UNIVERSAL

ADHESIVES
Pawee Petapa 640931013
Ratanatip Rattanapitak 640931031
Supanut Chaimahawan 640931032
Napat Supasiripenpong 640931038
Sookchai Manoean 65080301

Advisor : Clin.Prof.Dr.Sumana Jittidecharaks

 The Next
Evolution in
Adhesive Dentistr
y ? 
Gary Alex, DMD 2015
 OUTLINE
01 02 03
Is It Time To
Development of Switch to a
adhesive What is a Universal
“Universal” Adhesive?
Adhesive ?
 Development of dental
adhesives1995 1982
1st treating the enamel 1st  describe of “hybrid layer”
with phosphoric acid 

01 02 03 04

1970-1980s Trend in recent year

Enhance bonding Make them universal
properties to Dentin

3
 1955
• Dr.Michael Buonocore : Phosphoric
acid etching for Micromechanical
attachment
• Good in enamel
• More problem in dentin

Alex, 2015

4
 1970-1980s
• Enhance bonding properties to
Dentin 
• “1st & 2nd  Generation”
• No smear layer removal – pulp
protection reason
• 3rd Generation – Smear layer
removal with etchant

Courtesy of Min Han et al, 2017

Alex, 2015

5
 1982
● Nakabayashi “Hybrid layer” : Network of
collagens + Resin polymer
● Classification of Adhesive
● Total-etch
○ 3 step (4th generation)
○ 2 step (5th generation)
● Self-etch
○ 2 step (6th generation)
○ 1 step (7th generation) Courtesy of Paula Baldion, 2016
● Tends to simplify over generation

Alex, 2015

6
 •
Trend in recent year
Not just the simplification but making
them “Universal”

Alex, 2015

7
 What is a
2
“Universal”
9

Adhesive
Decisionsindentistry.com
 Definition

- No “official” definition
Universal Adhesive have been described by some manufacturers 

- Should not be confused with 7th Generation

Adhesive (All in One)
Should be broader for application than 7 th Gen System.

Alex, 2015

9 Equadent.eu.
 Ideal Characteristics
Ideally a single bottle, no mix, can be used in total-
etch, self-etch or selective-etch mode 

Used for placement of both direct and indirect

restoration and compatible with self-cure, light-cure
and dual-cure resin base cement 

Bond to dentin, enamel, zirconia, Noble, non-

precious metal, composite, silica-based ceramics 

Alex, 2015

10 Equadent.eu.
It’s all about
the CHEMIST
RY
 Universal Adhesive
• Hydrophilic same tame as
Hydrophobic
• “Thin” Film thickness
• Acidic enough to be effective
but not too much
• Adequate water

Alex, 2015

12 Equadent.eu.
 Universal Adhesive
• Universal Adhesive needs hydrophilic monomer
in order to bonding with wet tissue
• Somehow, Water sorption can occur with too
much hydrophilic monomer —> Hydrolysis
• Ideal bonding agent to dentin
• Hydrophilic at first
• Become Hydrophobic when polymerized

Alex, 2015

13 Equadent.eu.
 10-MDP
• Most popular functional monomer
used in Universal Adhesive
• Phosphate ester structure
• Hydrophobic methacrylate group :
bond with methacrylate resin cement
• Hydrophilic polar (phosphate group):
Bond with metal, Zirconia, Tooth
tissue/non-soluble Ca salt

Alex, 2015

14
 HEMA
PROS
• Low molecular weight hydrophilic
monomer
• Excellent adhesion promoting monomer
• HEMA helps minimizing phase
separation

CONS
• Water absorbing —> Discoloration —>
Hydrolysis of adhesive interface

Alex, 2015

15
 The PH Puzzle
: with tooth structure

• Mild and extra mild pH

• Effectively bond to dentine
• May not be effective for enamel bonding

• “selective-etching”

Alex, 2015

16
 The PH Puzzle
: with resin
cement/composite
• Self/Dual-cured resin cement / Resin composite may be
affected by too much acidity in bonding ; deactivation of
aromatic tertiary amine

• Addition of separate activator

Alex, 2015

17
 Will Universal
Adhesive replace
dedicated
Bonding to silica based
ceramic 
primers?  Some manufacturers “Add” some “not to add”
silane in to adhesive formulations
silane interaction is inhibited when combined
with other monomer

Bonding to Zotiondental.com

zirconia
Gpsdental.com
Some Universal Adhesive decreased significantly after
thermocycling 6 months in water Alex, 2015
1
Is It Time To Switch to a
Universal Adhesive ? 
Yes No
 Do you used any of the new Universal
Adhesive?

August 2014
“Key opinion What is your ‘go-to’ adhesive, the one you
use, or most recommended ?

leader”
symposium Do you still feel dedicated metal, zirconia,
Chicago, IL. Held by BISCO Inc. porcelain primers should be used?

Alex, 2015
20
 Do you used any of the new Universal
Adhesive? 30 of 32 participants

August 2014
Has been Used 
Universal Adhesive

“Key opinion What is your ‘go-to’ adhesive, the one you

use, or most recommended ? 19 of 32 participants

leader”
Choose Universal Adhesive
9 participants choose 4th or 5th Gen (Total-
etch)
4 participants choose 6th Gen (Self-Etch)

symposium Do you still feel dedicated metal, zirconia,

Chicago, IL. Held by BISCO Inc. porcelain primers should be used?
29 of 32 participants
Said they would still
use a dedicated primer
Alex, Alex,
2015 2015
2
 Certain points to keep in mind 
1. Make sure to evaporate the solvent
2. Event good chemistry will not overcome poor
clinical technique 
3. Check the expiration date
4. Be sure to read the directions  
Alex, 2015
22
UNIVERSAL
ADHESIVE
in MULTISU
BSTRATE
CONTEN
Ts
1 2 3 4 5
Ena Denti Zirco Base Glass-
Matrix
mel n nia Metal Ceramic
 Enamel

Enamel
Highly predictable in most adhesive restorative procedures. 
Bond strength is highly stable because of the nature of the enamel 
Bedran-Russo et al., 2017

Lab studies show E & R give better long-term bond

 ​
•  Application suggestions​
      .Active and prolong application​
      .Double application​
Nagarkar et al., 2019

25
 Enamel

Fluorotic Enamel

Efficiency of the bond

1. More acid-resistant (presence of fluorapatite)
2. External hypermineralized layer that is associated with a
hypomineralized sub-surface,  which prevents adequate wetting
of the enamel surface due to the low energy of the surface

Gungor et al., 2009

 Application suggestions

1. Grinding fluorotic enamel will remove superficial of the enamel layer 

    ↓
exposes a sub-surface layer that is more reactive to bonding procedures
    ↓
better bond strength

* highly recommended for moderate or severe fluorosis Erhardt  et al., 2008

2. Phosphoric acid : 30 sec Siqueira et al., 2019

26 3. EDTA : 30 sec, active application Siqueira et al., 2022

 Dentin

Dentin
Variations in the biochemistry, morphology, and
mechanical properties 

The dentin is highly hydrophilic, High Organic content

Bedran-Russo et al., 2017
​
Suggested applications 
• Applying MMPs inhibitors improves long-term
stability 
• Preconditioning with EDTA improves bond on
sclerotic dentin 
• Prolonged air-blowing  (15-30s) after adhesive
application

​Extended solvent evaporation time (15 s)

to ensure removal of residual water from the interface
• preventing hydrolytical degradation of the hybrid layer 
• preserving physical properties of the resin monomers upon polymerization

Results in higher dentin bond strengths and less nanoleakage

27 Nagarkar et al., 2019
 Dentin
The effect of Universal Adhesives on
dentine collagen 
Etchant VS Chelating agent VS Universal Adhesives in the self-etching
mode.
Before EDTA (pH : 6.8- Adhese Universal (pH : 2.5-
 Phosphoric acid (pH : 0.2)
7.4) 3)

Clearfil Universal Bond
Quick  G-Premio Bond (pH : 1.5) Prelude One (pH : 2.4) Scotchbond Universal 
(pH : 2.3) (pH : 2.7)
Universal Adhesive in pH 1.5-3 be compatible treatments more than phosphoric
28
acid Anastasiadis et al., 2021
 Dentin

Do we need to
leave dentin moist 
with universal adhesives?
 
Moist
denti
n Etched
dry
29 dentin
 Dentin

Do we need to
leave dentin moist 
with universal adhesives?
 
Dentin is intrinsically humid.

Dental adhesives contain hydrophilic monomers to enhance

the wettability to dentin.

30
 Dentin

Do we need to
leave dentin moist 
with universal adhesives?
 
Moist
denti
ideal substrate for E&R adhesives
to prevent the collapse of dentin collagen fibrils 

n Etched
dry
result in low bond strengths and
incomplete saturation of the hybrid layer

31 dentin Perdigao et al., 2001

 Dentin

Dry dentin

• Poor in vitro results

• But clinical studies have failed to demonstrate the need for leaving dentin moist
prior to applying E&R adhesives. 

5-year clinical performance of SBU in E&R mode applied on dry dentin did not
result in worse retention than when the adhesive was applied on moist dentin.

de Paris Matos et al., 2020

32
 Dentin

 successful clinical behavior of SBU on dry dentin :

          result from rubbing the adhesive in for 20 s

vigorous application of the adhesive 

↓
 more complete penetration of the adhesive solution into the
etched dentin collagen network
Zander-Grande et al., 2011
Thanatvarakorn et al., 2016

Active application of UA is also recommended on enamel,

especially in SE mode.

Loguercio et al., 2015

33
 Enamel and Dentin

Performance of
restoration in NCCL
• Restoration contains • Good access for
• Cervical lesions do
both enamel and operative procedure
not provide any
dentin margins and direct
mechanical retention
(sclerotic dentin) visualization

• Mechanical properties
• Reducing operator • Lesions are widely of the composite resin
are less important to the
variability available outcome than actual
performance of the
adhesive

34 Carvalho et al., 2012 

 Enamel and Dentin

Clinical studies with

UA
Scotchbond Universal Adhesive (SBU, 3M Oral Care, St. Paul, MN) 
                         : current gold standard for Universal Adhesives
de Paris Matos et al., 2020
Atalay et al., 2020

 E&R mode : 93% 

       independent of the degree of dentin moisture (dry or moist)

5-year retention rate in NCCLs

 de Paris Matos et al., 2020
SE mode : 81.4%
       marginal adaptation and marginal discoloration were significantly worse

35
 Enamel and Dentin

Clinical studies with

UA enamel etching 
E&R and selective
provided better clinical outcomes at 2 years with 
            All-Bond Universal (Bisco, Inc., Schaumburg, IL) 
            Gluma Universal (Kulzer North America, South Bend, IN)
 Oz et al., 2019

E&R strategy showed less marginal discoloration and better marginal adaptation than the SE approach.

Adhese Universal (ADU, Ivoclar Vivadent, Amherst, NY)

resulted in very good in vitro and clinical results after up to 3 years.

Fabiao et al., 2020

Rouse et al., 2020
36
 Enamel and Dentin

Clinical studies with

UA

Xeno Select / Prime & Bond One (Dentsply Sirona, Konstanz, Germany) 

were not acceptable as the overall retention rate in NCCLs was 
only 88% at 6 months. Lopes et al., 2016

This adhesive is no longer available.

37
 Enamel and Dentin

Products Clinical outcome

5-year retention rate in NCCLs

• E&R mode : 93%  (independent of the degree of
Scotchbond 
3M Oral Care, St. Paul, MN dentin moisture)
Universal Adhesive
• SE mode : 81.4% (marginal adaptation and
marginal discoloration were significantly worse)

All-Bond Universal Bisco, Inc., Schaumburg, IL

E&R and selective enamel etching mode
provided better clinical outcomes at 2 years 
Kulzer North America, South
Gluma Universal Bend, IN

Very good in vitro and clinical results after up to 3

Adhese Universal  Ivoclar Vivadent, Amherst, NY
years
Xeno Select Dentsply Sirona, Konstanz, Overall retention in NCCLs was only 88% at 6
 / Prime & Bond One  Germany months

38
 Enamel and Dentin

dentin interfaces formed with UA are fairly stable after artificial aging 
when dentin is not etched with phosphoric acid
Nagarkar et al., 2019
Sezinando et al., 2017

clinical behavior of UA depends on  enamel etching with phosphoric acid

Oz et al., 2019
Cuevas-Suárez et al., 2019

Selective enamel etching  → micro-mechanical retention and marginal sealing of etched enamel
+ potential chemical bonding between  functional monomer MDP and calcium in dentin HAp

39
Bonding to
Restorative
Material
10-MDP
 10-MDP
Zirconi
a Metal
A durable bond was MDP can adhere to
achieved by this phosphate zirconia via ionic and MDP monomer is a
monomer hydrogen bonding. standard functional
monomer for metal primers
Kern & Wegner, 1998
used with base-metal alloys
Nagaoka et al., 2017

Behroozibakhsh et al., 2018

42
 Zirconia
 Zirconia

The combination of grit blasting, and

chemical pre-treatments increased
the bond strength between zirconia and
resin-based cements 

Thammajaruk et al., 2018

44
 Zirconia

MDP and silane-based MDP-Containing

ethanol primers
Monobond UAs
Scotchbond Univers
Plus  al Adhesive 
(Ivoclar Vivadent)  (SBU, 3M Oral Care, St. Paul, MN) 

vs.
Clearfil Ceramic Clearfil Universal
Primer  Bond
(Kuraray Noritake Dental, Inc.) (Kuraray Noritake Dental, Inc.)

GC Ceramic Primer
II  All-Bond Universal
(GC America Inc., Alsip, IL)  (Bisco, Inc., Schaumburg, IL)

45
 Zirconia

• MDP-containing Universal Adhesives

MDP-Based • MDP and silane-based ethanol solutions
Are both recommended as
primers zirconia primers
& Perdigao et al., 2020

MDP-
Containing
46 UAs
 Zirconia

MDP-containing adhesive improved immediate bond

strength of Y-TZP surface to composite resin
MDP-Based substrate.

primers vs.
MDP- However, microtensile bond strength results for all
groups did not remain stable over 6 months.
Containing de Souza et al., 2014

UAs
47
 Zirconia

MDP-containing adhesive presented higher bond

strengths than MDP-based primers, but MDP-based

MDP-Based primers presented better bond durability.

Yang et al., 2018

primers vs. MDP-only containing primer is the only treatment

MDP- capable of promoting a stable bond to Y-TZP.

Containing Lima et al., 2019

UAs
48
 Zirconia

MDP-containing Universal
Adhesives still requires prior
abrasive surface treatment

Amaral et al., 2014

49 Alves et al., 2016
 Base metal
 Base Metal

MDP-Based primers & MDP-

Containing UAs

Bond strength in the SBU group was not significantly different from CN and ZP groups, which
showed that the MDP in SBU was chemically as effective as those two metal
primers.
51 Charattrakoon et al., 2019
 Silane
coupling
agent
 Bifunctional silane
molecule
forms a siloxane network and copolymerizes
with methacrylate groups of the dental
adhesive or the resin cement

r
M PS o
γMPTS

53 Perdigao et al., 2020

 MPS

Organic functional group:

Methacrylate

Hydrolyzable groups: three
alkoxy groups

54 Martinlinna et al., 2004

55 Martinlinna et al., 2018
 Glass-matrix
ceramics 
 Glass-Matrix Ceramic

Silane Primer
Need to be activated (hydrolyzed), then condensed
 adjusted by acitic acid

Dental commercial products are usually be pre-

hydrolyzed

MPS is diluted in water-ethanol solution which pH ≈ 4-5

Martinlinna et al., 2004
Kim et al., 2021

GC Ceramic Primer
Clearfil Ceramic Primer  Monobond Plus II 
(Kuraray Noritake Dental, Inc.) (Ivoclar Vivadent)  (GC America Inc., Alsip, IL) 
57
 Glass-Matrix Ceramic

Universal Adhesive
containing silane
Clearfil (Kuraray Noritake Dental, Inc.) 

Universal
Scotchbond Bond
(SBU, 3M Oral Care, St. Paul,

UniversalMN)

Adhesive Univers (Tokuyama Dental America,

al Bond Inc., Encinitas, CA)

58
 Glass-Matrix Ceramic

Effect of silanization depends on:

Nature of the solvent

Silane functional group

pH
Silane Concentration
Hydrolysis time

Temperature

Blending with cross-linking

Martinlinna et al., 2018
59
 Glass-Matrix Ceramic

Bis-GMA monomer reduces

contact angle of the solution

Silanols are more stable &

reactive when not combined
with resin monomers
Silanes become deactivated in
acidic solutions

60 Nagarkar et al., 2019

 Glass-Matrix Ceramic

Silane primer vs UA
containing silane 
HF improved the bonding strength between lithium
disilicate and resin

The bonding strength was improved in all the

experimental groups that were treated with silane
separately

Silane-containing Universal Adhesives were not

more effective than the non-silane-containing
universal adhesives

61 Kim et al., 2021


Other studies
01 02
The ability of universal
adhesives to achieve an
adequate and durable bond Hydrofluoric acid+silane-
to glass-based ceramics and containing universal
appears to be limited. adhesive was not as
effective as the hydrofluoric
acid+glass-ceramic primer
in promoting bond strength
Cuevas-Suárez et al., 2020 to glass-ceramic.
Lima et al., 2022
62
Glass-Matrix Ceramic
03
In general, the studies
showed better results for
ceramic etching with
hydrofluoric acid and
application of silane
separately to the universal
adhesive.
Melo et al., 2019
 Glass-Matrix Ceramic

Recent developments

Scotchbond Universal Plus

Application of a separate Adhesive (3M Oral Care),
silane solution is includes two silane molecules,
recommended. improved bonding
performance.

63 Perdigao et al., 2020

 Glass-Matrix Ceramic

1. With silane application the results from best to worst are

ADH+XTE>SBU>control
2. Without silane application the results from best to worst are
control>ADH+XTE>SBU
3. The best result came from the group using a combination of HF, silane and
ADH+XTE
4. It is interesting to that using HF with ADH+XTE (without silane application) had
similar results to the groups of HF, silane and SBU or HF with control
vs
Yao et al., 2021
64
 Glass-Matrix Ceramic

γMPTES (γMPTS analogue) having a polymerizable vinyl

group

APTES can chemically react with hydroxyl groups at the

ceramic surface through its silanol

65 Yao et al., 2021

Conclusion
 Clinical relevance of
o
UA
For enamel, recommended to use universal adhesive in etch & rinse mode and active application 
• Fluorotic enamel is recommended to be etched by phosphoric acid longer
o For dentin, recommended to use universal adhesive in self-etch mode , which in mild acid
• Applying MMPs inhibitors improves long-term stability
• Preconditioning with EDTA improves bond on sclerotic dentin 
• Prolonged air-blowing  (> 15 s) after adhesive application

o Active application of Universal Adhesive is recommended.

o E&R mode showed less marginal discoloration and better marginal adaptation than the SE
approach.
67
 Clinical relevance of
o
UA
Zirconia : Although MDP based primers are proven to be beneficial to bond
durability, MDP-containing Universal Adhesive can be used as zirconia primers but
the restorations would still require abrasive treatment. 
o Base metal : MDP-containing Universal Adhesive can be used as a metal primer
when appropriately used with suitable resin cement
o Glass-matrix ceramic : Bonding to glass-matrix ceramic need surface treatment
with HF and silane. In general, silane-containing Universal Adhesive are not
effective. For that reason, using new molecule of silane need further study

68
 ●
References
Perdigão, J., & Frankenberger, R. (2001). Effect of solvent and rewetting time on dentin adhesion. Quintessence international (Berlin, Germany : 1985), 32(5), 385–390.
● Zander-Grande, C., Ferreira, S. Q., da Costa, T. R., Loguercio, A. D., & Reis, A. (2011). Application of etch-and-rinse adhesives on dry and rewet dentin under rubbing action: a 24-month
clinical evaluation. Journal of the American Dental Association (1939), 142(7), 828–835. https://doi.org/10.14219/jada.archive.2011.0272
● Thanatvarakorn, O., Prasansuttiporn, T., Takahashi, M., Thittaweerat, S., Foxton, R. M., Ichinose, S., Tagami, J., & Nakajima, M. (2016). Effect of Scrubbing Technique with Mild Self-
etching Adhesives on Dentin Bond Strengths and Nanoleakage Expression. The journal of adhesive dentistry, 18(3), 197–204. https://doi.org/10.3290/j.jad.a36033
● Loguercio, A. D., Muñoz, M. A., Luque-Martinez, I., Hass, V., Reis, A., & Perdigão, J. (2015). Does active application of universal adhesives to enamel in self-etch mode improve their
performance?. Journal of dentistry, 43(9), 1060–1070. https://doi.org/10.1016/j.jdent.2015.04.005
● Atalay, C., Ozgunaltay, G., & Yazici, A. R. (2020). Thirty-six-month clinical evaluation of different adhesive strategies of a universal adhesive. Clinical oral investigations, 24(4), 1569–
1578. https://doi.org/10.1007/s00784-019-03052-2
● Oz, F. D., Ergin, E., & Canatan, S. (2019). Twenty-four-month clinical performance of different universal adhesives in etch-and-rinse, selective etching and self-etch application modes in
NCCL - a randomized controlled clinical trial. Journal of applied oral science : revista FOB, 27, e20180358. https://doi.org/10.1590/1678-7757-2018-0358
● Rouse, M. A., May, J. T., Platt, J. A., Cook, N. B., Capin, O. R., Adams, B. N., Kirkup, M. L., & Diefenderfer, K. E. (2020). Clinical evaluation of a universal adhesive in non-carious
cervical lesions. Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 32(7), 691–698.
https://doi.org/10.1111/jerd.12622
● Lopes, L. S., Calazans, F. S., Hidalgo, R., Buitrago, L. L., Gutierrez, F., Reis, A., Loguercio, A. D., & Barceleiro, M. O. (2016). Six-month Follow-up of Cervical Composite Restorations
Placed With a New Universal Adhesive System: A Randomized Clinical Trial. Operative dentistry, 41(5), 465–480. https://doi.org/10.2341/15-309-C
● Sezinando, A., Perdigão, J., & Ceballos, L. (2017). Long-term In Vitro Adhesion of Polyalkenoate-based Adhesives to Dentin. The journal of adhesive dentistry, 19(4), 305–316.
https://doi.org/10.3290/j.jad.a38895
● Cuevas-Suárez, C. E., da Rosa, W., Lund, R. G., da Silva, A. F., & Piva, E. (2019). Bonding Performance of Universal Adhesives: An Updated Systematic Review and Meta-Analysis. The
journal of adhesive dentistry, 21(1), 7–26. https://doi.org/10.3290/j.jad.a41975
● Bedran-Russo, A., Leme-Kraus, A. A., Vidal, C., & Teixeira, E. C. (2017). An Overview of Dental Adhesive Systems and the Dynamic Tooth-Adhesive Interface. Dental clinics of North
America, 61(4), 713–731. https://doi.org/10.1016/j.cden.2017.06.001
● Nagarkar, S., Theis-Mahon, N., & Perdigão, J. (2019). Universal dental adhesives: Current status, laboratory testing, and clinical performance. Journal of biomedical materials research.
Part B, Applied biomaterials, 107(6), 2121–2131. https://doi.org/10.1002/jbm.b.34305
● Anastasiadis, Kostas & Eliades, George & Verdelis, Konstantinos. (2021). The effect of universal adhesives on dentine collagen. Dental Materials. 37. 10.1016/j.dental.2021.05.004.
● Carvalho, R. M., Manso, A. P., Geraldeli, S., Tay, F. R., & Pashley, D. H. (2012). Durability of bonds and clinical success of adhesive restorations. Dental materials : official publication of
the Academy of Dental Materials, 28(1), 72–86. https://doi.org/10.1016/j.dental.2011.09.011 

69
 ●
References
Kern, M., & Wegner, S. M. (1998). Bonding to zirconia ceramic: adhesion methods and their durability. Dental materials : official publication of the Academy of Dental Materials, 14(1),
64–71. https://doi.org/10.1016/s0109-5641(98)00011-6
● Nagaoka, N., Yoshihara, K., Feitosa, V. P., Tamada, Y., Irie, M., Yoshida, Y., Van Meerbeek, B., & Hayakawa, S. (2017). Chemical interaction mechanism of 10-MDP with zirconia. Scientific
reports, 7, 45563. https://doi.org/10.1038/srep45563
● Thammajaruk, P., Inokoshi, M., Chong, S., & Guazzato, M. (2018). Bonding of composite cements to zirconia: A systematic review and meta-analysis of in vitro studies. Journal of the
mechanical behavior of biomedical materials, 80, 258–268. https://doi.org/10.1016/j.jmbbm.2018.02.008
● de Souza, G., Hennig, D., Aggarwal, A., & Tam, L. E. (2014). The use of MDP-based materials for bonding to zirconia. The Journal of prosthetic dentistry, 112(4), 895–902.
https://doi.org/10.1016/j.prosdent.2014.01.016
● Yang, L., Chen, B., Xie, H., Chen, Y., Chen, Y., & Chen, C. (2018). Durability of Resin Bonding to Zirconia Using Products Containing 10-Methacryloyloxydecyl Dihydrogen
Phosphate. The journal of adhesive dentistry, 20(4), 279–287. https://doi.org/10.3290/j.jad.a40989
● Lima, R., Barreto, S. C., Alfrisany, N. M., Porto, T. S., De Souza, G. M., & De Goes, M. F. (2019). Effect of silane and MDP-based primers on physico-chemical properties of zirconia and
its bond strength to resin cement. Dental materials : official publication of the Academy of Dental Materials, 35(11), 1557–1567. https://doi.org/10.1016/j.dental.2019.07.008
● Amaral, M., Belli, R., Cesar, P. F., Valandro, L. F., Petschelt, A., & Lohbauer, U. (2014). The potential of novel primers and universal adhesives to bond to zirconia. Journal of
dentistry, 42(1), 90–98. https://doi.org/10.1016/j.jdent.2013.11.004
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Thank you