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Adhesive Cementation of Lithium Disilicate Versus Zirconia Materials: Study of 2 Case Reports
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1  Department of Fixed Prosthodontics, Research Laboratory of Occlusodontics and Ceramic Prostheses, Faculty of Dental Medicine, University of Monastir, Monastir, 5000, Tunisia
Academic Editor: Marco Cicciù

Abstract:

Introduction:
Bonding is considered the gold standard for the luting of all-ceramic crowns, as it provides strong micromechanical and chemical adhesion between the tooth and the restoration. This approach enhances retention, improves marginal adaptation, reduces microleakage, and supports optimal esthetics. However, bonding protocols must be tailored to the ceramic material used. Glass-ceramics, such as lithium disilicate, can be etched with hydrofluoric acid and silanized, achieving reliable bond strength. In contrast, zirconia requires alternative protocols, including the APC concept (air abrasion, phosphate monomer-containing primer, and composite resin cement), to optimize adhesion.

Methods:
Two clinical cases treated at the fixed prosthetic department of the dental clinic of Monastir, Tunisia, were selected for comparison. In the first case, a maxillary anterior tooth was restored with a lithium disilicate glass-ceramic crown (E-max) using conventional adhesive bonding with hydrofluoric acid etching and silane application, followed by resin cementation. In the second case, a zirconia anterior crown was placed following the APC concept.

Results:
Both treatment protocols demonstrated excellent clinical outcomes, including precise marginal fit, stable retention, and high esthetic integration. Postoperative follow-up revealed healthy periodontal tissues and patient satisfaction with the final appearance.

Conclusions:
Material-specific adhesive protocols are crucial for the long-term success of all-ceramic restorations. Hydrofluoric acid etching and silanization remain the gold standard for glass-ceramics, while the APC concept provides a reliable strategy for zirconia bonding. Understanding and applying these protocols enhances the functional performance and esthetic longevity of anterior ceramic crowns.

Keywords: Adhesive cementation, Lithium disilicate, Zirconia, APC concept, Anterior restoration.
Comments on this paper
Raymond Gonzalez
This study compares two clinical cases involving the bonding of all-ceramic crowns to anterior teeth using different adhesive protocols. A lithium disilicate glass-ceramic crown was bonded using hydrofluoric acid etching and silane application, while a zirconia crown was bonded using the APC concept (air abrasion, phosphate monomer primer, and composite resin cement).

Raymond Gonzalez
Both treatment methods resulted in excellent clinical outcomes with proper fit, retention, esthetics, and patient satisfaction. The study highlights the importance of tailored adhesive protocols for different materials—hydrofluoric acid etching for glass-ceramics and the APC concept for zirconia—for optimal long-term success.



 
 
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