Evaluation of the bond strength of zirconia crowns to primary tooth dentin depending on the luting cement

Relevance. According to the World Health Organization, dental caries in primary teeth is the most common chronic disease in childhood, affecting 514 million children worldwide in 2022. In children aged 0–5 years, the first signs of carious lesions are typically detected in the anterior teeth, with the maxillary incisors and canines being most frequently affected. Various approaches are available for restoring primary teeth; however, in cases of extensive crown destruction, prefabricated full-coverage crowns, including zirconia crowns, are preferred. Successful treatment requires reliable bonding of crowns to primary tooth dentin using luting cements. Luting cements must meet several requirements, including adequate adhesion to hard dental tissues and indirect restorations, biocompatibility, and favorable esthetic properties. This study evaluated the bond strength of zirconia crowns to primary tooth dentin using different luting cements.

Objective. To evaluate the bond strength of zirconia crowns to primary tooth dentin using different luting cements.

Materials and methods. The bond strength of zirconia specimens to primary tooth dentin was evaluated using different luting cements. Sixty sections of primary teeth extracted for clinical indications and mechanically prepared were used as test specimens. Bond strength was assessed using shear and tensile bond strength tests.

Results. The self-adhesive resin cement Maxcem Elite demonstrated high bond strength to both zirconia and primary tooth dentin in the shear and tensile tests: 5.95 [4.33; 8.78] MPa and 13.94 [11.95; 17.88] MPa, respectively. Specimens bonded with the glass ionomer luting cement GC Fuji I also showed good results in the shear test: 5.15 [3.38; 7.70] MPa; however, tensile bond strength was low: 0.90 [0.80; 1.40] MPa. Bonding of primary tooth dentin to zirconia using the glass ionomer cement CEMION-F showed lower values in both shear and tensile tests: 1.60 [1.00; 2.45] MPa and 0.49 [0.30; 1.26] MPa, respectively.

Conclusion. The self-adhesive resin cement Maxcem Elite provided the highest bond strength between zirconia and primary tooth dentin. The glass ionomer cement Fuji I also demonstrated favorable bond strength when used to lute zirconia to primary tooth dentin. The glass ionomer cement CEMION-F showed lower bond strength.

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