RESIN BOND TO DENTAL CERAMICS,PART I: REVIEW AND SILICA‐BASED CERAMICS

Silica‐based ceramics (eg, feldspathic, glass, and leucite‐reinforced feldspathic ceramics) are preferred materials for conservative, highly esthetic indirect restorations such as laminate veneers, ceramic inlays and onlays, and full‐coverage crowns because of their optical properties, biocompatibility, and longevity. Adhesive cementation of ceramics to the supporting tooth using resin cements has been identified as the main determinant for the excellent clinical success of bonded silica‐based ceramic restorations. The first article discussed in this Critical Appraisal reviews the current evidence for the need of adhesive technologies to support ceramics. Even though review articles typically are not addressed in this section, its thoroughness and clear conclusions make this article an important contribution to the field of esthetic and restorative dentistry. Controlled clinical trials are ideal to evaluate the success of certain materials or therapeutic interventions. However, laboratory studies are necessary to compare large varieties of materials and influencing parameters and to identify superior materials and bonding techniques prior to their clinical application. Numerous in vitro studies have evaluated the ceramic‐composite resin interface. The in vitro studies reviewed in this section indicate that acid‐etching and silane application are ideal methods to achieve strong and durable resin bonds to silica‐based ceramics. The selected articles indicate interesting trends in testing methods and interpretation of results. Earlier studies favor shear bond strength testing methods and emphasize the importance of surface microstructure and mechanical interlocking. However, some recent studies prefer modified tensile bond strength methods, and find silane application, and therefore chemical interaction, to be the main contributor to reliable resin‐ceramic bonds. Unfortunately, direct comparisons between different studies are difficult owing to the variations in methods and materials and the lack of standard protocols.