Bonding to oxide ceramics—Laboratory testing versus clinical outcome

• Purpose was to present the best available clinical evidence for successful bonding of oxide ceramic restorations.
• PubMed database was searched for articles on clinical trials with resin-bonded alumina or zirconia ceramic restorations.
• Overall only 10 articles reported on clinical trials with resin-bonded oxide ceramic restorations.
• Clinically, using phosphate monomer containing luting agents after air-abrasion provided long-term durable bonding.
• For most alternative bonding methods no clinical evidence of durable bonding could be found.

ObjectivesDespite a huge number of published laboratory bonding studies on dental oxide ceramics clinical long-term studies on resin bonded oxide ceramic restorations are rare. The purpose of this review is to present the best available clinical evidence for successful bonding of dental oxide ceramic restorations.MethodsClinical trials with resin-bonded restorations that had no or only limited mechanical retention and were made from alumina or zirconia ceramic were identified using an electronic search in PubMed database. Overall 10 publications with clinical trials could be identified. Their clinical outcome was compared with that laboratory bond strength studies.ResultsClinical data provide strong evidence that air-abrasion at a moderate pressure in combination with using phosphate monomer containing primers and/or luting resins provide long-term durable bonding to glass-infiltrated alumina and zirconia ceramic under the humid and stressful oral conditions.SignificanceAs simple and clinically reliable bonding methods to oxide ceramics exist, the rationale for development of alternative bonding methods might be reconsidered especially when these methods are more time consuming or require rather complicated and/or technique sensitive procedures.