OBJECTIVES: To evaluate the bond strength of dental resin agent to zirconia ceramic after surface pre-treatment with different techniques.
METHODS: Specimens of hot isostatic pressed yttrium-oxide-partially-stabilized zirconia blocks (ZF) were fabricated (Procera Zircon, Nobel Biocare, Sweden) and compared to glossy dense zirconia blocks (ZG). Four groups of specimens with different surface treatment were prepared. Group I: ZF (n = 5) and ZG (n = 5) without any pre-treatment, Group II: ZF-s (n = 5) and ZG-s (n = 5) treated with silane solution, Group III: ZF-P (n = 10) and ZG-P (n = 10) treated with RF plasma spraying (hexamethyldisiloxane) using a reactor (Plasma Electronic, Germany), Group IV: ZF-p (n = 10) and ZG-p (n = 10) treated with micro pearls of low fusing porcelain (720 degrees C) on the surfaces. Composite cylinders (Charisma, Hereus Kulzer, Dormagen, Germany) were luted with Variolink II (Ivoclar-Vivadent, Schaan, Liechtenstein) to the test specimens. The specimens were then stored in air for 1 h before shear loading in a universal testing machine (LRX, Lloyd Instruments, Farnham, England) until failure.
RESULTS: No statistical difference was found between the untreated ZF and ZG specimens (Group I) neither between the specimens treated with silane (Group II). Plasma spraying treatment improved bond strength by a factor of three (p < 0.001). Treatment with low fusing porcelain micro pearls increased the bond strength by a factor of 10 compared to untreated surfaces (p < 0.001). No significant difference was seen between the surfaces treated ZF-p and ZG-p specimens. The thickness of the glass pearls layer did not exceed 5 microm. SEM showed dense grain borders of ZF and a flat glossy texture of ZG.
SIGNIFICANCE: Treatment of zirconia ceramic surfaces with plasma spraying or a low fusing porcelain pearl layer significantly increased the bond strength of resin cement to the ceramic surface.

Bond strength of composite luting cement to zirconia ceramic surfaces.
Derand T, Molin M, Kvam K.
Dent Mater. 2005 Dec;21(12):1158–62. Epub 2005 Jul 7.