ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Zirconia With Aluminum Oxide Sandblasting Treatment Followed By MDP-containing Primer Has Greater Bond Strength Than Zirconia With No Surface Treatment
Clinical Question In an adult patient receiving a zirconia crown, will a crown that is treated with air abrasion and primer have higher bond strength compared to a crown with no surface treatment?
Clinical Bottom Line Zirconia that is treated with aluminum oxide sandblasting treatment that is followed by MDP-containing primer has a greater bond strength compared to zirconia that has not received surface treatment.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24563487Inokoshi/2014141 studies included from which 1,371 individual bond strength results usedMeta-Analysis
Key resultsThis systematic review demonstrated that there is a higher predicted bond strength with zirconia that is treated with Aluminum Oxide sand blasting and the use of an ‘MDP-containing primer’ compared to when not treated no mechanical pre-treatment. At 95% CI, it is shown that non-aged zirconia with no mechanical or chemical pretreatment bond strength is 8 +/- 4 MPa, while when treated with Aluminum Oxide sandblasting with MDP containing primer has a 95% CI bond strength of 23 +/- 3 MPa. Because there is no overlap between the 95% CI of Aluminum Oxide sandblasting with MDP containing primer and the 95% CI of no mechanical or chemical pretreatment, it is concluded that the mean bond strength of Aluminum Oxide sandblasting with MDP containing primer is significantly higher.
Evidence Search ("object attachment"[MeSH Terms] OR ("object"[All Fields] AND "attachment"[All Fields]) OR "object attachment"[All Fields] OR "bonding"[All Fields]) AND effectiveness[All Fields] AND ("zirconium oxide"[Supplementary Concept] OR "zirconium oxide"[All Fields] OR "zirconia"[All Fields])
Comments on
The Evidence
Validity: In this meta-analysis, inclusion criteria included that bond strength of at least one luting material to zirconia was measured, shear or tensile strength was applied, and for each experimental group, type of test, mean bond strength, standard deviation, number of specimens and number of possible pre-testing failures were recorded, yielding groups that were similar at the start. There are no competing interests.
Applicability This information applies to patients who are to receive a zirconia crown, as well as to practitioners that are to be placing the zirconia crown. This is of significance because it shows how important it is to treat the zirconia crown with aluminum oxide sandblasting prior to placement so that it is a strong, lasting restoration because no treatment would not give the crown adequate retention. Note that this is different from the standard PFM or porcelain crown that does not require surface treatment prior to cementation to have adequate bond strength.
Specialty/Discipline (General Dentistry) (Prosthodontics)
Keywords Zirconia crown, bond effectiveness, surface treatment
ID# 2812
Date of submission: 04/08/2015spacer
E-mail patelk10@livemail.uthscsa.edu
Author Krishna Patel
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Karen Troendle, DDS, MPH
Faculty mentor/Co-author e-mail troendle@livemail.uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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