Adhesion/cementation to zirconia and other non-silicate ceramics: where are we now?

Non-silicate ceramics, especially zirconia, have become a topic of great interest in the field of prosthetic and implant dentistry. A clinical problem with use of zirconia-based components is the difficulty in achieving suitable adhesion with intended synthetic substrates or natural tissues. Traditional adhesive techniques used with silica-based ceramics do not work effectively with zirconia. Currently, several technologies are being utilized clinically to address this problem, and other approaches are under investigation. Most focus on surface modification of the inert surfaces of high strength ceramics. The ability to chemically functionalize the surface of zirconia appears to be critical in achieving adhesive bonding. This review will focus on currently available approaches as well as new advanced technologies to address this problem.