Res Express 2020;7(9):095403. DOI: 10.1088/2053-1591/abb5c9
  19. Comino-Garayoa R, Peláez J, Tobar C, et al. Adhesion to zirconia: a systematic review of surface pretreatments and resin cements. Materials 2021;14(11):2751. DOI: 10.3390/ma14112751
  20. Martins JD, Moura D, Lima CM, et al. Surface treatment and cementation of lithium silicate ceramics containing zro2. Oper Dent 2022;47(2):202–213. DOI: 10.2341/20-156-L
  21. Öztürk E, Bolay Ş, Hickel R, et al. Shear bond strength of porcelain laminate veneers to enamel, dentine and enamel–dentine complex bonded with different adhesive luting systems. J Dent 2013;41(2):97–105. doi: 10.1016/j.jdent.2012.04.005
  22. Alammar A, Att W. Bonding durability between zirconia and different types of tooth or implant abutments-a systematic review. Part I: outcomes of in vitro studies. Int J Prosthodont 2021;34(5):650–669. DOI: 10.11607/ijp.6870
  23. Alammar A, Att W. Bonding durability between zirconia and different types of tooth or implant abutments-a systematic review. Part II: outcomes of clinical studies. Int J Prosthodont 2022;35(4):512–529. DOI: 10.11607/ijp.6871
  24. Alammar A, Blatz MB. The resin bond to high-translucent zirconia—a systematic review. J Esthet Restor Dent 2022;34(1):117–135. DOI: 10.1111/jerd.12876
  25. Yoshida K. Influence of alumina air-abrasion for highly translucent partially stabilized zirconia on flexural strength, surface properties, and bond strength of resin cement. J Appl Oral Sci 2020;28:e20190371. DOI: 10.1590/1678-7757-2019-0371
  26. Monteiro RV, Dos Santos DM, Bernardon JK, et al. Effect of surface treatment on the retention of zirconia crowns to tooth structure after aging. J Esthet Restor Dent 2020;32(7):699–706. DOI: 10.1111/jerd.12623
  27. Ismail AM, Bourauel C, ElBanna A, et al. Micro versus macro shear bond strength testing of dentin-composite interface using chisel and wireloop loading techniques. Dent J (Basel) 2021;9(12):140. DOI: 10.3390/dj9120140
  28. Ågren M, Kou W, Molin Thorén M. Bond strength of surface-treated novel high translucent zirconia to enamel. Biomater Investig Dent 2019;6(1):35–42. DOI: 10.1080/26415275.2019.1684200
  29. Sahafi A, Peutzfeldt A, Ravnholt G, et al. Resistance to cyclic loading of teeth restored with posts. Clin Oral Investig 2005;9(2):84–90. DOI: 10.1007/s00784-004-0299-7
  30. Çöterta HS, Dündarb M, Öztürka B. The effect of various preparation designs on the survival of porcelain laminate veneers. Margin 2009;11(5):405–411. DOI: 10.3290/j.jad.a17634
  31. Zhu J, Gao J, Jia L, et al. Shear bond strength of ceramic laminate veneers to finishing surfaces with different percentages of preserved enamel under a digital guided method. BMC Oral Health 2022;22(1):3. DOI: 10.1186/s12903-021-02038-5
  32. Moon JE, Kim SH, Lee JB, et al. Effects of airborne-particle abrasion protocol choice on the surface characteristics of monolithic zirconia materials and the shear bond strength of resin cement. Ceram Int 2016;42(1):1552–1562. DOI: 10.1016/j.ceramint.2015.09.104
  33. Inokoshi M, Shimizubata M, Nozaki K, et al. Impact of sandblasting on the flexural strength of highly translucent zirconia. J Mech Behav Biomed Mater 2021;115:104268. DOI: 10.1016/j.jmbbm.2020.104268
  34. Tyor S, Al-Zordk W, Sakrana AA. Fracture resistance of monolithic translucent zirconia crown bonded with different self-adhesive resin cement: influence of MDP-containing zirconia primer after aging. BMC Oral Health 2023;23(1):636. DOI: 10.1186/s12903-023-03365-5
  35. Kim MJ, Kim YK, Kim KH, et al. Shear bond strengths of various luting cements to zirconia ceramic: surface chemical aspects. J Dent 2011;39(11):795–803. DOI: 10.1016/j.jdent.2011.08.012
  36. Ural Ç, Külünk T, Külünk Ş, et al. Determination of resin bond strength to zirconia ceramic surface using different primers. Acta Odontol Scand 2011;69(1):48–53. DOI: 10.3109/00016357.2010.517558
  37. de Souza G, Hennig D, Aggarwal A, et al. The use of MDP-based materials for bonding to zirconia. J Prosthet Dent 2014;112(4):895–902. DOI: 10.1016/j.prosdent.2014.01.016
  38. Kwon SJ, Lawson NC, McLaren EE, et al. Comparison of the mechanical properties of translucent zirconia and lithium disilicate. J Prosthet Dent 2018;120(1):132–137. DOI: 10.1016/j.prosdent.2017.08.004
  39. Inokoshi M, Shimizu H, Nozaki K, et al. Crystallographic and morphological analysis of sandblasted highly translucent dental zirconia. Dent Mater 2018;34(3):508–518. DOI: 10.1016/
  40. Sharafeddin F, Shoale S. Effects of universal and conventional MDP primers on the shear bond strength of zirconia ceramic and nanofilled composite resin. J Dent 2018;19(1):48–56. DOI: 10.30476/dentjods.2018.41791
  41. Zakavi F, Mombeini M, Dibazar S, et al. Evaluation of shear bond strength of zirconia to composite resin using different adhesive systems. J Clin Exp Dent 2019;11(3):e257–e263. DOI: 10.4317/jced.55428
  42. Valente F, Mavriqi L, Traini T. Effects of 10-MDP based primer on shear bond strength between zirconia and new experimental resin cement. Materials 2020;13(1):235. DOI: 10.3390/ma13010235
  43. Kansal R, Rani S, Kumar M, et al. Comparative evaluation of shear bond strength of newer resin cement (RelyX ultimate and RelyX U200) to lithium disilicate and zirconia ceramics as influenced by thermocycling. Contemp Clin Dent 2018;9(4):601–606. DOI: 10.4103/ccd.ccd_601_18
  44. Go EJ, Shin Y, Park JW. Evaluation of the microshear bond strength of MDP-containing and non–MDP-containing self-adhesive resin cement on zirconia restoration. Oper Dent 2019;44(4):379–385. DOI: 10.2341/18-132-L
  45. Ziada A, Csaba D. Effect of post-etching cleaning methods on surface micromorphology and shear bond strength of composite resin cement to feldspathic ceramic blocks. Egypt Dent J 2019;65(1):475–482. DOI: 10.21608/EDJ.2019.72723
  46. de Paula DM. Influência e caracterização dos efeitos do 10-MDP na adesâo zircônia e cálcio. 2017.
  47. Elsantawi AM, Elgabarouny M, Saad D, et al. Evaluation of the shear bond strength of two types of adhesive resin cements to zirconia after surface treatment using silica coating. Dent Sci Updates 2020;1(1):23–30. DOI: 10.21608/DSU.2020.14819.1005
  48. Sami OM, Naguib EA, Afifi RH, et al. Effect of different adhesion protocols on the shear bond strength of universal adhesive systems to sound and artificial caries-affected dentin. Eur J Gen Dent 2021;10(1):30–36. DOI: 10.1055/s-0041-1732776
  49. Lüthy H, Loeffel O, Hammerle CHF. Effect of thermocycling on bond strength of luting cements to zirconia ceramic. Dental Mater 2006;22(2):195–200. DOI: 10.1016/
  50. Mously HA, Kazim SA, Nageeb RN, et al. Influence of shear bonding strength of lithium disilicate to enamel under different surface treatments. J Evol Med Dent Sci 2020;9(10):705–711. DOI: 10.14260/jemds/2020/154
  51. Shin YJ, Shin Y, Yi YA, et al. Evaluation of the shear bond strength of resin cement to Y-TZP ceramic after different surface treatments. Scanning 2014;36(5):479–486. DOI: 10.1002/sca.21142
  52. Kim JE, Kim JH, Shim JS, et al. Effect of surface treatment on shear bond strength between resin cement and Ce-TZP/Al 2 O 3. Biomed Res Int 2016;2016:7576942. DOI: 10.1155/2016/7576942
  53. Mohamed M, Farghaly E. Comparison of the shear bond strength of translucent zirconia and lithium disilicate ceramic following immediate dentin sealing. Egypt Dent J 2022;68(2):1713–1720. DOI: 10.21608/EDJ.2022.122023.1984
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.