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Alumina sandblasting - best method for zirconia surface cleaning & to improve its resin-bond strength

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Alumina sandblasting is the best method for zirconia surface cleaning that improves the resin-bond strength of zirconia. (Photo: www.authoritydental.org)

Mon. 25 April 2022

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According to the latest systematic review and meta-analysis, alumina sandblasting is the best method for zirconia surface cleaning that improves the resin-bond strength of zirconia.

Zirconia is an excellent ceramic material with superior mechanical and esthetic properties and massive demand for cosmetic treatments. However, many clinical studies report that fractures in ceramic crowns and the adhesion failure between the zirconia ceramics and composite cement decrease the longevity of these restorations. The factors involved in these adhesive failures include contamination by saliva, silicone, and blood.

Several cleaning methods for contaminated zirconia surfaces have been explored, including cleaning with water, alcohol, phosphoric acid, plasma, aluminum oxide sandblasting, sodium hypochlorite, and cleaning solutions. Alumina sandblasting, plasma, and cleaning solutions have yielded favorable results among these methods.

The meta-analysis disclosed that alumina sandblasting is an excellent method for cleaning zirconia samples contaminated with saliva.

In addition, cleaning solutions (Ivoclean, Ivoclar Vivadent) are the best alternative because of their higher bonding performance than the contaminated zirconia samples cleaned with water.

Nevertheless, cleaning with phosphoric acid or alcohol showed the same bond strength as water. Therefore, these methods must be eluded for zirconia cleaning.

X-ray Photoelectron Spectroscopy (XPS) has shown remarkable results of alumina sandblasting as an alternative for cleaning zirconia restorations contaminated with saliva, silicone, and blood.

Furthermore, the bond strength to composite cement attained by zirconia cleaned with alumina sandblasting is similar to non-contaminated zirconia.

The cleaning solution (Ivoclean, Ivoclar Vivadent) is also a fruitful method for saliva-contaminated zirconia. Meta-analysis revealed the improved bonding performance compared to water cleaning only and showed similar bond strengths to those of the control group of non-contaminated zirconia in most studies.

Phosphoric acid and alcohol are not good options for cleaning saliva-contaminated zirconia. Studies revealed that cleaning zirconia ceramics with phosphoric acid is not adequate. The phosphate groups present in the acid form a layer on the ceramic surface, compromising bond strength. Thus, phosphoric acid and alcohol methods do not seem to be effective.

Another method investigated is an antimicrobial and deproteinizing agent, sodium hypochlorite. It has been used for cavity and root disinfection and to eliminate organic content from enamel and dentin substrates to improve the bond strength to resin-based materials. Also, its use for zirconia cleaning has shown positive results.

Other cleaning methods, 1% hydrogen peroxide and 1% sodium dodecyl sulfate, yielded low bond strengths similar to water rinsing and thus are not suggested for cleaning saliva-contaminated zirconia surfaces.

Air abrasion with alumina was the most acceptable method for cleaning zirconia surfaces contaminated with saliva before adhesive luting, upgrading better and durable bond strength of resin composite cement to zirconia.

Plasma treatment, cleaning solution, and sodium hypochlorite are also acceptable alternatives for removing salivary contaminants.

Reference: Silva NRD, Araújo GM, Vila-Nova TEL, Bezerra MGPG, Calderon PDS, Özcan M, Souza ROAE. Which Zirconia Surface-cleaning Strategy Improves Adhesion of Resin Composite Cement after Saliva Contamination? A Systematic Review and Meta-Analysis. J Adhes Dent. 2022 Apr 13;24(1):175-186. doi: 10.3290/j.jad.b2916437. PMID: 35416445.

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