10-Methacryloyloxydecyl Dihydrogen Phosphate (10-MDP)-Containing Cleaner Improves Bond Strength to Contaminated Monolithic Zirconia: An In-Vitro Study

Abstract

Contamination of zirconia restorations before cementation can impair the resin–zirconia bonding durability. The objective of this study was to evaluate the effect of human saliva or blood decontamination with 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP)-containing cleaner on the resin–zirconia shear bond strength (SBS). Methods: A total of 220 zirconia specimens were prepared and air-abraded and randomly distributed into 11 groups (n = 20 per group). Except for the control group (no contamination), zirconia specimens were contaminated with either human saliva (five groups) or blood (five groups), and then subjected to one of five cleaning methods: water rinsing, 38% phosphoric acid etchant (Pulpdent Corp., Watertown, MA, USA), 70% isopropanol alcohol (Avalon Pharma, Riyadh, Saudi Arabia), Ivoclean (Ivoclar Vivadent, Schaan, Lichtenstein) and Katana Cleaner (Kuraray Noritake, Tokyo, Japan). The resin–zirconia SBS was tested at 24 h and after thermocycling (10 k cycles). Three-way ANOVA followed by Tukey’s multiple comparisons test were utilized to analyze the SBS data. Failure modes were evaluated using a scanning electron microscope. Results: Both blood and saliva significantly affected resin–zirconia SBS as contaminants. After thermocycling, there was no statistically significant difference between SBS obtained after decontamination with the Katana Cleaner (blood, 6.026 ± 2.805 MPa; saliva, 5.206 ± 2.212 MPa) or Ivoclean (blood, 7.08 ± 3.309 MPa; saliva, 6.297 ± 3.083 MPa), and the control group (no contamination, 7.479 ± 3.64 MPa). Adhesive and mixed failures were the most frequent among the tested groups. Conclusion: Both 10-MDP-containing cleaner (Katana Cleaner) and zirconium oxide-containing cleaner (Ivoclean) could eliminate the negative effect of saliva and blood contamination on resin–zirconia SBS.

Effect of Different Cleaning Methods on Shear Bond Strength of Resin Cement to Contaminated Zirconia

“…In the presented study, this method was proven to be ineffective in restoring bond strength. The same findings were reported by different authors, regardless of the contaminants used [ 11 , 13 , 22 ].…”

“…The application of ceramic primer containing 10-MDP on the cleaned zirconia surface is recommended for increasing bond strength [ 7 ]. The phosphate ester group of the 10-MDP reacts with the zirconia surface to create a bond that is more resistant to biodegradation and increases the durability of the bonding [ 22 , 26 ]. The mechanism of chemical interaction of 10-MDP and zirconia were investigated by Nagaoka et al [ 28 ].…”

“…In the current study, KATANA TM Cleaner was more effective in restoring the SBS (17.27 MPa), while ZirClean TM showed the lowest performance amongst all groups (11.59 MPa). There are limited studies available in the literature about the effectiveness of KATANA TM Cleaner or ZirClean TM as cleaning methods [ 13 , 22 , 25 , 26 ]. A single study included both ZirClean TM and KATANA TM Cleaner and found no significant difference in SBS [ 13 ].…”

“…Sahin et al [ 26 ] found that after 1 week of ageing at 37 °C, there was no statistical difference in SBS between the Ivoclean and KATANA TM Cleaner groups with two different resin cements. Awad et al [ 22 ] and Tian et al [ 11 ] found that Ivoclean and KATANA TM cleaners are effective methods for the decontamination of a zirconia surface exposed to saliva and blood. In our study, we found a statistically significant difference between Ivoclean and KATANA TM cleaners after thermocycling.…”

“…10-MDP has a hydrophobic group that bonds to contaminants and a hydrophilic group that makes it easily removed by water rinse [ 13 ]. Another promising technique is Non-Thermal Atmospheric Plasma (NTAP) [ 22 ]. Despite this method of cleaning being difficult to be applied clinically, it has shown effective results in elimination of saliva [ 23 ].…”