Microshear Bond Strength and Finite Element Analysis

of Resin Composite Adhesion to Press-on-Metal Ceramic

for Repair Actions after Various Conditioning Methods
Burcu Kanata / M. Erhan Çömlekoùlub / Mine Dündar Çömlekoùlub / Osman Çulhac /
Mutlu Özcand / Mehmet Ali Güngöre

Purpose: This study evaluated the repair bond strength of differently surface-conditioned press-on-metal ceramic
to repair composites and determined the location of the accumulated stresses by finite element analysis.
Materials and Methods: Press-on-metal ceramic disks (IPS InLine PoM, Ivoclar Vivadent) (N = 45, diameter:
3 mm, height: 2 mm) were randomly divided into 3 groups (n = 15 per group) and conditioned with one of the
following methods: 9.5% hydrofluoric acid (HF) (Porcelain etch), tribochemical silica coating (TS) (CoJet), and an
unconditioned group acted as the control (C). Each group was divided into three subgroups depending on the repair
composite resins: a) Arabesk Top (V, a microhybrid; VOCO), b) Filtek Z250 (F, a hybrid;3M ESPE); c) Tetric Evo-
Ceram (T, a nanohybrid; Ivoclar Vivadent) (n = 5 per subgroup). Repair composites disks (diameter: 1 mm, height:
1 mm) were photopolymerized on each ceramic block. Microshear bond strength (MSB) tests were performed
(1 mm/min) and the obtained data were statistically analyzed using 2-way ANOVA and Tukey’s post-hoc test
(_ = 0.05). Failure types were analyzed under SEM. Vickers indentation hardness, Young’s modulus, and finite ele-
ment analysis (FEA) were performed complementary to MSB tests to determine stress accumulation areas.
Results: MSB results were significantly affected by the surface conditioning methods (p = 0.0001), whereas
the repair composite types did not show a significant effect (p = 0.108). The interaction terms between
the repair composite and surface conditioning method were also statistically significant (p = 0.0001).
The lowest MSB values (MPa ± SD) were obtained in the control group (V = 4 ± 0.8; F = 3.9 ± 0.7;
T = 4.1 ± 0.7) (p < 0.05). While the group treated with T composite resulted in significantly lower MSB val-
ues for the HF group (T= 4.1 ± 0.8) compared to those of other composites (V = 8.1 ± 2.6; F = 7.6 ± 2.2)
(p < 0.05), there were no significant differences when TS was used as a conditioning method (V = 5 ± 1.7;
F = 4.7 ± 1; T = 6.2 ± 0.8) (p > 0.05). The control group presented exclusively adhesive failures. Cohesive fail-
ures in composite followed by mixed failure types were more common in HF and TS conditioned groups. Elastic-
ity modulus of the composites were 22.9, 12.09, and 10.41 GPa for F, T, and V, respectively. Vickers hardness
of the composites were 223, 232, and 375 HV for V, T, and F, respectively. Von Mises stresses in the FEA
analysis for the V and T composites spread over a large area due to the low elastic modulus of the composite,
whereas the F composite material accumulated more stresses at the bonded interface.
Conclusion: Press-on-metal ceramic could best be repaired using tribochemical silica coating followed by silani-
zation, regardless of the repair composite type in combination with their corresponding adhesive resins, provid-
ing that no cohesive ceramic failure was observed.
Keywords: ceramic repair, finite element analysis, hydrofluoric acid, microshear bond strength, press-on-metal
ceramic, surface conditioning method, tribochemical silica coating.
J Adhes Dent 2014; 16: 63–70. Submitted for publication: 07.07.12; accepted for publication: 06.03.13
doi: 10.3290/j.jad.a30164

Part of this study was presented at the 16th Aegean Region Chambers of Dentists International Scientific Congress and Exhibition
(EBDO), 21-23 October, 2011, Izmir, Turkey.

a Research Assistant, Department of Prosthodontics, Faculty of Dentistry, Ege
University, Izmir, Turkey. Performed experiments, analyzed data, prepared
draft of manuscript, discussed results, commented on manuscript at all
stages.
b Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Ege
University, Izmir, Turkey. Designed study, wrote and edited manuscript, dis-
cussed results, commented on manuscript at all stages.
c Assistant Professor, Department of Material Engineering, Engineering Faculty,
Celal Bayar University, Manisa, Turkey. Conducted finite element analysis, ed-
ited manuscript, discussed results, commented on manuscript at all stages.
d Professor, University of Zurich, Dental Materials Unit, Center for Dental and
Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental
Materials Science, Zurich, Switzerland. Designed study, wrote and edited
manuscript, discussed results, commented on manuscript at all stages.
e Professor, Department of Prosthodontics, Faculty of Dentistry, Ege University,
Izmir, Turkey. Discussed results, commented on manuscript at all stages.
Correspondence: Dr. Burcu Kanat, Ege University, School of Dentistry, Depart-
ment of Prosthodontics, Bornova 35100 Izmir, Turkey. Tel: +90-232-388-0327,
Fax: +90-232-388-0325. e-mail: burcukanat@hotmail.com

Vol 16, No 1, 2014 63

Kanat et al
A lthough all-ceramic restorations are increasingly used
in fixed prosthodontics, metal-ceramic fixed dental
prostheses (FDP) are still extensively preferred due to
their mechanical properties and long-term successful
clinical performance.8,29 Many attempts have been made
over the years to improve the bond strength between the
veneering ceramic and the metal substructure, but frac-
ture or chipping of the veneering ceramic are still being
reported as a technical clinical complication.35 Press-on-
metal ceramic materials that are claimed to exhibit higher
compressive and flexural strength21 have been developed
to overcome the veneering ceramic chipping or fracture.39
The press-on metal system is a hybrid technique for cre-
ating restorations that take advantage of the strength of
metal framework and the esthetic properties of leucite-
based pressable ceramics. In this method, traditional
lost-wax metal copings are made and low fusing press-
able ceramics in a variety of colors are pressed directly
onto the opaqued metal.15,21 When using a press-on
metal system, complete contour of the restoration includ-
ing the desired centric and eccentric occlusal contacts
can be established on wax models, and due to the non-
shrinking leucite structure during firing, accurate FDPs
can be obtained.18,21
Chipping of the veneering ceramic presents a challeng-
ing clinical situation, because replacement of the FDP
may cause complications such as damage to the sup-
porting teeth, fracture of the ceramic, and discomfort to
the patient.26,30 With the developments in adhesive den-
tistry, intraoral repair of the restorations using resin-based
composites can be considered as a simple alternative
method to extraoral repair, depending on the size of the
fracture.30,32 Also, time consuming, costly replacement of
the restoration can be prevented.30 For the clinical suc-
cess of the repair procedure, the quality and durability of
the interfacial bond between the ceramic and the repair
composite plays an important role.10,26
In order to enhance the bond strength of repair compos-
ite to ceramic, different surface conditioning methods are
proposed that usually comprise mechanical and chemical
adhesion.1 One of the commonly used conditioning me-
dia for glass-based ceramics is hydrofluoric acid (HF) gel,
reported to be the most effective method for uniformly
increasing the porosities that facilitate micromechanical
interlocking of the resin composite.16,32 One of the other
frequently used alternative conditioning methods devel-
oped especially for acid-resistant ceramics is tribochemi-
cal silica coating.28,30 In this technique, alumina particles
coated with silica are air abraded onto the ceramic sur-
face under pressure, producing a silica-modified ceramic
surface that is more chemically reactive to silane.32 Silica-
coated alumina particles can penetrate up to 15 μm into
the ceramic.41 Both ceramic-repair methods – HF gel and
tribochemical silica coating – create micromechanical re-
tention, but chemical adhesion must be obtained using
silane coupling agents in order to enhance bonding.32
An understanding of the properties of veneering ceramics
and the effects of surface conditioning methods to ceramic
are important to obtain a durable bond between the ceramic
and repair composite.2,32 The objectives of the present
64
study were therefore to a) evaluate the repair bond strengths
of a press-on-metal ceramic system after conditioning either
with hydrofluoric acid or tribochemical silica coating and us-
ing different resin composites and b) determine the location
of the accumulated stresses on the fractured surfaces us-
ing finite element analysis (FEA). The tested null hypothesis
was that the microshear bond strength values obtained with
various ceramic repair methods would not be affected by
conditioning methods or different repair composites.
MATERIALS AND METHODS
The brand names, codes, manufacturers, chemical com-
positions, and batch numbers of the materials used in
this study are listed in Table 1.
Specimen Preparation
Disk-shaped specimens (diameter 3 mm, thickness
2 mm) of press-on-metal ceramic (IPS InLine PoM, Ivo-
clar Vivadent; Schaan, Liechtenstein) consisting of 50%
to 60% SiO2, 8% to 20% Al2O3, 4% to 12% Na2O, 7% to
13% K2O, other oxides, 0% to 6% fluoride, and 0% to 3%
pigments, with an elasticity modulus of 29.83 GPa were
manufactured in using the lost-wax technique according
to the manufacturer’s recommendations (N = 45). The
specimens were ultrasonically cleaned (Quantrex 90 WT,
L&R Manufacturing; Kearny, NJ, USA) in ethanol and
distilled water for 15 min. Polyethylene plates having a
hole (diameter: 1 mm) in the center were prepared to
secure the bonding area. The ceramic specimens were
then randomly divided into 3 groups (n = 15 per group)
and conditioned with one of the following methods: 9.5%
hydrofluoric acid (HF) (Porcelain etch, Ultradent; South
Jordan, UT, USA), tribochemical silica coating (TS) (CoJet,
3M ESPE; Seefeld, Germany); the unconditioned group
acted as the control (C). All conditioning and bonding pro-
cedures were carried out by the same operator.
Surface Conditioning Methods
Control group (C): The untreated specimens served as
the control group. Hydrofluoric acid etching (HF): The
specimens were conditioned with 9.5% HF gel (Ultradent
Porcelain Etch) for 60 s, washed and rinsed for 10 s,
and dried for 5 s. Tribochemical silica-coating (TS): The
specimens in this group were air abraded with 30-μm
alumina particles coated with silica (CoJet-Sand, CoJet)
using an intraoral air-abrasion device (CoJet-Prep, CoJet)
from a distance of approximately 10 mm at a pressure
of 2.5 bar for 4 s. Following air abrasion, the sand par-
ticle remnants were gently air blown.
While the TS group was coated with a-MPS silane (Si-
lane, Ultradent) and left to react for 5 min, both HF and C
groups were silanized (Silane, Ultradent) and allowed to
react for 30 s.
Two additional ceramic specimens from each group
were fabricated and evaluated with a scanning elec-
tron microscope (SEM) (JEOL JSM-5200; Tokyo, Japan)
(2000X) to observe the morphological effects of surface
conditioning methods on the press-on-metal ceramic.
The Journal of Adhesive Dentistry
 Kanat et al

Table 1 The brands, abbreviations, manufacturers, chemical compositions, and batch numbers of the materials
used in this study

Brand Manufacturer Chemical composition Batch number

IPS InLine PoM Ivoclar Vivadent; Schaan, SiO2, Al2O3, Na2O, K2O, other oxides, fluoride, pigments L34082
Liechtenstein

Hydrofluoric acid (HF) Porcelain Etch, Ultradent; Hydrofluoric acid (9.5%) 18005525512
South Jordan, UT, USA

CoJet-Sand (TS) 3M ESPE; Seefeld, Germany Aluminum trioxide particles coated with silica, particles 68421
size: 30 μm

Silane Ultradent Methacryloxypropyltrimethoxy silane, Isopropyl alcohol B577F

Solobond M VOCO; Cuxhaven, Germany bis-GMA, HEMA, phosphate methacrylates, BHT, 0902048
acetone, CQ, amine accelerator

Adper Scotchbond 3M ESPE Dimethacrylates, HEMA, polyalkenoid acid copolymer, 6PP

Multi-Purpose 5-nm silane treated colloidal silica, ethanol, water, pho-
toinitiator

Heliobond Ivoclar Vivadent bis-GMA, TEG-DMA, catalysts, stabilizers K00250

Arabesk Top (V) VOCO bis-GMA, UDMA and TEG-DMA monomers, microfillers, 750490
(microhybrid) and small particle fillers (56 vol%)

Filtek Z250 (F) 3M ESPE bis-GMA, UDMA, bis-EMA monomers, ZrO2, 8PR
(hybrid) SiO2 containing fillers (60 vol%)

Tetric EvoCeram (T) Ivoclar Vivadent Dimethacrylate monomers, barium glass, ytterbium K01495
(nanohybrid) trifluoride, mixed oxide and prepolymer fillers (55 vol%)

Bonding Procedures
The specimens in each conditioned group were ran-
domly divided into 3 subgroups (n = 15 per subgroup) to
be repaired with different resin composites, namely: Ara-
besk Top ([V], VOCO; Cuxhaven, Germany; microhybrid),
Filtek Z250 ([F], 3M ESPE; hybrid), and Tetric EvoCeram
([T], Ivoclar Vivadent; nanohybrid).
The corresponding bonding agents of the resin compos-
ites (Solobond M, VOCO; Adper Scotchbond Multi-Purpose,
3M ESPE; Heliobond, Ivoclar Vivadent) were applied using a
microbrush, air thinned, and photopolymerized (Bluephase,
Ivoclar Vivadent) for 10 s. Repair composites were applied
in one layer (diameter: 1 mm, height: 1 mm) using a poly-
ethylene mold on the conditioned ceramic surfaces and
photopolymerized for 40 s. After polymerization, the poly-
ethylene molds were gently removed and the specimens
were stored in dry conditions in the dark at 37°C.
Microshear Bond Strength Test and Failure Analysis
The microshear bond strength (MSBS) tests were per-
formed in a universal testing machine (Autograph,
Shimadzu; Kyoto, Japan) at a crosshead speed of
1 mm/min, with the shear force applied to the ceramic/
composite interface until debonding occurred. After MSB
tests, all specimens were analyzed to identify the failure
types using an optical microscope (MP 320, Carl Zeiss;
Jena, Germany) at 50X magnification.
After evaluating all specimens, the failure types were
defined as a) adhesive between the ceramic and repair
composite (ADHES); b) cohesive in the repair composite
(COHES-com); c) mixed when cohesive and adhesive fail-
ure occurred between the ceramic and repair composite
(MIX).5,24,31
Vickers Hardness and Finite Element Analysis
The instrumented indentation method (Fischer-Cripps
indentation tester; Sydney, Australia) was employed,
which provides a continuous record of the variation of
indentation load, P, as a function of the depth of pen-
etration (h), into the indented specimen through which
hardness and Young’s modulus of the materials under
applied peak load were calculated.20,42
During the loading step of the test, the response
generally follows the relation described by Kick’s Law:
P=Ch2,where C is the loading curvature. The average
contact pressure (hardness), H=Pmax/Amax (Vickers hard-
ness at maximum load) can be identified with the hard-
ness of the indented material.6 Using the initial part of
the unloading curve, both stiffness and contact depth
are determined at the maximum depth of penetration,
h = hmax. Then, the stiffness of the contact is given by
S = dP = 2 Er √Ac
dh √/
1 1 – p2 1 – po2
= +
Er E Eo
where Er = reduced elastic modulus, E = elastic modu-
lus of material, Eo = elastic modulus of indenter (dia-
mond), and p and po are the Poisson ratios of the
material and indenter (diamond).27

Vol 16, No 1, 2014 65

Kanat et al

N = 45 Polyethylene plate
control

HF
1 mm SiO
2
2 mm
POM ceramic

3 mm
n = 15 n = 15 n = 15

sil
an
Polyethylene plate Polyethylene plate Polyethylene plate

n=5 n=5 n=5

Fig 1 Schematic representation of specimen preparation for microshear bond strength test: press-on-metal ceramic disks were
prepared; polyethylene plates with 1-mm-diameter hole prepared in the middle; the specimens were divided into 3 groups (control
and two surface conditioning groups); silane was applied to all specimens; each main group was divided into 3 subgroups depend-
ing on the repair composite resin types; bonding agent specific to the composite resin systems was applied; the composites were
bonded using a polyethylene mold; ceramic block-resin composite specimens were obtained.

Table 2 Microshear bond strength (MPa) results of Statistical Analysis

three different resin composites after hydrofluoric acid Statistical analysis was performed using SPSS 11.0
etching (HF) and tribochemical silica coating (TS) software for Windows (SPSS; Chicago, IL, USA). Micro-
shear bond strength data (MPa) were submitted to two-
Repair Control (C) Hydrofluoric Tribochemical way ANOVA with the bond strength as the dependent
composite acid etching silica coating variable and surface conditioning methods (2 levels:
(HF) (TS) hydrofluoric acid etching vs tribochemical silica coat-
ing) and repair composite types (3 levels: V, F, T) as
V 4 ± 0.8a,A 8.1 ± 2.6b,B 5 ± 1.7a,A
independent variables. Multiple comparisons were made
F 3.9 ± 0.7a,A 7.6 ± 2.2b,B 4.7 ± 1a,A using Tukey’s test. In all tests, statistical significance
was set at p < 0.05.
T 4.1 ± 0.7a,A 4.1 ± 0.8a,A 6.2 ± 0.8b,A

Same superscript small letters indicate no significant difference in the

row, same superscript capital letters indicate no significant difference
in the column. See Table 1 for group abbreviations. Results of two-way
analysis of microshear bond strength of repair composite and surface
conditioning method (p < 0.05). Statistically significant difference at the
level of 5%.
After determining the elasticity modulus of materials by
Vickers indentation, a finite element analysis (FEA) model
was built (Abaqus 6.10, 3DS; Vélizy-Villacoublay, France).
Analysis was performed with 125 nodes, 1000 elements
with structured CAX4R element type, A-4 node bilinear
quadrilateral, reduced integration, and hourglass control
for determination of stress-strain and fracture stress anal-
ysis of the contact region.
RESULTS
MSB results were significantly affected by the surface
conditioning methods (p = 0.0001), whereas the re-
pair composite types did not show a significant effect
(p = 0.108) (two-way ANOVA, Tukey’s test). The interac-
tion terms between the repair composite and surface
conditioning method was also statistically significant
(p = 0.0001) (Table 2).
The lowest MSB values (MPa ± SD) were obtained
in the control group, where V = 4 ± 0.8, F = 3.9 ± 0.7,
and T = 4.1 ± 0.7 (p < 0.05, Table 2). While the group
treated with T composite resulted in significantly lower
MSB values for the HF group (T = 4.1 ± 0.8) compared to
those of other composites (V = 8.1 ± 2.6, F = 7.6 ± 2.2)
(p < 0.05), there were no significant differences when

66 The Journal of Adhesive Dentistry

 Kanat et al

TS was used as a conditioning method (V = 5 ± 1.7, DISCUSSION

F = 4.7 ± 1, T = 6.2 ± 0.8) (p > 0.05).
Elasticity moduli of the composites were 22.9, 12.01,
and 10.41 GPa for F, T, and V, respectively. Vickers in-
dentation hardness of the composites were 223, 232,
and 375 HV for T, V, and F, respectively.
The control group presented exclusively ADHES type
of failures (Table 3). COHES-com followed by MIX fail-
ure types was more common in HF and TS conditioned
groups.
Representative SEM images of the ceramic surface
morphologies depending on different conditioning meth-
ods are presented in Fig 2. In the untreated control speci-
mens, the intact glassy phase of the press-on-metal
ceramic was visible (Fig 2a). HF etching resulted in vis-
ible leucite crystals due to glass matrix dissolution (Fig
2b). TS conditioning created rough surface irregularities
(Fig 2c).
FEA analysis of ceramic-composite combinations show-
ing stress accumulation areas is presented in Fig 3. While
Von Mises stresses for V and T composites spread over a
large area due to low elastic modulus of the composite, F
composite material accumulated stresses at the bonded
interface, possibly due to the alleged rigidity of this com-
posite. FEA findings revealed similar results, verifying the
bond strength data.
In this study, the bond strengths of three different resin
composites using two surface conditioning methods
were evaluated for the purpose of repairing press-on-
metal ceramic. A significant effect of the surface condi-
tioning method was observed compared to the control
group and composite types showed different results
when the HF conditioning method was employed. Thus,
the null hypothesis was rejected.
Although the mechanism of delamination causing ce-
ramic failure is well documented, veneering ceramic chip-
ping is still reported to be the most commonly encountered
mechanical complication of FDPs.35 Chipping of the veneer-
ing ceramic represents an inconvenient clinical situation,
especially with long-span FDPs where temporary removal of
the prosthesis for laboratory repair procedures might have
a detrimental effect on tooth structure. The press-on-metal
ceramic system, introduced as an alternative to conven-
tional feldspathic porcelain, exhibits higher flexural and
compressive strengths because the ratio of uniformly dis-
tributed leucite phase is increased.12 This ceramic press
technology provides porosity-free ceramic structures, since
the metal framework and the veneer, pressure injected
onto the core, are highly adapted to each other due to the
elimination of trapped air during sintering and layering.15,22
Since no information is available about the repair of press-

Table 3 Distribution of the frequencies of failure types for experimental groups

Type of failure*
HF TS C
Composite ADHES COHES-com MIX ADHES COHES-com MIX ADHES COHES-com MIX
V 1 3 1 2 2 1 5 0 0

F 1 3 1 1 4 0 5 0 0

T 2 2 1 2 1 2 5 0 0

ADHES: Adhesive failure between the ceramic and repair composite; COHES-com: Cohesive failure in the repair composite; MIX: Cohesive failure of the
repair composite and adhesive failure between the ceramic and repair composite.

Fig 2a SEM image of the press-on- Fig 2b SEM image of the press-on- Fig 2c SEM image of the press-on-
metal ceramic surface (2000X) of an un- metal ceramic surface (2000X) of an metal ceramic surface (2000X) of a TS-
treated control specimen. Note the intact HF-etched specimen with visible leucite conditioned specimen. Note the rough
glassy phase. crystals due to glass matrix dissolution. surface irregularities.

Vol 16, No 1, 2014 67

Kanat et al
Fig 3a FEA analysis of ceramic-composite combination show-
ing stress accumulation areas. Initial situation before force
application.
Fig 3c FEA analysis of ceramic-composite combination show-
ing T composite spreading on a large area due to low elasticity
modulus of the composite resin.
on-metal ceramics, this study was undertaken to investi-
gate the most effective combination of surface condition-
ing method and repair composite. Chipping or fractures
of veneering ceramics have been attributed to a thermal
mismatch between the ceramic and the framework, lack
of calibration of the ceramic furnace, laboratory mistakes,
iatrogenic causes, brittleness of the ceramics, or trauma.29
The quality and durability of the bond between the ceramic
veneer and the repair composite also affect the longevity
and clinical success of a restoration.26 The key principles
for successful adhesion of repair composite to a ceramic
surface are preparation of a clean surface, providing a
rough surface for micromechanical retention, supplying
chemical retention with silane, adequate wetting of the
ceramic by the bonding agent, creating enough surface
energy, and wettability of the repair composite.10,18,29
The viscosity of the resin composite and adhesive resin
systems plays an important role in their wettability behav-
ior, due to variations in surface tension and contact angle
of the adhesive resin.9 In this study, resin composite and
corresponding adhesive system combinations belonging
to the same manufacturer were preferred in all groups
in order to eliminate possible chemical incompatibility
as well as wettability problems. Ceramic surfaces can
be roughened in different ways to obtain micromechani-
cal retention. HF acid roughens feldspathic ceramic, and
68
Fig 3b FEA analysis of ceramic-composite combination show-
ing Von Mises stresses for V composite.
Fig 3d F composite material accumulated stresses at the
bonded interface possibly due to the alleged rigidity of this
composite.
greater bond strength of repair composite resin could
be obtained.3 HF acid dissolves the glassy matrix of
the ceramic (SiO2) and remaining leucite or lithium dis-
ilicate, leading to microporosities. This is because the
affinity of fluoride to silicon is higher than to oxygen:
4HF+SiO2ASiF4+2H2O.32 On the other hand, air abrasion
with silica coating decreases the water contact angle,
which provides adsorption of the silane coupling agent;
this in turn facilitates the diffusion of the resin composite
into micromechanical porosities of the ceramic due to
the increased surface roughness.17 Furthermore, silane
improves the interfacial adhesion of resin composite to
ceramic by about 25%.13 The silane (3-methacryloxypropyl
trimethoxysilane) used in this study is a bifunctional mon-
omer containing a hydrolyzable methoxy group that bonds
to the SiO2 of the ceramic and involves a nonhydrolyzable
methacrylate group that copolymerizes with the organic
matrix of the composite resin. The methoxy groups (-Si-
O-CH3) of silane react with water to form three silanol
groups (-Si-OH), which eventually react with the silica layer
deposited on the ceramic surface to form a siloxane (-Si-
O-Si-O) network. Methacrylate groups of the silane mol-
ecules react with the methacrylate groups of composite
resins.32 When silane is used without any surface condi-
tioning methods, the bond strength is affected negatively
due to insufficient mechanical retention.37 However, if
The Journal of Adhesive Dentistry

the initial bond strength is high, it has been shown that
it decreases over time10 because of the formation of a
multimolecular layer of silane, which is less stable than
a monolayer of the deposited silane.19 Silanization after
HF acid etching has been recommended for successful
bonding between ceramic and resin composite vs silane
application alone.14,17 The MSB results obtained from the
control group of the present study were significantly lower
with respect to HF acid and tribochemical silica coating
groups, since only silane treatment without any surface
modification was employed.
Subsequent application of bonding agent on the si-
lanized ceramic surface produces a carbon-carbon double
bond between the nonhydrolyzable functional group of the
silane and the methacrylate groups of the matrix resin.
In this way, the bifunctional activity of silane can provide
successful adhesion between the organic bonding agent
and fractured inorganic ceramic.25 When repairing resin-
based composite restorations, the use of bonding agents
containing hydrophobic monomers has been recom-
mended and higher shear bond strength values have been
obtained for the repaired composite specimens with the
use of a bonding agent than without.40 Additionally, the
bonding agent wets the surface to be treated and alters
surface tension, allowing deep penetration into pits and
grooves on the repair surface with the same mechanism
for enamel and dentin.40 In this study, all repair compos-
ites were applied in combination with their corresponding
adhesive resins, as clinicians often use the adhesives
belonging to the composite system. Results may change
when adhesives other than the respective ones are used.
Except for the Tetric EvoCeram (T) composite in combina-
tion with HF conditioning, all other composites presented
nonsignificantly different results within each conditioning
group. This could be attributed to the fact that the mono-
mer of the nanohybrid composite Tetric EvoCeram is com-
posed of bis-GMA and UDMA and the hybrid composite
Filtek Z250 contains TEG-DMA, UDMA, and bis-EMA. The
maximum polymerization degrees of UDMA and bis-GMA
were reported to be higher than for TEG-DMA and bis-
EMA.38 However, a lower % filler content of the material
might have led to some unreacted monomers in reacting
with silanized silica particles and resulted in higher MSB
values and fewer adhesive failures. The resin composite
with low viscosity based on reduced filler content has
an effect on the adhesion due to decreased contact an-
gle. Moreover, a rougher substrate has a greater surface
area, which promotes increased surface free energy and
thereby better wettability of the resin composite.33,34 In
future studies, surface roughness created as a function
of deposition duration should be examined for correlation
with bond strength.
Material properties, flaw distribution, level of stress,
and environmental conditions are the main factors affect-
ing the fracture behavior of adhesive interfaces. Thus, the
reliability of the bonded interfaces can be evaluated by
examining failed surfaces together with fracture mechan-
ics analysis.4 The finite element stress analysis in the
present study revealed that nonuniform interfacial stress
distribution caused by MSB tests might have led to frac-
Vol 16, No 1, 2014
Kanat et al
ture initiation from flaws at the interface or in high stress
accumulation regions in the substrate.11 Bond strength
tests have been used to predict the clinical performance
of repaired ceramic restorations in the oral environment.26
Shear stresses have been reported to be more clinically
relevant due to similarity to the direction of the chewing
forces.36 It is assumed that the restorations which pos-
sess high resistance to MSB forces have high survival
rates under masticatory forces.15 However, bond strength
interpretations should also be coupled with failure type
analysis. The control group demonstrated low MSB values
and showed only adhesive failures due to weak bonding
based on the lack of surface conditioning. This also indi-
cates the indispensability of surface modification prior to
silane and/or adhesive resin application, irrespective of
the repair composite type. Cohesive failure in composite
after debonding can indicate a stable bond compared
to mixed failures.7,23 The HF and TS groups presented
mainly cohesive failure types in composites and mixed
failures. It should be noted than in none of the groups was
cohesive failure in the ceramic substrate observed. This
implies that the bond strength obtained at the ceramic/
composite interface did not exceed the cohesive strength
of the ceramic substrate tested. Thus, adhesive promot-
ers or conditioning methods for improved adhesion to this
ceramic require development.
Complementary tests measuring Vickers hardness and
elasticity modulus in addition to implementing these data
in the FEA model provided additional information on the
stress distribution at the ceramic/composite interface.
The elasticity modulus of V (10.41) and T (12.09) compos-
ites were lower than that of F (22.9). In support of these
findings, FEA analysis – showing stress distributions of
these materials at identical loading conditions – indicated
larger stress areas both in the composite and the bonded
area, compared to F, where a smaller stress area and
larger strain field were observed. Nevertheless, the inci-
dence of cohesive failures in this composite was not lower
than in the other composites, possibly indicating that its
corresponding adhesive resin provided better adhesion
which compensated for the cohesive strength of this ma-
terial. Clinical studies should report the location and sur-
vival of repairs in combination with the materials tested.
CONCLUSIONS
From this study, the following could be concluded:
y When press-on-metal ceramic is repaired using hy-
drofluoric acid followed by silanization, microhybrid
and hybrid composites in combination with their cor-
responding adhesive resins showed similar results,
but the nanohybrid composite presented significantly
lower results.
y Tribochemical silica-coated and silanized groups did
not show significant differences between any of the
repair composites tested.
y After debonding, in both conditioning groups, mainly
cohesive failures in the composite were observed, fol-
lowed by mixed failure types.
69
Kanat et al
ACKNOWLEDGMENT
The authors thank the manufacturers for generously providing the
resin cements tested.
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Clinical relevance: Considering microshear bond
strength data and failure types, press-on-metal ce-
ramic can be repaired using using hydrofluoric acid or
tribochemical silica coating followed by silanization in
combination with either microhybrid, hybrid, or nano-
hybrid composites.
The Journal of Adhesive Dentistry