In spite of high mechanical strength, zirconia-based ceramics (ZrO2) has poor bond strength after conventional bond cementation procedures, requiring different surface treatment methods (STMs). This review gathered information about the STM for adhesive cementation (AC) to ZrO2 in the PubMed database, considering in vitro studies pertaining to AC for acid-resistant ceramics (ZrO2) limited to peer-reviewed papers published in English between 1965 and 2013 in dental journals. Different STMs have been proposed for ZrO2: air-abrasion (laboratory or chairside) with silica- (Si-) coated aluminum particles, the use of materials containing phosphate monomers, primer or silane application, laser irradiation, Si vapor phase deposition, and selective infiltration etching. In conclusion, STMs improve bond strength of resin luting cement to ZrO2 mainly when tested in short time. STMs must be correlated to the type of ZrO2 and the resin cement. 1. Introduction Recent developments in ceramic materials science for dental applications have led to a class of high fracture strength materials represented by alumina (Al2O3) and zirconia-based ceramics (ZrO2) that potentially enable long-term durability [1, 2]. These improved properties allowed the use of all-ceramic materials in situations of high mechanical stress, such as framework materials, crowns, bridges, core, and post systems [3]. The increase of mechanical properties by ZrO2 addition is accompanied by a reduction in the glassy matrix and Si content [3, 4] resulting in acid-resistant ceramics [5]. In the Si-based ceramics the glassy matrix is selectively removed by hydrofluoric acid (HF) etching, increasing the surface roughness (Ra) for micromechanical bonding [6–8]. This procedure is generally followed by application of a silane coupling agent, that is able to bond with the silicone dioxide (SiO2) and copolymerizes with the organic matrix of the resin cement [2]. The lack of a glassy matrix and the absence of SiO2 make acid etching plus silane application incapable of modifying and treating the zirconia surface [9–12], with no apparent improvement in bond strength [7, 8, 13]. The clinical success of ceramic restorations depends on the cementation process [7]. Adhesive cementation (AC) to ZrO2 ceramics is desirable [14] since it improves retention [2, 15], marginal adaptation, and fracture resistance [16], reduces the possibility of recurrent decay [8, 17], and enables more conservative cavity preparations [15]. Different methods to promote the adequate adhesion between the resin cement and ZrO2 have been proposed:
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