Bonding between CAD/CAM resin and resin composite cements dependent on bonding agents: three different in vitro test methods

The aim of this study was to assess the bonding properties between CAD/CAM resin and three resin composite cements combined with different bonding agents using three test methods.Four hundred twenty CAD/CAM resin substrates were fabricated and divided into three test methods (shear bond strength (SBS, n = 180), tensile bond strength (TBS, n = 180) and work of adhesion (WA, n = 60)), further into four pretreatment methods (VP connect (VP), visio.link (VL), Clearfil Ceramic Primer (CP) and no pretreatment (CG)) and three cements (RelyX ARC, Variolink II and Clearfil SA Cement). Each subgroup contained 15 specimens. SBS and TBS were measured after 24 h H2O/37 °C + 5000 thermal-cycles (5/55 °C) and failure types were assessed. WA was determined for pretreated CAD/CAM resin and non-polymerized resin composite cements. Data were analysed with Mann-Whitney U, Kruskal-Wallis H, Chi(2) and Spearman's Rho tests.Within SBS and TBS tests, CGs and groups pretreated with CP (regardless of resin composite cements), and VP pretreated with Clearfil SA Cement showed no bond. However, CG combined with RelyX ARC showed a TBS of 5.6 ± 1.3 MPa. In general, highest bond strength was observed for groups treated with VL. CG and groups pretreated using VL showed lower WA than the groups treated with VP or CP.Measured TBS values were higher than SBS ones. In general, SBS and TBS showed similar trends for the ranges of the values for the groups. WA results were not comparable with SBS/TBS results and admitted, therefore, no conclusions on it.For a clinical use of XHIP-CAD/CAM resin, the bond surface should be additionally pretreated with visio.link as bonding agent.