Efficacy of Various Surface Treatments on the Bonding Performance of Saliva-contaminated Lithium-Disilicate Ceramics.

To investigate the efficacy of different ceramic surface cleaning methods after saliva contamination on the resin bond strength to lithium disilicate ceramics. 300 e.max CAD blocks (Ivoclar Vivadent) were polished with 600-grit silicon carbide paper and divided into five groups with or without human saliva contamination and according to the surface treatment performed (n = 10); control: no pretreatment; MP: Monobond Plus; PA+MP: 37% phosphoric acid (PA) followed by MP; HF+MP: 5% hydrofluoric acid (HF) followed by MP; MEP: Monobond Etch & Prime. The specimens were bonded with one of three resin cements: Variolink Esthetic DC (VE), Multilink Automix (MA) and Speed CEM (SC). After 24-h water storage, tensile bond strength (TBS) was measured. The ceramic surfaces after pretreatment were analyzed using x-ray photoelectron spectroscopy (XPS). XPS analysis showed similar elemental distributions between saliva contamination vs no saliva in PA, HF, and MEP. The TBSs were significantly influenced by surface treatments (p < 0.05). HF+MP and MEP showed statistically non-significantly different bond strengths to saliva-contaminated HF+MP and MEP, but were different from MP and saliva-contaminated MP. The TBSs after 24 h were significantly higher in HF+MP and MEP groups with VE. HF+MP and MEP did not show statistically significant differences among any groups with or without saliva contamination. Surface treatments with PA or HF followed by silane or by MEP alone were effective in removing saliva contamination and enhancing the resin bond strength.