Effect of different cleansing methods on the artificially aged bond strength of resin to contaminated zirconia: A systematic review

Abstract

PURPOSE: The aim of this review was to evaluate studies investigating the effect of cleansing methods on the artificially aged bond strength of resin to contaminated zirconia restorations and determine which cleansing method of contaminated zirconia for resin bonding improvement is more efficient. METHODS: An electronic search of published studies in English language was carried out until July 2021 on Scopus, Web of Science, and Medline databases. Data from in vitro studies involving the evaluation of the artificially aged bond strength of resin to contaminated zirconia following different cleansing methods were included. In vitro studies in which samples were not subjected to at least 5000 thermocycles, were excluded. RESULTS: Of 162 articles retrieved initially, 19 were eligible to be included in the systematic review, of which 5 articles were excluded. Therefore, the final sample was 14 in vitro studies. All of the included studies for air abrasion suggested this method as an effective cleansing method, but 6 of 8 included studies reported cleaning paste (Ivoclean) as an effective cleansing method. All of the included studies for NaOCl and a cleaning gel (AD Gel) reported their efficacy. Finally, the results of included studies showed the ineffectiveness of phosphoric acid, water, isopropanol, enzymatic detergents, hydrogen peroxide, and acetone. CONCLUSIONS: Air abrasion has been reported as an effective cleansing method to improve the bond strength of resin to contaminated zirconia. To improve the effectiveness of cleaning paste in resin bonding, another efficient cleansing method should be followed after this method. However, the superior cleaning potential of air abrasion rather than cleaning paste has been reported. Sodium hypochlorite and cleaning gel seem to be as effective as air abrasion, but extensive water-rinsing is necessary after the application of these cleaning agents.