Effects of cold atmospheric plasma treatment on resin bonding to hightranslucency zirconia ceramics

This study aims to evaluate the effects of cold atmospheric plasma (CAP) treatment on the bonding of resin cement to high-translucency zirconia. Zirconia specimens were subjected to different treatments: no treatment (ZrT), 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing primer (ZrT-M), alumina particle air-abrasion with/without MDP-containing primer (ZrT-AM/ZrT-A), CAP with/without MDP-containing primer (ZrT-PM/ZrT-P). The surface topography, wettability, and chemical composition were evaluated. The shear bond strength (SBS) was tested before and after thermocycling. CAP did not alter the morphology, increased the wettability, and decreased the carbon/oxygen ratio of zirconia surface. The SBSs of ZrT-PM and ZrT-P were significantly higher than the other groups. After thermocycling, ZrT-A, ZrT-M, ZrT-AM, and ZrT-P showed comparable SBSs, all of which were lower than ZrT-PM. It was concluded that CAP improved the bonding performance of high-translucency zirconia without damaging its surface. The combination of CAP with MDP further enhanced the bond strength and may enable durable bonding.