•  
  •  
 

Abstract

Aim of the study: The study aimed to evaluate and compare the effectiveness of various decontamination protocols in removing contamination of saliva from the surface of zirconia and enhancing their cleanliness to enhance optimal bonding. Material and Method: Fifty-six multilayer (ML) monolithic high translucent zirconia discs (DD cubeX2 ® ML;10 mm × 2 mm) were fabricated through milling and sintered in according to the manufacturer's guidelines. The specimens were then air-abraded with 50 µm aluminium oxide particles after being polished with silicon carbide abrasive paper. The samples were randomly assigned to 5 groups (n = 10) based on the cleaning technique used after being contaminated with human saliva: water rinsing, phosphoric acid application alone, phosphoric acid mixed with ethanol, and Ivoclean treatment. Field emission scanning electron microscope (FESEM) and Energy-Dispersive X-ray Spectroscopy (EDS) were used to examine the surface morphology and elemental composition in order to evaluate the cleaning effectiveness of each treatment. Results: EDS analysis showed significant reductions in carbon (C%) and increases in zirconium (Zr%) with all cleaning methods. The HsPO4 + Ethanol treatment was the most effective, reducing carbon to (8.52±0.27%) and increasing zirconium to (66.88±1.15%). One-way ANOVA confirmed significant differences in C% and Zr% (p < 0.001), with post-hoc tests showing significant improvements in surface composition, enhancing zirconia's bonding potential. Conclusion: Phosphoric acid combined with ethanol was the most effective in decontamination of zirconia surfaces, Ivoclean also performed well, though small zirconia agglomerates were noted. Water rinsing demonstrated the lowest effective. Effective cleaning is crucial for optimal surface preparation and reliable bonding.

References

1] Mendes JM, Bentata ALG, de Sa J, Silva AS. Survival rates of anterior-region resin-bonded fixed dental prostheses: an integrative review. Eur J Dent 2021;15(4):788—97.

[2] Bapat RA, Yang HJ, Chaubal TV, Dharmadhikari S, Abdulla AM, Arora S, et al. Review on synthesis, properties and multifarious therapeutic applications of nanostructured zirconia in dentistry. RSC Adv 2022 Apr 27;12(20):12773—93. https://doi.org/10.1039/d2ra00006g.

[3] Alajrash MM, Gholam MK. Effect of different resin luting materials on the marginal fit of lithium disilicate CAD/CAM crowns (A comparative study). Indian J Forensic Med Tox icol 2020;14(2):1110—4.

[4] Ebeid K, Wille S, Salah T, Wahsh M, Zohdy M, Kern M. Evaluation of the effect of different surface treatments on the bond strength of resin cement to zirconia ceramic. J Prosthodont Res 2018;62(2):210—7.

[5] Yang B, Lange-Jansen HC, Scharnberg M, Wolfart S, Ludwig K, Adelung R, et al. Influence of saliva contamination on zirconia ceramic bonding. Dent Mater 2008;24:508—13.

[6] Sulaiman TA, Altak A, Abdulmajeed A, Rodgers B, Lawson N. Cleaning zirconia surface prior to bonding: a comparative study of different methods and solutions. J Prosthodont 2022;31(3):239—44.

[7] Hannig M, Hannig C. Does a biofilm free of bacteria exist in situ? J Parodontol Implantol Orale 2007;26:187—200.

[8] Phark JH, Duarte S Jr, Kahn H, Blatz MB, Sadan A. Influence of contamination and cleaning on bond strength to modified zirconia. Dent Mater 2009 Dec;25(12):1541—50. https://doi. org/10.1016/j.dental.2009.07.007. Epub 2009 Aug 25. PMID: 19709723.

[9] Lima RBW, Barreto SC, Alfrisany NM, Porto TS, De Souza GM, De Goes MF. Effect of silane and MDP-based primers on physico-chemical properties of zirconia and its bond strength to resin cement. Dent Mater 2019;35(11):1557—67.

[10] Genc O, Demir N, € Ozcan M. Effects of cleaning protocols on resin bond strength to saliva-contaminated monolithic Zir conia. J Adhes Dent 2025;27:93—102.

[11] Noori ST, Gholam MK. Evaluation of the marginal dis crepancy of cobalt chromium metal copings fabricated with additive and subtractive techniques. J Int Oral Health 2021; 13(4):386—92.

[12] Abdulwahab MAQ, Mohammed KG. The Influence of Different Types of Surface Treatment on the Surface Roughness and Bond Strength of Zirconia (An in Vitro Study). Frontiers in Biomedical Technologies. 2025; Vol. 0, Issue 0. Available from: https://fbt.tums.ac.ir/index.php/fbt/ article/view/1013

[13] Ali RH, Gholam MK. The influence of cement spacer thickness on retentive strength of monolithic zirconia crowns cemented with different luting agents (A com parative in-vitro study). Indian J Forensic Med Toxicol 2021; 15(1):2246—52.

[14] Feitosa SA, Patel D, Borges ALS, € Ozcan M. Effect of cleansing methods on saliva-contaminated zirconia: an XPS and shear bond strength analysis. J Adhes Dent 2014;16(5): 427—34.

[15] Ishii R, Tsujimoto A, Takamizawa T, Tsubota K, Suzuki T, Shimamura Y, et al. Influence of surface treatment of con taminated zirconia on surface free energy and resin cement bonding. Dent Mater J 2015;34(1):91—7.

[16] Lümkemann N, Sch€ onhoff LM, Buser R, Stawarczyk B. Effect of cleaning protocol on bond strength between resin composite cement and three different CAD/CAM materials. Materials 2020;13:4150.

[17] Wattanasirmkit K, Charasseangpaisarn T. Effect of different cleansing agents and adhesive resins on bond strength of contaminated zirconia. J Prosthodont Res 2019;63(3):271—6.

[18] Sukcheep C, Thammajaruk P, Guazzato M. Investigating the impact of different cleaning techniques on bond strength between resin cement and zirconia and the resulting physical and chemical surface alterations. 220 MA'AEN JOURNAL FOR MEDICAL SCIENCES 2025;4:212—220 J Prosthodont 2024. https://doi.org/10.1111/jopr.13932 [Epub ahead of print].

[19] Sadid-Zadeh R, Strazzella A, Li R, Makwoka S. Effect of zirconia etching solution on the shear bond strength between zirconia and resin cement. J Prosthet Dent 2021;126 (5):693—7.

[20] Al-Dobaei E, Al-Akhali M, Polonskyi O, Strunskus T, Wille S, Kern M. Influence of cleaning methods on resin bonding to contaminated translucent 3Y-TZP ceramic. J Adhes Dent 2020;22(4):383—91.

[21] Pornatitanakul V, Klaisiri A, Sriamporn T, Swasdison S, Thamrongananskul N. The influence of tooth primer and zirconia cleaners on the shear bond strength of saliva-con taminated zirconia bonded with self-adhesive resin cement. Appl Sci 2025;15(8):4561.

[22] Alada g A, Elter B, Ç€ omleko glu E, Kanat B, Sonugelen M, Kesercioglu A, et al. Effect of different cleaning regimens on the adhesion of resin to saliva-contaminated ceramics. J Prosthodont 2015;24:136—45.

[23] Noronha MDS, Fronza BM, Andre CB, de Castro EF, Soto- Montero J, Price RB, et al. Effect of zirconia decontamination protocols on bond strength and surface wettability. J Esthet Restor Dent. 2020 Jul;32(5):521—9. https://doi.org/https:// doi.org/10.1111/jerd.12615.

[24] Angkasith P, Burgess JO, Bottino MC, Lawson NC. Cleaning methods for zirconia following salivary contamination. J Prosthodont 2016 Jul;25(5):375—9. https://doi.org/https:// doi.org/10.1111/jopr.12441. Epub 2016 Feb 2. PMID: 26833856.

[25] € Ozcan M, Bernasconi M. Adhesion to zirconia used for dental restorations: a systematic review and meta-analysis. J Adhes Dent 2015;17:7—26.

[26] Wahsh MM, Taha DTS, Shaheen OMM. Effect of surface contamination and cleansing methods on resin bond strength and failure modes of partially stabilized zirconia: An in vitro study. Int J Appl Dent Sci. 2024;10(1):1 -15. https://doi.org/10.22271/oral.2024.v10.i1a.1888

[27] Negreiros WM, Ambrosano GMB, Giannini M. Effect of cleaning agent, primer application and their combination on the bond strength of a resin cement to two yttrium- tetragonal zirconia polycrystal zirconia ceramics. Eur J Dent. 2017 Jan-Mar;11(1):6-11. https://doi.org/10.4103/ejd.ejd_276_ 16. PMID: 28435358; PMCID: PMC5379837.

[28] Takahashi A, Takagaki T, Wada T, Uo M, Nikaido T, Tagami J. The effect of different cleaning agents on saliva contamination for bonding performance of zirconia ceram ics. Dent Mater J 2018 Sep 30;37(5):734—9. https://doi.org/ https://doi.org/10.4012/dmj.2017-376. Epub 2018 Jul 26. PMID: 30047509.

[29] Charasseangpaisarn T, Wiwatwarrapan C, Siriwat N, Khochachan P, Mangkorn P, Yenthuam P, et al. Different cleansing methods effect on bond strength of con taminated zirconia. J Dent Assoc Thai 2018;68(DFCT Suppl):28—35.

[30] Yoshida K. Influence of cleaning methods on resin bonding to saliva-cont

Download

Share

COinS