Title Zirconia Crowns Cleaned with Zirconium Oxide Paste (Ivoclean) Prior to Cementation Have Increased Bond Strength to Resin Cement
Clinical Question In a patient receiving a zirconia crown, will treatment with a cleansing paste (Ivoclean) before the application of resin cement increase bond strength, as compared to a zirconia crown with no cleansing treatment?
Clinical Bottom Line For patients receiving zirconia crowns, cleansing paste treatment using Ivoclean before cementation improves bond strength compared to zirconia crowns cleansed with a water rinse and no cleansing paste, or phosphoric acid and no cleansing paste.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
25136900Feitosa/2015180 specimens divided into three groups: water rinse; 37% phosphoric acid; cleansing pasteLaboratory study
Key resultsThis laboratory study demonstrated higher shear bond strength in 180 crowns that were immersed in saliva in comparison to the control. After 24 hours, the use of cleansing paste resulted in a 21.5 MPa bond strength (95% CI, 5.2 to 8.3 MPa); after 150 days, 6.5 MPa (95% CI, 18.9 to 24.4 MPa) bond strength. The cleansing paste and the uncontaminated control groups had similar shear bond strength values, which were higher than both the water rinse and the phosphoric acid treatments. The results showed that zirconium-based cleansing paste was the most effective cleansing method in an environment with salivary contamination.
Evidence Search (cleansing[All Fields] AND ("methods"[MeSH Terms] OR "methods"[All Fields] OR "method"[All Fields])) AND (("zirconium oxide"[Supplementary Concept] OR "zirconium oxide"[All Fields] OR "zirconia"[All Fields]) AND bond[All Fields] AND durability[All Fields])
Comments on
The Evidence
Validity: This laboratory study assesses the shear bond strength after the use of different cleansing methods on 180 zirconia crowns. The crowns were split into three test groups and one control group. Each specimen was prepared according to their group; a resin cement buttons was applied and then subjected to specific aging conditions. The shear bond strength was determined, statistical analysis was performed on the transformed data, and failure analysis was used to compare the overall groups. This was an in vitro study that did not use human subjects. The trial had a good sample size with 100% completion rate. The trial authors certify no conflict of interest of any kind.
Applicability Zirconia crowns are an esthetic solution for a full-coverage restoration; however, zirconia requires a specific pre-cementation cleaning method as compared to other all ceramic crowns. In order to achieve a durable bond between zirconia and resin cements, specific cleansing methods are used. This study is applicable since cleansing methods were used on saliva-contaminated zirconia crowns; it simulates what would be expected in vivo.
Specialty (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Zirconia crown, Ceramics, Cleansing paste, Shear bond strength, resin cements
ID# 2859
Date of submission 04/09/2015
E-mail rodriguezkd@livemail.uthscsa.edu
Author Kristan Rodriguez
Co-author(s) e-mail
Faculty mentor Mark Littlestar, DDS
Faculty mentor e-mail littlestarm@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?)
None available
Comments and Evidence-Based Updates on the CAT
None available