Adhesion to dental zirconia: A literature review

Abstract

Introduction: Yttria-stabilized tetragonal zirconia polycrystals have become increasingly popular in dental restorations because of their aesthetic appeal, biocompatibility, and mechanical strength. However, currently there is no standardized treatment for zirconia. Aims: Analyze the literature of adhesion to dental zirconia. Zirconia, decontaminating the internal surface of zirconia restorations, importance of 10-MDP in zirconia bonding and cementation protocol will be analyzed. Methodology: A comprehensive literature review was conducted on the subject of Adhesion to Zirconia. The literature review consisted of 40 articles, which were obtained from different databases: PubMed, Springer Link, Wiley Online Library, Elsevier, using the terms “Zirconia”, “Air-abrasion”, “Adhesion”, “MDP”, “Dental Materials”. Results: When considering adhesion to zirconia the following factors should be taken into account: Zirconia, is a versatile ceramic with different crystalline phases, stabilized for dental use by doping with yttria. Decontaminating the internal surface of zirconia restorations, is crucial for strong bonding, with air abrasion being the most effective method. Importance of 10-MDP in zirconia bonding, improve zirconia's adhesion to composite resins by chemically bonding with zirconia and aiding polymerization. Cementation protocol, with adhesive cements offering better bond strength and aesthetics than traditional cements. Conclusion: Bonding zirconia restorations requires effective surface preparation, contamination removal, and the use of specialized bonding agents. Air-particle abrasion and cleaning solutions like Ivoclean or ZirClean help remove contaminants, while primers with adhesive phosphate monomers like 10-MDP enhance bond strength. Dual-cure or self-cure composites ensure proper polymerization beneath the zirconia. The APC zirconia-bonding concept, which involves abrasion, primer application, and composite resin cement, provides a reliable method for strong, durable bonds, ensuring both mechanical stability and aesthetic quality in clinical use.