Clinical Update quiz
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July 2026 Clinical Update
Does the surface conditioning of glass and hybrid ceramics with self-etching silane present a bond strength similar to that of conventional bonding? Systematic review and meta-analysis of in vitro studies
Bento VAA, de Souza Rolim PA, de Matos JRV, de Araújo Lemos CA, Pellizzer EP, Guiotti AM. (2026). Does the surface conditioning of glass and hybrid ceramics with self‐etching silane present a bond strength similar to that of conventional bonding? Systematic review and meta‐analysis of in vitro studies. Journal of Prosthodontics, 35(1), 23-36.
Compiled by Dr Francis Chan.
This article was originally published by the Journal of Prosthodontics and has been edited for brevity and clarity.
Introduction
Ceramic materials are widely used in oral rehabilitation due to their favourable mechanical, optical, and physical properties that closely resemble natural tooth structure. With the increasing use of computer-aided designs and computer aided-manufacturing technology in dentistry, a variety of ceramic materials has emerged. These can be classified as glass, polycrystalline, or hybrid ceramics. Glass ceramics are non-metallic inorganic materials that have a glassy phase in their composition, including feldspathic ceramics. Hybrid ceramics are those with a resinous matrix, also known as polymer-infiltrated ceramics.
Achieving durable adhesion between ceramic restorations and resin cement is critical for long-term clinical success, and this is heavily influenced by the surface conditioning method, adhesion system, and cementing agent. Conventional surface treatment typically involves 4-5% or 9-10% hydrofluoric acid (HF) etching followed by silane application. HF selectively dissolves the glass phase, creating a rough and porous surface that enhances micromechanical retention, increasing surface energy and facilitating silane wettability. Silane facilitates chemical bonding between the ceramic silicon oxides and the resin cement’s organic matrix. This protocol is technique-sensitive, involves multiple steps, and may induce adverse effects such as toxicity, microcracks, and fissures on the ceramic surface.
Self-etching ceramic primers have been introduced to simplify the procedure, combining acidic monomers and silane into a single-step system. Studies have shown that self-etching primers promote a less aggressive corrosion pattern than HF, however it is unclear whether they provide bond strength comparable to conventional HF etching with silane. This systematic review and meta-analysis aimed to evaluate the bond strength of glass and hybrid ceramics treated with self-etching primers compared with conventional HF-based protocols through in vitro studies, considering the application of different concentration of HF and silane with or without ageing. The null hypothesis was that self-etching primers would exhibit a similar bond strength to HF etching.
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