BACKGROUND: Due to the stability of the physical and chemical properties of zirconia ceramics, its poor adhesiveness has seriously affected the clinical application of zirconia ceramic prosthesis. OBJECTIVE: To analyze the effect of different surface treatment methods and resin cement on the bonding strength of zirconia ceramics. METHODS: Totally 240 zirconia blocks were randomly divided into 16 groups, with 15 in each group. In group A, the treatment method was sandblasting+hydrofluoric acid+Monobond-s+Panavia F 2.0. In group B, the treatment method was sandblasting+hydrofluoric acid+Monobond-s+Perma Cem-Dual. In group C, the treatment method was sandblasting+hydrofluoric acid+new silane coupling agent+Panavia F 2.0. In group D, the treatment method was sandblasting+hydrofluoric acid+new silane coupling agent+Perma Cem-Dual. In group E, the treatment method was sandblasting+Monobond-s+Panavia F 2.0. In group F, the treatment method was sandblasting+Monobond-s+Perma Cem-Dual. In group G, the treatment method was sandblasting+Monobond-s+Panavia F 2.0 resin cement binder. In group H, the treatment method was sandblasting+new silane coupling agent+Perma Cem-Dual. In group I, the treatment method was hydrofluoric acid+Monobond-s+Panavia F 2.0. In group J, the treatment method was hydrofluoric acid+Monobond-s+Perma Cem-Dual. In group K, the treatment method was hydrofluoric acid+new silane coupling agent+Panavia F 2.0. In group L, the treatment method was hydrofluoric acid+new silane coupling agent+Perma Cem-Dual. In group M, the treatment method was Monobond-s+Panavia F 2.0. In group N, the treatment method was Monobond-s+Perma Cem-Dual. In group O, the treatment method was new silane coupling agent+Panavia F 2.0. In group P, the treatment method was new silane coupling agent+Perma Cem-Dual. Panavia F 2.0 and Perma Cem-Dual were resin cement binders. Monobond-s was commercial silane coupling agent. The bonding strength of each group was tested. RESULTS AND CONCLUSION: (1) The bonding strength of groups C, G and H was higher than that of the remaining 13 groups (P < 0.05). The bonding strength of groups A, B, C, D, E, F, G and H was higher than that of groups I, J, K, L, M, N, and P (P < 0.05). (2) The results show that the combined use of zirconia sandblasting and new silane coupling agent can significantly improve the bonding strength of ceramic-cement. Hydrofluoric acid pretreatment is ineffective. The different types of cement will have a certain effect on the bonding strength. [ABSTRACT FROM AUTHOR]