Effect of primer compositions on the bond strength of resin cement to ceramic materials.

Purpose: To investigate the effect of different chemical compositions of primers on the bond strength between nano-ceramic, polymer-infiltrated ceramic, and zirconia ceramic materials and dual-cure cement.

Methods: Fifty 2 mm-thick specimens were prepared from Vita Enamic, Cerasmart, and Katana Zirconia UTML. The specimens were embedded in acrylic blocks. To standardize the surfaces, 600 grit silicon carbide abrasives were applied underwater for 60 seconds. Then, each section underwent grit-blasting using Al₂O₃ with a particle size of 50 µm at 10 mm and a pressure of 2 bar for 10 seconds. Each prepared sample from the experimental groups received the appropriate primer (Z-PRIME Plus, G-Multi Primer, Alloy Primer, Clearfil Primer Plus) according to the manufacturers' instructions. Subsequently, the prepared CAD-CAM specimens underwent cementation using Duo-Link Universal Adhesive Resin Cement with a cylinder mold of 2.6 mm diameter and 3 mm height. The cement was light-cured for 20 seconds from both sides. The specimens obtained were stored in distilled water at 37°C for 24 hours. The shear bond strength test of the specimens was performed using a Bisco Shear Bond Tester device. The data were statistically analyzed using ANOVA and the Kruskal-Wallis test (P< 0.05).

Results: The highest bond strength was observed in Z-Prime Plus applied specimens, regardless of material differences (Cerasmart 11.60±4.61; Vita Enamic 12.93±3.86; Katana Zirconia 13.85±4.00). The lowest bond strength, showing differences according to materials (P< 0.05), was found for Clearfil Ceramic Primer Plus-Cerasmart (7.88±3.90), Alloy Primer-Vita Enamic (7.90±2.14), and G Multi Primer-Katana Zirconia UTML (4.98±3.67).

Clinical significance: Failure of the restoration usually occurs at the weakest point in this three-element structure, thus correct primer selection according to material type is important. Additionally, for all CAD-CAM materials used in the study, Z-Prime Plus showed significantly greater adhesion strength than other systems so it may be more appropriate for use in clinics.