Effect of different surface treatments on bond strength between additively manufactured definitive restorative materials

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This study investigates the effects of surface treatment and thermocycling on the bond strength between additively manufactured definitive restoration materials and self-adhesive resin cement (SARC). Materials and Methods Disc-shaped specimens were fabricated using four 3D printable definitive resin materials: two composites (Crowntec (Crowntec), CRS Composite (CRS) and two ceramic-filled composites (Alias Dental Crown (Alias), Permanent Crown (PC). Each material group (n = 24) was subdivided according to surface treatment: control (C; no treatment), 9% hydrofluoric acid–etched (HF), 50 µm Al₂O₃–sandblasted (S50), and 110 µm Al₂O₃–sandblasted (S110). SARC was applied to the center of each specimen using teflon molds (Ø3 × 3 mm). Shear bond strength (SBS) tests were performed after 24 h of storage in water at 37°C or after 10,000 thermocycles (n = 12). Data were analyzed with the Kruskal–Wallis and Mann–Whitney U tests (α = 0.05). Failure modes were examined microscopically and classified as adhesive, mixed, or cohesive. Results SBS values of Crowntec significantly decreased following HF treatment compared to other groups ( p 0.05). However, Alias demonstrated statistically significant increases in SBS compared to control after S110 treatment ( p < 0.05). Following thermocycling, SBS values were affected by both material type and the surface treatments used. All surface-treated CRS and Alias groups had significantly higher SBS values than their respective controls ( p 0.05). Failure mode analysis revealed mainly adhesive failures in the control groups, whereas the surface-treated groups had a mix of cohesive and adhesive failure patterns after thermocycling. Conclusion The application of surface treatments provided higher bond strength between the SARC and additively manufactured definitive restorative materials after 10,000 thermocycling. Additive Manufacturing Bond Strength CAD/CAM Cementation Surface Treatment Figures Figure 1 Figure 2 Figure 3 Background Computer-aided design and computer-aided manufacturing (CAD/CAM) is rapidly developing and increasing in popularity in dentistry, aiming to standardize manufacturing processes, decrease manufacturing costs, and improve treatment efficiency [ 1 ]. While subtractive manufacturing provides the advantage of increased quality of new materials, it also has significant disadvantages with respect to material waster and cost due to the use of non-recyclable materials used in the manufacturing process [ 2 , 3 ]. The rapid advancement of additive manufacturing, especially three-dimensional (3D) printing has revolutionized the field of prosthodontics due to its ability to make accurate, customized dental restorations [ 4 ]. Compared to subtractive methods, 3D printing offers the advantages of material efficiencies, complex geometries, and a digital workflow that integrates intraoral scanning with CAD/CAM design [ 5 ]. Vat Photopolymerization (VP) technology, a specific type of additive manufacturing, has gained widespread acceptance as a method for producing definitive restorative materials due to its accuracy, repeatability, and cost-effectiveness [ 6 ]. There has been continual development and diversification of ceramic and resin-based materials within CAD/CAM systems [ 7 ]. Photopolymerizable resins are among the most extensively used restorative materials currently available due primarily to their printability and ability to be reinforced with ceramic fillers to enhance mechanical performance [ 8 – 10 ]. The durability of restorations based on resin is influenced predominantly by the adhesion quality between the adhesive restorative material and the luting cement [ 11 , 12 ]. A strong bond reduces post-operative sensitivity and improves the fracture resistance of the restoration, while also preventing marginal leakage and secondary marginal caries [ 13 , 14 ]. Adhesive bonding is affected by factors such as the composition of the restorative material and the resin cement, the surface treatments, and the type of adhesion mechanism [ 15 , 16 ]. To improve bond strength, mechanical (sandblasting, bur grinding) and chemical (silane, primer, acid application) surface treatments are employed [ 7 , 11 ]. Sandblasting cleans and roughens the resin surface, exposing filler particles and thereby enhancing micromechanical retention. The exposed filler particles consequently become available for silanization [ 17 ]. Hydrofluoric acid tends to dissolve the glassy phase of the material, whereas the polymer network remains intact. The remaining polymer network creates a honeycomb structure and, therefore, a high micromechanical interlocking potential [ 18 , 19 ]. The adhesive interface is primarily subjected to both chemical and mechanical degradation induced by mastication, swallowing and bruxism [ 20 ]. Chemically, the tooth–material interface is exposed to water, salivary components, and enzymes of host and bacterial origin, leading to hydrolysis and plasticization of the resin matrix, followed by leaching and structural breakdown [ 21 ]. Thermocycling has been widely used to simulate intraoral thermal fluctuations and to assess the aging resistance of adhesive interfaces [ 22 , 23 ]. Shear bond strength (SBS) testing is commonly employed to evaluate adhesion between restorative materials and dental substrates, as the applied parallel load application approximates functional masticatory shear forces [ 24 , 25 ]. Despite its limitation of non-uniform stress distribution, it remains an accepted method for assessing adhesive performance [ 26 , 27 ]. Several studies have investigated the bond strength of 3D-printed materials after chemical or mechanical surface treatments [ 11 , 16 , 23 , 28 , 29 ]. However, only a limited number have evaluated the effects of different surface treatments on the adhesion between various 3D-printed restorative materials and resin cements [ 19 ]. There is no consensus on the optimal surface treatment for bonding additively manufactured permanent restorations. Therefore, the purpose of this study was to investigate the effects of surface treatment and thermal cycling on the bond strength of 3D-printed definitive restorative materials luted with self-adhesive resin cement (SARC). The null hypothesis was that bond strength would not be affected by material type, surface treatment, or thermocycling. Material and Methods Ethical approval was granted by the Cyprus Health and Social Sciences University Research Ethics Committee (Approval No: KSTU//2024/354). Information regarding each material evaluated is summarized in Table 1 . The sample size was calculated using statistical power analysis software G*Power (version 3.1.9.3; Heinrich Heine University Düsseldorf). 12 specimens per group afforded a power of %99 at α = .05. Table 1 Contents and manufacturer of the materials used Group Code Product-Brand Name Manufacturer Material Composition Shade/Lot Number Crowntec Crowntec Saremco, Rebstein, Switzerland Bis-EMA, 30–50% 0.7 µm barium aluminum borosilicate glass fillers, 4,4′-isopropylidiphenol, ethoxylated and 2-methylprop−2enoic acid, silanized dental glass, pyrogenic silica, catalysts, inhibitors and color pigments. E522 CRS CRS Composite CRSCAM Technology, Antalya, Turkey Methacrylated aliphatic urethane oligomer, 3,6,9-trioxaundecamethylene dimethacrylate, phenyl bis(2,4,6-trimethylbenzoyl)-phosphine oxide CBA102408 Alias Alias Dental Crown Dokuz Kimya, Aydın, Turkey 30–50% inorganic fillers (0.7 µm glass filler), UDMA, glycol methacrylate, and phosphine oxide 240591 PC Permanent Crown Formlabs, Massachusetts, USA Esterification products of 4,4′ isopropylidiphenol, ethoxylated and 2-methylprop-2enoic acid; ethoxylated bisphenol A dimethacrylate (Bis-EMA, methacrylate polymer), silanized dental glass, methyl benzoylformate, diphenyl (2,4,6 trimethylbenzoyl) phosphine oxide (TPO, photoinitiator), 30–50 wt.%—inorganic fillers (particle size 0.7 µm) 601400 G-CEM ONE™ GC Corp., Tokyo, Japan UDMA, 10-MDP, other dimethacrylate monomers, fluoroaluminosilicate glass, silicon dioxide, trimethoxysilane, 6-tert-butyl-2,4-xylenol, 2,6-di-tert-butyl-p-cresol, EDTA disodium salt dihydrate, vanadyl acetylacetonate, TPO, initiators, ascorbic acid, camphorquinone, MgO, pigments 2312061 A disc-shaped specimen (∅ 6×3 mm) was designed by using the FreeCAD 0.19 open-source software program and saved as a standard tessellation language (STL) file for manufacturing the specimens. All of the specimens were printed with 0° printing orientation. Crowntec and CRS specimens were manufactured with a DLP-based 3D printer (Asiga Max UV, Asiga, Sydney, Australia). The light source was 385nm (high power UV LED). After printing, the specimens were cleaned for 10 minutes in an unheated ultrasonic bath containing 99% isopropyl alcohol, air-dried, and post-polymerized for 10 minutes in a washing and curing machines respectively (Elegoo Mercury X Bundle ; Shenzhen Elegoo Technology Co. Ltd., Shenzhen, China), Alias specimens were manufactured with a MSLA based (Masked Stereolithography) printer (Anycubic Photon Mono X, Anycubic, Shenzhen, China) with a 405 nm LED. Specimens were cleaned for 5 minutes in an unheated ultrasonic bath containing 99% isopropyl alcohol, air-dried, and post-polymerized for 5 minutes in a polymerization unit (ShapeCure UV; RAYSHAPE, Shenzhen, China). Permanent Crown specimens were manufactured with an SLA-based (Form 3B, Formlabs, Somerville, Massachusetts, USA) printer. The light source used was a 405nm ultraviolet source and a 250mW laser, after printing, the specimens were cleaned for 3 minutes by ultrasonic cleaning with FormWash (Formlabs, Somerville, Massachusetts, USA) in a solution of 99% isopropyl alcohol prior to post polymerization in FormCure (Formlabs, Somerville, Massachusetts, USA), an ultraviolet polymerization device, for 20 minutes at 60° two times. A total of 384 specimens were embedded in aluminum molds ( \(\varnothing15\times20mm\) ) using auto-polymerizing acrylic resin (Imicryl, Turkey), ensuring the cementation surfaces remained exposed. The cementation surfaces were polished with 600-grit silicon carbide abrasive paper under continuous water irrigation, and the specimens were then ultrasonically cleaned to remove surface residues. The specimens were randomly allocated into four groups (n = 12) using a simple lottery method. Control (C): No surface treatment was applied to the cementation surface. Hydrofluoric acid (HF): A 9% hydrofluoric acid gel was applied to the cementation surface of the specimens for 1 minute, then thoroughly rinsed with water, and dried with oil-free compressed air. 50 µm Al₂O₃ (S50): Airborne-particle abrasion was performed on the cementation surface using 50 µm aluminium oxide particles at 2 bar pressure from a distance of 2 cm for 15 seconds. 110 µm Al₂O₃ (S110): Airborne-particle abrasion was performed on the cementation surface of the specimens using 110 µm aluminum oxide particles at 2 bar pressure from a distance of 2 cm for 15 seconds. The sandblasted specimens were then ultrasonically cleaned in distilled water for 5 minutes. After the surface treatments, the specimens underwent the cementation process. Teflon molds with a cement gap of Ø3x3mm were positioned on the specimen surfaces, and SARC was applied using an auto-mixing tip, followed by polymerization according to the manufacturer’s instructions. The specimens were then stored in distilled water at 37 °C for 1 day. All the specimens were prepared by a single operator (İCK). Subsequently, 12 samples from each group (192 in total) were subjected to thermocycling. Thermocycling was performed using a thermocycler (SD Mechatronik Thermocycler, SD Mechatronik; Westerham, Germany) in accordance with ISO 11405. Each cycle consisted of 25-second immersions in distilled water at 5°C and 55°C (± 1°C), with a 10-second transfer time. A total of 10,000 cycles were applied. The SBS of all specimens was tested using a universal testing machine (Lloyd LRX, Lloyd Instruments Ltd., Fareham, UK). A 1-mm crosshead was aligned with the resin cement material interface, and load was applied at 1 mm/min until failure. The failure load (N) was recorded digitally. SBS (MPa) was calculated by using the following formula: σ = P/A, where σ is SBS (MPa), P is the failure load (N), and A is the bonded area (mm²). After SBS testing, the fracture surfaces were examined under a digital microscope x50 magnification (USB Digital Microscope; Shenzhen Northvision Technologies Co Inc) to determine failure modes, which were subsequently recorded. Statistical analyses were performed using NCSS software (Number Cruncher Statistical System, 2007, Kaysville, Utah, USA). Descriptive statistics (mean, standard deviation, median, minimum, maximum) were computed, and data distribution was evaluated using the Shapiro–Wilk test. Group differences were analyzed using the Kruskal–Wallis test. Pairwise comparisons were performed with the Mann-Whitney U test. The effect of thermocycling on SBS within each group was also assessed using the Mann–Whitney U test, with the significance level set at α = 0.05. Results The median, minimum, and maximum SBS values for all materials before and after thermocycling are presented in Tables 2 and 3 . Before thermocycling, the Kruskal–Wallis test demonstrated that material type had a statistically significant effect on SBS values in the C ( p = 0.001), HF ( p = 0.034), and S110 ( p = 0.007) groups, whereas no statistically significant effect was observed in the S50 group ( p = 0.093). The Mann–Whitney U test revealed that Crowntec exhibited the highest SBS values in the C group and the lowest SBS values in the HF group ( p = 0.001). PC exhibited significantly lower SBS values in the S110 group compared with the other materials ( p = 0.001). The Kruskal–Wallis test demonstrated that surface treatments had a statistically significant effect on SBS values in Crowntec ( p = 0.001) and Alias ( p = 0.016), whereas no statistically significant effect was observed in CRS ( p = 0.333) or PC ( p = 0.152). According to the Mann–Whitney U test, HF significantly decreased SBS values in Crowntec compared with the C group, whereas sandblasting procedures (S50 and S110) had no effect on SBS values. S110 significantly increased bond strength in Alias compared with the C group, whereas the other surface treatments showed no significant effect. Table 2 Median (Med), minimum (min), and maximum (max) of shear bond strength (SBS) values for tested materials before thermocycling (MPa) SBS (MPa) according to surface treatment C HF S50 S110 Material Med (Min-Max) Med (Min-Max) Med (Min-Max) Med (Min-Max) Crowntec 14.9 Aa (9.1–21.5) 6.7 Ab (4.2–14.6) 13.9 Aa (7.5–21.3) 13.4 Aa (8.8–19.3) CRS 10.6 Ba (7.2–19.5) 11.3 Ba (3.2–18.2) 11.6 Aa (7.4–16.6) 13.7 Aa (9.9–18.5) Alias 8.5 Ba (4.3–17.7) 13.2 Bab (5.5-20.96) 12.1 Aa (7.4–13.6) 15.2 Ab (11.4–21.6) PC 8.6 Ba (5.3–13.6) 13.4 Ba (7.3–21.5) 9.9 Aa (6.8–13.3) 9.5 Ba (4.9–18.4) Crowntec: Crowntec, CRS: CRS Composite, Alias: Alias Dental Crown, PC: Permanent Crown. C: Control, HF: Hydrofluoric acid etched, S50: 50 µm Al 2 O 2 -sanblasted, S110: 110 µm Al 2 O 2 -sanblasted. Different uppercase letters within a column indicate significant differences among materials under the same surface treatment. Different lowercase letters within a row indicate significant differences among surface treatments within the same material ( p < 0.05). After thermocycling, the Kruskal–Wallis test demonstrated that material type had a statistically significant effect on SBS values in the C, HF, and S110 groups ( p = 0.001 for all), while no statistically significant effect was observed in the S50 group ( p = 0.378). The Mann–Whitney U test revealed that Alias exhibited the lowest SBS values in the C group, followed by PC, Crowntec, and CRS. PC exhibited the lowest SBS values in the HF and S110 groups ( p = 0.001), whereas no statistically significant differences in SBS values were observed among the remaining materials. The Kruskal–Wallis test demonstrated that surface treatments had a statistically significant effect on SBS values in Crowntec ( p = 0.048), CRS ( p = 0.001), Alias ( p = 0.001), and PC ( p = 0.001). According to the Mann–Whitney U test, HF, S50, and S110 surface treatments resulted in significantly higher SBS values in Crowntec, CRS, and Alias compared with the C group ( p = 0.001); however, no statistically significant differences in SBS values were detected among these surface treatments. All surface treatments were associated with increased SBS values in PC compared with the C group, with the highest SBS values observed following the S50 surface treatment ( p = 0.001). Table 3 Median (Med), minimum (min), and maximum (max) of shear bond strength (SBS) values for tested materials after thermocycling (MPa) SBS (MPa) according to surface treatment C HF S50 S110 Material Med (Min-Max) Med (Min-Max) Med (Min-Max) Med (Min-Max) Crowntec 14.7 Aa (8.1–19.6) 18.0 Ab (14.6–25.6) 18.2 Ab (10.6–26.7) 17.1 Ab (10.5–25.1) CRS 12.1 Aa (7.5–20.4) 17.8 Ab (12.4–22.3) 17.2 Ab (11.8–23.6) 18.5 Ab (10.9–26.1) Alias 6.96 Ba (4.2–13.5) 20.2 Ab (13.1–24.3) 18.6 Ab (10.4–25.9) 18.6 Ab (10.4–25.9) PC 9.3 Ca (6.1–13.6) 13.2 Bb (6.7–16.9) 17.1 Ac (10.3–20.3) 13.6 Bb (6.4–20.3) Crowntec: Crowntec, CRS: CRS Composite, Alias: Alias Dental Crown, PC: Permanent Crown. C: Control, HF: Hydrofluoric acid etched, S50: 50 µm Al 2 O 2 -sanblasted, S110: 110 µm Al 2 O 2 -sanblasted. Different uppercase letters within a column indicate significant differences among materials under the same surface treatment. Different lowercase letters within a row indicate significant differences among surface treatments within the same material ( p < 0.05). Thermocycling resulted in a significant increase in SBS values for Crowntec in the HF and S110 groups, CRS in the HF, S50, and S110 groups, Alias in the HF and S50 groups, and PC in the S50 group (Table 4 ). Table 4 Statistically significant differences between materials for each surface pretreatment depending on thermocycling Material P values C HF S50 S110 Crowntec 0.514 0.001* 0.149 0.008* CRS 0.326 0.002* 0.001* 0.023* Alias 0.094 0.003* 0.001* 0.133 PC 0.551 0.686 0.001* 0.908 Crowntec: Crowntec, CRS: CRS Composite, Alias: Alias Dental Crown, PC: Permanent Crown. C: Control, HF: Hydrofluoric acid etched, S50: 50 µm Al 2 O 2 -sanblasted, S110: 110 µm Al 2 O 2 -sanblasted. Asterisk (*): Statistically significant difference before and after thermocycling. P = 0.05 Before thermocycling, failure mode analysis showed that cohesive fractures within the restorative materials were the most frequently observed failure pattern in all experimental groups, accounting for approximately 50–80% of the failures, independent of the surface treatment applied (Fig. 1 ). Adhesive failures occurred less often, generally ranging from 10% to 40%, with comparatively higher frequencies observed in the control and hydrofluoric acid–treated groups. Mixed failure patterns were uncommon and were mainly detected in the S110 sandblasted groups, where they represented up to 15–30% of the failures. Cohesive failures within the resin cement were rare across all groups and consistently remained below 10%. After thermocycling, failure mode analysis demonstrated that cohesive fractures within the restorative materials continued to be the most prevalent failure type in all groups, accounting for approximately 45–75% of the observed failures (Fig. 2 ). Adhesive failures were more variably distributed after aging, ranging from 20% to 60%, with clearly higher frequencies noted in the control groups. Mixed failures were observed in all surface treatment groups and accounted for roughly 15–30% of the recorded failures, with a modest increase noted in the sandblasted conditions. cohesive Failures within the resin cement were uncommon and, in all groups, represented less than 10% of the total failures. The failure patterns are shown in Fig. 3 Discussion In this in vitro study, material type and surface treatment significantly influenced the SBS of SARC to 3D-printed definitive restorative materials. Accordingly, the null hypothesis regarding the effects of material type, surface treatment, and thermocycling on bond strength was rejected. Water storage is popular method for artificial aging for assessing the degradation of resin-based materials, however, thermocycling simulates oral cavities temperature changes to provide a more relevant measure of bond durability over time [ 30 , 31 ]. In the current study, 10,000 thermal cycles were applied, to half of the specimens, representing approximately one year of simulated clinical aging [ 32 ]. SBS test is a popular and standardized method for evaluating the bonding performance of dental materials after different surface treatments [ 16 , 28 , 29 ]. Since the masticatory forces in the oral cavity are predominantly in shear nature SBS test is considered a clinically relevant method [ 25 ]. Although tensile bond strength tests theoretically provide a more uniform stress distribution, their reliability may be compromised by factors such as specimen misalignment [ 33 , 34 ]. The findings of the current study demonstrated that SBS values increased after thermocycling; however, the control groups did not show any statistically significant increase. In the literature, thermocycling is commonly related with hydrolytic degradation of adhesive interfaces [ 35 , 36 ]. Previous studies have reported a reduction in SBS after thermocycling, which has been attributed to dimensional changes caused by differences in thermal expansion coefficients and water sorption of hydrophilic adhesive components [ 37 ]. The increase in SBS after thermocycling in surface-treated groups can be attributed to temperature-induced post-polymerization of the resin cements and restorative materials, particularly those containing residual unreacted methacrylate groups [ 38 ]. In addition, the used SARC contains 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and trimethoxysilane coupling agents, which may enhance interfacial bonding with restorative material. MDP can build ionic interactions with the organic components of 3D-printed resin materials and copolymerize with residual methacrylate groups, promoting a more cohesive polymer network. [ 39 ]. The long hydrophobic character of the alkylene component of MDP also contributes hydrophobicity, limiting hydrolytic degradation and advancing long-term bond durability [ 40 ]. Additionally, silane content in SARC promotes chemical coupling with inorganic fillers, improved surface wettability, and enhanced micromechanical interlocking [ 23 ]. Findings of the current study showed that both material and surface treatment significantly affected the SBS values of additively manufactured definitive restorative materials prior to thermocycling assessments in all groups except S50. This may indicate that the 50 micron sandblasting has a more neutral effect on the surfaces of different materials which yielded similar SBS values in all tested groups [ 41 ]. In the present study Crowntec HF group showed the lowest SBS values compared with the control and sandblasting groups before thermocycling. Hydrofluoric acid dissolves the glass matrix of the ceramic materials but it may not be as effective on resin based restorative materials [ 42 ]. This can be related to the high resin polymer content of the material and lower inorganic filler content. In addition, the Crowntec material contains barium glass, an inorganic component that does not react with HF as reported by Niizuma et al. [ 43 ]. Parallel to the present study, in previous articles, SBS of CAD/CAM hybrid ceramic materials were tested after sandblasting and HF etching, and results showed that HF etching was not as effective as sandblasting [ 44 , 45 ]. In the present study, after thermocycling, the SBS values of the Crowntec HF group increased. This can be explained by the effect of post polymerization induced by the increased temperature in thermocycling process which influenced the bond strength of the resin cement. Lankes et al. [ 38 ] tested the SBS after different surface treatments on the resin based material and found that thermocycling significantly improved the SBS values, similar to the results of the present study. In contrast Mao et al. [ 44 ] studied different surface treatments on machinable and printable resin based materials and found that thermocycling did not show statistically significant differences on the SBS values. In literature, various particle sizes have been investigated, however, optimal airborne-particle abrasion parameters for 3D-printed definitive restorative materials have not yet been established. The results of this study showed that the PC S110 group, demonstrated lower SBS values both before and after thermocycling when compared to the other materials with S110 surface treatment. This may be attributed to the reduction in physical properties associated with the use of larger alumina particle sizes during airborne-particle abrasion. A previous study has shown that increasing alumina particle size adversely affects physical properties of the resin based definitive restoration materials [ 46 ]. After thermocycling, the PC S50 group demonstrated a statistically significant increase in SBS. This effect may be attributed to increased surface roughness and disruption of C–C and C–H polymer chains, which enhances the micromechanical interlocking and improves the wettability and penetration of the bonding agent into the polymer matrix, in addition, free radicals generated by polymer chain breakage may further strengthen chemical bonding with resin-based adhesive cements through chain transfer reactions [ 47 ]. The results of the present study showed that, Alias S110 group exhibited significantly higher SBS values when compared to the Alias C group before and after thermocycling. This may be explained by the material’s resin matrix characteristics. A UDMA-based resin matrix has been reported to exhibit lower maximum deformation and higher elastic recovery under identical loading conditions compared with Bis-EMA-based materials [ 46 ]. As a result, this allows effective surface modification with sandblasting without substantial mechanical degradation, which may explain the favorable bonding performance observed after S110 treatment. Failure mode analysis revealed a predominance of cohesive failures within the restorative materials both before and after thermocycling, suggesting that the interfacial bond strength may exceed the intrinsic cohesive strength of the materials [ 48 ]. The higher incidence of adhesive failures observed in the C and HF-treated groups before thermocycling indicates that the surface modifications in these groups were less effective. In contrast, the increased occurrence of mixed failures in the S110 groups may reflect a more balanced distribution of stress between the adhesive interface and the restorative material. Cohesive failures within the resin cement were rare, indicating that cement integrity was not the limiting factor in bond performance. Overall, these findings are consistent with previous studies reporting that surface treatments enhance durable bonding and shift failure patterns toward cohesive modes in 3D-printed restorative materials following thermocycling [ 15 , 18 ]. The present study demonstrated that bond strength varied according to the type of restorative material, as materials respond differently to similar surface treatments due to variations in resin matrix compositions and the type and distribution of fillers. Selection of surface treatments should therefore be guided by the specific compositional and structural characteristics of the restorative materials. This approach may achieve more consistent adhesive outcomes and reduce the risk of interfacial complications such as microleakage or debonding. In this context, material-specific surface treatment protocols appear critical for ensuring the long-term clinical reliability of 3D-printed definitive restorative materials. This study has some limitations. The in vitro design and relatively small sample size cannot fully replicate the in vivo intraoral environment, where factors such as saliva and masticatory forces may influence material behavior. Only one resin cement was evaluated, which limits generalizability of the results. Other surface treatment methods. (eg. laser etching), were not included and may have produced different outcomes. Future studies should include larger sample sizes, different restorative materials, and a variety of surface treatment techniques. Moreover, long-term clinical studies are necessary to validate these findings under realistic clinical conditions Conclusio Within the limitations of this in vitro study, both material type and surface treatment significantly affected the SBS of SARC to 3D-printed definitive restorative materials. Sandblasting generally improved bond strength and maintained adhesion after thermocycling, whereas the effectiveness of hydrofluoric acid etching was material-dependent and limited in resin based materials. Thermocycling did not adversely affect bond strength in surface-treated groups and, in some conditions, resulted in increased SBS values. These findings emphasize the significance of choosing appropriate surface treatment protocols compatible with material composition to enhance bond strength of 3D-printed definitive restorative materials. Abbreviations 3D Three dimensional CAD/CAM Computer aided design and computer aided manufacturing DLP Digital light processing HF Hydrofluoric acid LED Light- emitting diode MSLA Masked stereolithography SARC Self- adhesive resin cement SBS Shear bond strength SLA Stereolithography STL Standard tessellation language UV Ultraviolet VP Vat photopolymerization Declarations Ethics approval Ethical approval was granted by the Cyprus Health and Social Sciences University Research Ethics Committee (Approval No: KSTU//2024/354). Data availability The datasets generated and/or analyzed during the current study are availablefrom the corresponding author on reasonable request. Consent for publication Not applicable Funding No funding was received for this study. Competing interests The authors declare no competing interests. Authors’ contributions İ.C.K. Investigation, Conceptualization, Methodology, Validation, Resources, Writing-Original Draft, Writing-Review& Editing. Y.A.S.A.H. 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Bond strength of conventional resin-based adhesive cement and self-adhesive resin cement to CAD-CAM restorative materials. BMC Oral Health 2025;25:296. https://doi.org/10.1186/s12903-025-05527-z. Yeolekar TS, Chowdhary NR, Mukunda KS, Kiran NK. Evaluation of Microleakage and Marginal Ridge Fracture Resistance of Primary Molars Restored with Three Restorative Materials: A Comparative in vitro Study. Int J Clin Pediatr Dent 2015;8:108–13. https://doi.org/10.5005/jp-journals-10005-1294. Kumari A, Singh N. A comparative evaluation of microleakage and dentin shear bond strength of three restorative materials. Biomater Investig Dent 2022;9:1–9. https://doi.org/10.1080/26415275.2022.2033623. Alp G, Subaşı MG, Johnston WM, Yilmaz B. Effect of different resin cements and surface treatments on the shear bond strength of ceramic-glass polymer materials. J Prosthet Dent 2018;120:454–61. https://doi.org/10.1016/j.prosdent.2017.12.016. Hammamy M, Rueda S, Pio A, Rizzante F, Lawson N. 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Assessment of Bonding Effectiveness of Adhesive Materials to Tooth Structure using Bond Strength Test Methods: A Review of Literature. Open Dent J 2018;12:664–78. https://doi.org/10.2174/1745017901814010664. al-Salehi SK, Burke FJ. Methods used in dentin bonding tests: an analysis of 50 investigations on bond strength. Quintessence Int Berl Ger 1985 1997;28:717–23. Leinfelder KF. Dentin adhesives for the twenty-first century. Dent Clin North Am 2001;45:1–6. Dederichs M, Badr Z, Viebranz S, Nietzsche S, Schulze-Späte U, Schmelzer A-S, et al. Effect of surface conditioning on the adhesive bond strength of 3D-printed resins used in permanent fixed dental prostheses. J Dent 2025;155:105621. https://doi.org/10.1016/j.jdent.2025.105621. Kim M, Lee J, Park C, Jo D, Yu B, Khalifah SA, et al. Evaluation of Shear Bond Strengths of 3D Printed Materials for Permanent Restorations with Different Surface Treatments. Polymers 2024;16:1838. https://doi.org/10.3390/polym16131838. Lüthy H, Loeffel O, Hammerle CHF. Effect of thermocycling on bond strength of luting cements to zirconia ceramic. Dent Mater 2006;22:195–200. https://doi.org/10.1016/j.dental.2005.04.016. Eliasson ST, Dahl JE. Effect of thermal cycling on temperature changes and bond strength in different test specimens. Biomater Investig Dent 2020;7:16–24. https://doi.org/10.1080/26415275.2019.1709470. Gale MS, Darvell BW. Thermal cycling procedures for laboratory testing of dental restorations. J Dent 1999;27:89–99. https://doi.org/10.1016/S0300-5712(98)00037-2. Sirisha K, Ravishankar Y, Ravikumar P, Rambabu T. Validity of bond strength tests: A critical review-Part II. J Conserv Dent 2014;17:420. https://doi.org/10.4103/0972-0707.139823. Aydin N, Celik Oge S, Guney O, Okbaz O, Sertdemir Y. A Comparison of the Shear Bond Strength between a Luting Composite Resin and Both Machinable and Printable Ceramic–Glass Polymer Materials. Materials 2024;17:4697. https://doi.org/10.3390/ma17194697. Smith RL, Villanueva C, Rothrock JK, Garcia-Godoy CE, Stoner BR, Piascik JR, et al. Long-term microtensile bond strength of surface modified zirconia. Dent Mater 2011;27:779–85. https://doi.org/10.1016/j.dental.2011.03.018. Deng D, Yang H, Guo J, Chen X, Zhang W, Huang C. Effects of different artificial ageing methods on the degradation of adhesive–dentine interfaces. J Dent 2014;42:1577–85. https://doi.org/10.1016/j.jdent.2014.09.010. Sutuven EO, Yildirim NC. Bond strength of self-adhesive resin cement to definitive resin crown materials manufactured by additive and subtractive methods. Dent Mater J 2025;44:41–51. https://doi.org/10.4012/dmj.2024-111. Lankes V, Reymus M, Liebermann A, Stawarczyk B. Bond strength between temporary 3D printable resin and conventional resin composite: influence of cleaning methods and air-abrasion parameters. Clin Oral Investig 2022;27:31–43. https://doi.org/10.1007/s00784-022-04800-7. Palomeque S, Loguercio AD, Arrais CAG, Sánchez C, Pulido C. Three-dimensionally printed and milled composite materials for definitive restorations. Part 2: Effect of surface treatment on the bond strength of light-polymerized resin cement and surface morphology. J Prosthet Dent 2025:S0022391325007656. https://doi.org/10.1016/j.prosdent.2025.09.033. Lee S-E, Bae J-H, Choi J-W, Jeon Y-C, Jeong C-M, Yoon M-J, et al. Comparative Shear-Bond Strength of Six Dental Self-Adhesive Resin Cements to Zirconia. Materials 2015;8:3306–15. https://doi.org/10.3390/ma8063306. Bourgi R, Etienne O, Holiel AA, Cuevas-Suárez CE, Hardan L, Roman T, et al. Effectiveness of Surface Treatments on the Bond Strength to 3D-Printed Resins: A Systematic Review and Meta-Analysis. Prosthesis 2025;7:56. https://doi.org/10.3390/prosthesis7030056. Kilinc H, Sanal FA, Turgut S. Shear bond strengths of aged and non-aged CAD/CAM materials after different surface treatments. J Adv Prosthodont 2020;12:273. https://doi.org/10.4047/jap.2020.12.5.273. Niizuma Y, Kobayashi M, Toyama T, Manabe A. Effect of etching with low concentration hydrofluoric acid on the bond strength of CAD/CAM resin block. Dent Mater J 2020;39:1000–8. https://doi.org/10.4012/dmj.2018-398. Mao Z, Schmidt F, Beuer F, Yassine J, Hey J, Prause E. Effect of surface treatment strategies on bond strength of additively and subtractively manufactured hybrid materials for permanent crowns. Clin Oral Investig 2024;28:371. https://doi.org/10.1007/s00784-024-05767-3. Palomeque S, Loguercio AD, Arrais CAG, Sánchez C, Pulido C. Three-dimensionally printed and milled composite materials for definitive restorations. Part 2: Effect of surface treatment on the bond strength of light-polymerized resin cement and surface morphology. J Prosthet Dent 2025:S0022391325007656. https://doi.org/10.1016/j.prosdent.2025.09.033. Kang Y-J, Kim H, Lee J, Park Y, Kim J-H. Effect of airborne particle abrasion treatment of two types of 3D-printing resin materials for permanent restoration materials on flexural strength. Dent Mater 2023;39:648–58. https://doi.org/10.1016/j.dental.2023.05.007. Alnafaiy SM, Labban N, Albaijan R, AlKahtani RN, Al-Aali KA, Abozaed HW, et al. Evaluation of Shear Bond Strength and Failure Modes of Lithium Disilicate Ceramic Veneering Material to Different High-Performance Polymers. Polymers 2025;17:554. https://doi.org/10.3390/polym17050554. Kim J-E, Kim J-H, Shim J-S, Roh B-D, Shin Y. Effect of air-particle pressures on the surface topography and bond strengths of resin cement to the hybrid ceramics. Dent Mater J 2017;36:454–60. https://doi.org/10.4012/dmj.2016-293. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9049343","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":605152497,"identity":"ea25a72d-fbe8-40d5-ab41-983b1131ef0c","order_by":0,"name":"İbrahim Can Karslı","email":"data:image/png;base64,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","orcid":"","institution":"Cyprus Health and Social Sciences University","correspondingAuthor":true,"prefix":"","firstName":"İbrahim","middleName":"Can","lastName":"Karslı","suffix":""},{"id":605152498,"identity":"1d599d3d-e976-452b-9030-270f4017da13","order_by":1,"name":"Youssef A.S.A Hassan","email":"","orcid":"","institution":"Cyprus Health and Social Sciences University","correspondingAuthor":false,"prefix":"","firstName":"Youssef","middleName":"A.S.A","lastName":"Hassan","suffix":""},{"id":605152499,"identity":"16d0946e-e747-4ef6-85e1-17bc36c5a1cd","order_by":2,"name":"Artur İsmatullaev","email":"","orcid":"","institution":"Cyprus Health and Social Sciences University","correspondingAuthor":false,"prefix":"","firstName":"Artur","middleName":"","lastName":"İsmatullaev","suffix":""},{"id":605152500,"identity":"185a2b67-1d3a-4f13-af2c-9ac1cae48043","order_by":3,"name":"Simge Taşın","email":"","orcid":"","institution":"Cyprus Health and Social Sciences University","correspondingAuthor":false,"prefix":"","firstName":"Simge","middleName":"","lastName":"Taşın","suffix":""}],"badges":[],"createdAt":"2026-03-06 10:24:05","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9049343/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9049343/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104550095,"identity":"9b5a1c6e-bfa2-4d18-814c-9a8e0abdbc82","added_by":"auto","created_at":"2026-03-13 08:07:44","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":78134,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of failure patterns before thermocycling| C: Control, HF: Hydrofluoric acid etched, S50: 50: 50 mm Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted, S110: 110 mm Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted; Crowntec: Crowntec, CRS: CRS Composite, Alias: Alias dental crown,\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9049343/v1/0258bfcb2f121e4a1dc694fc.jpg"},{"id":104780981,"identity":"5ab81b7e-6ab5-4eb3-bb76-7b90ca6bc529","added_by":"auto","created_at":"2026-03-17 07:54:23","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":79237,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of failure patterns after thermocycling| C: Control, HF: Hydrofluoric acid etched, S50: 50: 50 mm Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted, S110: 110 mm Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted; Crowntec: Crowntec, CRS: CRS Composite, Alias: Alias dental crown,\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9049343/v1/202dfcb692413f2eedb833ec.jpg"},{"id":104550096,"identity":"24bbffd6-fccc-4a3d-8a58-1fc422da9a6e","added_by":"auto","created_at":"2026-03-13 08:07:44","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":55383,"visible":true,"origin":"","legend":"\u003cp\u003eFailure types of tested materials; A-Adhesive, B: Cohesive from resin cement, C: Mixed, D: Cohesive from material.\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9049343/v1/0872e459ddae4ebfb964115f.jpg"},{"id":104784523,"identity":"611bca68-1276-4f90-807e-e92722bcc1c9","added_by":"auto","created_at":"2026-03-17 08:08:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":914443,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9049343/v1/6f5a0f94-389d-40a1-8f56-f80927d689c8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of different surface treatments on bond strength between additively manufactured definitive restorative materials","fulltext":[{"header":"Background","content":"\u003cp\u003eComputer-aided design and computer-aided manufacturing (CAD/CAM) is rapidly developing and increasing in popularity in dentistry, aiming to standardize manufacturing processes, decrease manufacturing costs, and improve treatment efficiency [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. While subtractive manufacturing provides the advantage of increased quality of new materials, it also has significant disadvantages with respect to material waster and cost due to the use of non-recyclable materials used in the manufacturing process [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe rapid advancement of additive manufacturing, especially three-dimensional (3D) printing has revolutionized the field of prosthodontics due to its ability to make accurate, customized dental restorations [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Compared to subtractive methods, 3D printing offers the advantages of material efficiencies, complex geometries, and a digital workflow that integrates intraoral scanning with CAD/CAM design [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eVat Photopolymerization (VP) technology, a specific type of additive manufacturing, has gained widespread acceptance as a method for producing definitive restorative materials due to its accuracy, repeatability, and cost-effectiveness [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. There has been continual development and diversification of ceramic and resin-based materials within CAD/CAM systems [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Photopolymerizable resins are among the most extensively used restorative materials currently available due primarily to their printability and ability to be reinforced with ceramic fillers to enhance mechanical performance [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe durability of restorations based on resin is influenced predominantly by the adhesion quality between the adhesive restorative material and the luting cement [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. A strong bond reduces post-operative sensitivity and improves the fracture resistance of the restoration, while also preventing marginal leakage and secondary marginal caries [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdhesive bonding is affected by factors such as the composition of the restorative material and the resin cement, the surface treatments, and the type of adhesion mechanism [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. To improve bond strength, mechanical (sandblasting, bur grinding) and chemical (silane, primer, acid application) surface treatments are employed [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Sandblasting cleans and roughens the resin surface, exposing filler particles and thereby enhancing micromechanical retention. The exposed filler particles consequently become available for silanization [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Hydrofluoric acid tends to dissolve the glassy phase of the material, whereas the polymer network remains intact. The remaining polymer network creates a honeycomb structure and, therefore, a high micromechanical interlocking potential [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe adhesive interface is primarily subjected to both chemical and mechanical degradation induced by mastication, swallowing and bruxism [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Chemically, the tooth\u0026ndash;material interface is exposed to water, salivary components, and enzymes of host and bacterial origin, leading to hydrolysis and plasticization of the resin matrix, followed by leaching and structural breakdown [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Thermocycling has been widely used to simulate intraoral thermal fluctuations and to assess the aging resistance of adhesive interfaces [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Shear bond strength (SBS) testing is commonly employed to evaluate adhesion between restorative materials and dental substrates, as the applied parallel load application approximates functional masticatory shear forces [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Despite its limitation of non-uniform stress distribution, it remains an accepted method for assessing adhesive performance [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral studies have investigated the bond strength of 3D-printed materials after chemical or mechanical surface treatments [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. However, only a limited number have evaluated the effects of different surface treatments on the adhesion between various 3D-printed restorative materials and resin cements [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. There is no consensus on the optimal surface treatment for bonding additively manufactured permanent restorations. Therefore, the purpose of this study was to investigate the effects of surface treatment and thermal cycling on the bond strength of 3D-printed definitive restorative materials luted with self-adhesive resin cement (SARC). The null hypothesis was that bond strength would not be affected by material type, surface treatment, or thermocycling.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003ewas granted by the Cyprus Health and Social Sciences University Research Ethics Committee (Approval No: KSTU//2024/354).\u003c/p\u003e \u003c/p\u003e \u003cp\u003eInformation regarding each material evaluated is summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The sample size was calculated using statistical power analysis software G*Power (version 3.1.9.3; Heinrich Heine University D\u0026uuml;sseldorf). 12 specimens per group afforded a power of %99 at α\u0026thinsp;=\u0026thinsp;.05.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eContents and manufacturer of the materials used\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup Code\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProduct-Brand Name\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eManufacturer\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMaterial Composition\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eShade/Lot Number\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCrowntec\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCrowntec\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSaremco, Rebstein, Switzerland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBis-EMA, 30\u0026ndash;50% 0.7 \u0026micro;m barium aluminum borosilicate glass fillers, 4,4\u0026prime;-isopropylidiphenol, ethoxylated and\u003c/p\u003e \u003cp\u003e2-methylprop\u0026minus;2enoic acid, silanized dental glass, pyrogenic silica, catalysts, inhibitors and color pigments.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eE522\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCRS Composite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCRSCAM Technology, Antalya, Turkey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMethacrylated aliphatic urethane oligomer, 3,6,9-trioxaundecamethylene dimethacrylate, phenyl bis(2,4,6-trimethylbenzoyl)-phosphine oxide\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCBA102408\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlias\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlias Dental Crown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDokuz Kimya, Aydın, Turkey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u0026ndash;50% inorganic fillers (0.7 \u0026micro;m glass filler), UDMA, glycol methacrylate, and phosphine oxide\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e240591\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePermanent Crown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFormlabs, Massachusetts, USA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEsterification products of 4,4\u0026prime; isopropylidiphenol, ethoxylated and 2-methylprop-2enoic acid; ethoxylated bisphenol A dimethacrylate (Bis-EMA, methacrylate polymer), silanized dental glass, methyl benzoylformate, diphenyl (2,4,6 trimethylbenzoyl) phosphine oxide (TPO, photoinitiator), 30\u0026ndash;50 wt.%\u0026mdash;inorganic fillers (particle size 0.7 \u0026micro;m)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e601400\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eG-CEM ONE\u0026trade;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGC Corp., Tokyo, Japan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUDMA, 10-MDP, other dimethacrylate monomers, fluoroaluminosilicate glass, silicon dioxide, trimethoxysilane, 6-tert-butyl-2,4-xylenol, 2,6-di-tert-butyl-p-cresol, EDTA disodium salt dihydrate, vanadyl acetylacetonate, TPO, initiators, ascorbic acid, camphorquinone, MgO, pigments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2312061\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA disc-shaped specimen (\u0026empty; 6\u0026times;3 mm) was designed by using the FreeCAD 0.19 open-source software program and saved as a standard tessellation language (STL) file for manufacturing the specimens. All of the specimens were printed with 0\u0026deg; printing orientation. Crowntec and CRS specimens were manufactured with a DLP-based 3D printer (Asiga Max UV, Asiga, Sydney, Australia). The light source was 385nm (high power UV LED). After printing, the specimens were cleaned for 10 minutes in an unheated ultrasonic bath containing 99% isopropyl alcohol, air-dried, and post-polymerized for 10 minutes in a washing and curing machines respectively (Elegoo Mercury X Bundle ; Shenzhen Elegoo Technology Co. Ltd., Shenzhen, China), Alias specimens were manufactured with a MSLA based (Masked Stereolithography) printer (Anycubic Photon Mono X, Anycubic, Shenzhen, China) with a 405 nm LED. Specimens were cleaned for 5 minutes in an unheated ultrasonic bath containing 99% isopropyl alcohol, air-dried, and post-polymerized for 5 minutes in a polymerization unit (ShapeCure UV; RAYSHAPE, Shenzhen, China). Permanent Crown specimens were manufactured with an SLA-based (Form 3B, Formlabs, Somerville, Massachusetts, USA) printer. The light source used was a 405nm ultraviolet source and a 250mW laser, after printing, the specimens were cleaned for 3 minutes by ultrasonic cleaning with FormWash (Formlabs, Somerville, Massachusetts, USA) in a solution of 99% isopropyl alcohol prior to post polymerization in FormCure (Formlabs, Somerville, Massachusetts, USA), an ultraviolet polymerization device, for 20 minutes at 60\u0026deg; two times. A total of 384 specimens were embedded in aluminum molds (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\varnothing15\\times20mm\\)\u003c/span\u003e\u003c/span\u003e) using auto-polymerizing acrylic resin (Imicryl, Turkey), ensuring the cementation surfaces remained exposed. The cementation surfaces were polished with 600-grit silicon carbide abrasive paper under continuous water irrigation, and the specimens were then ultrasonically cleaned to remove surface residues. The specimens were randomly allocated into four groups (n\u0026thinsp;=\u0026thinsp;12) using a simple lottery method. Control (C): No surface treatment was applied to the cementation surface. Hydrofluoric acid (HF): A 9% hydrofluoric acid gel was applied to the cementation surface of the specimens for 1 minute, then thoroughly rinsed with water, and dried with oil-free compressed air. 50 \u0026micro;m Al₂O₃ (S50): Airborne-particle abrasion was performed on the cementation surface using 50 \u0026micro;m aluminium oxide particles at 2 bar pressure from a distance of 2 cm for 15 seconds. 110 \u0026micro;m Al₂O₃ (S110): Airborne-particle abrasion was performed on the cementation surface of the specimens using 110 \u0026micro;m aluminum oxide particles at 2 bar pressure from a distance of 2 cm for 15 seconds. The sandblasted specimens were then ultrasonically cleaned in distilled water for 5 minutes.\u003c/p\u003e \u003cp\u003eAfter the surface treatments, the specimens underwent the cementation process. Teflon molds with a cement gap of \u0026Oslash;3x3mm were positioned on the specimen surfaces, and SARC was applied using an auto-mixing tip, followed by polymerization according to the manufacturer\u0026rsquo;s instructions. The specimens were then stored in distilled water at 37 \u0026deg;C for 1 day. All the specimens were prepared by a single operator (İCK). Subsequently, 12 samples from each group (192 in total) were subjected to thermocycling. Thermocycling was performed using a thermocycler (SD Mechatronik Thermocycler, SD Mechatronik; Westerham, Germany) in accordance with ISO 11405. Each cycle consisted of 25-second immersions in distilled water at 5\u0026deg;C and 55\u0026deg;C (\u0026plusmn;\u0026thinsp;1\u0026deg;C), with a 10-second transfer time. A total of 10,000 cycles were applied.\u003c/p\u003e \u003cp\u003eThe SBS of all specimens was tested using a universal testing machine (Lloyd LRX, Lloyd Instruments Ltd., Fareham, UK). A 1-mm crosshead was aligned with the resin cement material interface, and load was applied at 1 mm/min until failure. The failure load (N) was recorded digitally. SBS (MPa) was calculated by using the following formula: σ\u0026thinsp;=\u0026thinsp;P/A, where σ is SBS (MPa), P is the failure load (N), and A is the bonded area (mm\u0026sup2;). After SBS testing, the fracture surfaces were examined under a digital microscope x50 magnification (USB Digital Microscope; Shenzhen Northvision Technologies Co Inc) to determine failure modes, which were subsequently recorded.\u003c/p\u003e \u003cp\u003eStatistical analyses were performed using NCSS software (Number Cruncher Statistical System, 2007, Kaysville, Utah, USA). Descriptive statistics (mean, standard deviation, median, minimum, maximum) were computed, and data distribution was evaluated using the Shapiro\u0026ndash;Wilk test. Group differences were analyzed using the Kruskal\u0026ndash;Wallis test. Pairwise comparisons were performed with the Mann-Whitney U test. The effect of thermocycling on SBS within each group was also assessed using the Mann\u0026ndash;Whitney U test, with the significance level set at α\u0026thinsp;=\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe median, minimum, and maximum SBS values for all materials before and after thermocycling are presented in Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eBefore thermocycling, the Kruskal\u0026ndash;Wallis test demonstrated that material type had a statistically significant effect on SBS values in the C (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), HF (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.034), and S110 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.007) groups, whereas no statistically significant effect was observed in the S50 group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.093). The Mann\u0026ndash;Whitney U test revealed that Crowntec exhibited the highest SBS values in the C group and the lowest SBS values in the HF group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). PC exhibited significantly lower SBS values in the S110 group compared with the other materials (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). The Kruskal\u0026ndash;Wallis test demonstrated that surface treatments had a statistically significant effect on SBS values in Crowntec (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) and Alias (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016), whereas no statistically significant effect was observed in CRS (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.333) or PC (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.152). According to the Mann\u0026ndash;Whitney U test, HF significantly decreased SBS values in Crowntec compared with the C group, whereas sandblasting procedures (S50 and S110) had no effect on SBS values. S110 significantly increased bond strength in Alias compared with the C group, whereas the other surface treatments showed no significant effect.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMedian (Med), minimum (min), and maximum (max) of shear bond strength (SBS) values for tested materials before thermocycling (MPa)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eSBS (MPa) according to surface treatment\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eS50\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS110\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaterial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCrowntec\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.9\u003csup\u003eAa\u003c/sup\u003e (9.1\u0026ndash;21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.7\u003csup\u003eAb\u003c/sup\u003e (4.2\u0026ndash;14.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.9\u003csup\u003eAa\u003c/sup\u003e (7.5\u0026ndash;21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.4\u003csup\u003eAa\u003c/sup\u003e (8.8\u0026ndash;19.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.6\u003csup\u003eBa\u003c/sup\u003e (7.2\u0026ndash;19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.3\u003csup\u003eBa\u003c/sup\u003e (3.2\u0026ndash;18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.6\u003csup\u003eAa\u003c/sup\u003e (7.4\u0026ndash;16.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.7\u003csup\u003eAa\u003c/sup\u003e (9.9\u0026ndash;18.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlias\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.5\u003csup\u003eBa\u003c/sup\u003e (4.3\u0026ndash;17.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.2\u003csup\u003eBab\u003c/sup\u003e (5.5-20.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.1\u003csup\u003eAa\u003c/sup\u003e (7.4\u0026ndash;13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.2\u003csup\u003eAb\u003c/sup\u003e (11.4\u0026ndash;21.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.6\u003csup\u003eBa\u003c/sup\u003e (5.3\u0026ndash;13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.4\u003csup\u003eBa\u003c/sup\u003e (7.3\u0026ndash;21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.9\u003csup\u003eAa\u003c/sup\u003e (6.8\u0026ndash;13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.5\u003csup\u003eBa\u003c/sup\u003e (4.9\u0026ndash;18.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eCrowntec: Crowntec, CRS: CRS Composite, Alias: Alias Dental Crown, PC: Permanent Crown. C: Control, HF: Hydrofluoric acid etched, S50: 50 \u0026micro;m Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted, S110: 110 \u0026micro;m Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted.\u003c/p\u003e \u003cp\u003eDifferent uppercase letters within a column indicate significant differences among materials under the same surface treatment. Different lowercase letters within a row indicate significant differences among surface treatments within the same material (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAfter thermocycling, the Kruskal\u0026ndash;Wallis test demonstrated that material type had a statistically significant effect on SBS values in the C, HF, and S110 groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001 for all), while no statistically significant effect was observed in the S50 group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.378). The Mann\u0026ndash;Whitney U test revealed that Alias exhibited the lowest SBS values in the C group, followed by PC, Crowntec, and CRS. PC exhibited the lowest SBS values in the HF and S110 groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), whereas no statistically significant differences in SBS values were observed among the remaining materials. The Kruskal\u0026ndash;Wallis test demonstrated that surface treatments had a statistically significant effect on SBS values in Crowntec (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.048), CRS (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), Alias (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), and PC (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). According to the Mann\u0026ndash;Whitney U test, HF, S50, and S110 surface treatments resulted in significantly higher SBS values in Crowntec, CRS, and Alias compared with the C group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001); however, no statistically significant differences in SBS values were detected among these surface treatments. All surface treatments were associated with increased SBS values in PC compared with the C group, with the highest SBS values observed following the S50 surface treatment (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMedian (Med), minimum (min), and maximum (max) of shear bond strength (SBS) values for tested materials after thermocycling (MPa)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eSBS (MPa) according to surface treatment\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eS50\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS110\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaterial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMed (Min-Max)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCrowntec\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.7\u003csup\u003eAa\u003c/sup\u003e (8.1\u0026ndash;19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.0\u003csup\u003eAb\u003c/sup\u003e (14.6\u0026ndash;25.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.2\u003csup\u003eAb\u003c/sup\u003e (10.6\u0026ndash;26.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17.1\u003csup\u003eAb\u003c/sup\u003e (10.5\u0026ndash;25.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.1\u003csup\u003eAa\u003c/sup\u003e (7.5\u0026ndash;20.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.8\u003csup\u003eAb\u003c/sup\u003e (12.4\u0026ndash;22.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.2\u003csup\u003eAb\u003c/sup\u003e (11.8\u0026ndash;23.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.5\u003csup\u003eAb\u003c/sup\u003e (10.9\u0026ndash;26.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlias\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.96\u003csup\u003eBa\u003c/sup\u003e (4.2\u0026ndash;13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.2\u003csup\u003eAb\u003c/sup\u003e (13.1\u0026ndash;24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.6\u003csup\u003eAb\u003c/sup\u003e (10.4\u0026ndash;25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.6 \u003csup\u003eAb\u003c/sup\u003e (10.4\u0026ndash;25.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.3\u003csup\u003eCa\u003c/sup\u003e (6.1\u0026ndash;13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.2\u003csup\u003eBb\u003c/sup\u003e (6.7\u0026ndash;16.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.1\u003csup\u003eAc\u003c/sup\u003e (10.3\u0026ndash;20.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.6\u003csup\u003eBb\u003c/sup\u003e (6.4\u0026ndash;20.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eCrowntec: Crowntec, CRS: CRS Composite, Alias: Alias Dental Crown, PC: Permanent Crown. C: Control, HF: Hydrofluoric acid etched, S50: 50 \u0026micro;m Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted, S110: 110 \u0026micro;m Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted.\u003c/p\u003e \u003cp\u003eDifferent uppercase letters within a column indicate significant differences among materials under the same surface treatment. Different lowercase letters within a row indicate significant differences among surface treatments within the same material (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThermocycling resulted in a significant increase in SBS values for Crowntec in the HF and S110 groups, CRS in the HF, S50, and S110 groups, Alias in the HF and S50 groups, and PC in the S50 group (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStatistically significant differences between materials for each surface pretreatment depending on thermocycling\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMaterial\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eP values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eS50\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS110\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCrowntec\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.514\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.008*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.326\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.002*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.023*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlias\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.003*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.133\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.686\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.908\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eCrowntec: Crowntec, CRS: CRS Composite, Alias: Alias Dental Crown, PC: Permanent Crown. C: Control, HF: Hydrofluoric acid etched, S50: 50 \u0026micro;m Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted, S110: 110 \u0026micro;m Al\u003csub\u003e2\u003c/sub\u003eO\u003csub\u003e2\u003c/sub\u003e-sanblasted.\u003c/p\u003e \u003cp\u003eAsterisk (*): Statistically significant difference before and after thermocycling.\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBefore thermocycling, failure mode analysis showed that cohesive fractures within the restorative materials were the most frequently observed failure pattern in all experimental groups, accounting for approximately 50\u0026ndash;80% of the failures, independent of the surface treatment applied (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Adhesive failures occurred less often, generally ranging from 10% to 40%, with comparatively higher frequencies observed in the control and hydrofluoric acid\u0026ndash;treated groups. Mixed failure patterns were uncommon and were mainly detected in the S110 sandblasted groups, where they represented up to 15\u0026ndash;30% of the failures. Cohesive failures within the resin cement were rare across all groups and consistently remained below 10%. After thermocycling, failure mode analysis demonstrated that cohesive fractures within the restorative materials continued to be the most prevalent failure type in all groups, accounting for approximately 45\u0026ndash;75% of the observed failures (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Adhesive failures were more variably distributed after aging, ranging from 20% to 60%, with clearly higher frequencies noted in the control groups. Mixed failures were observed in all surface treatment groups and accounted for roughly 15\u0026ndash;30% of the recorded failures, with a modest increase noted in the sandblasted conditions. cohesive Failures within the resin cement were uncommon and, in all groups, represented less than 10% of the total failures. The failure patterns are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this in vitro study, material type and surface treatment significantly influenced the SBS of SARC to 3D-printed definitive restorative materials. Accordingly, the null hypothesis regarding the effects of material type, surface treatment, and thermocycling on bond strength was rejected.\u003c/p\u003e \u003cp\u003eWater storage is popular method for artificial aging for assessing the degradation of resin-based materials, however, thermocycling simulates oral cavities temperature changes to provide a more relevant measure of bond durability over time [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In the current study, 10,000 thermal cycles were applied, to half of the specimens, representing approximately one year of simulated clinical aging [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. SBS test is a popular and standardized method for evaluating the bonding performance of dental materials after different surface treatments [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Since the masticatory forces in the oral cavity are predominantly in shear nature SBS test is considered a clinically relevant method [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Although tensile bond strength tests theoretically provide a more uniform stress distribution, their reliability may be compromised by factors such as specimen misalignment [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The findings of the current study demonstrated that SBS values increased after thermocycling; however, the control groups did not show any statistically significant increase. In the literature, thermocycling is commonly related with hydrolytic degradation of adhesive interfaces [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Previous studies have reported a reduction in SBS after thermocycling, which has been attributed to dimensional changes caused by differences in thermal expansion coefficients and water sorption of hydrophilic adhesive components [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. The increase in SBS after thermocycling in surface-treated groups can be attributed to temperature-induced post-polymerization of the resin cements and restorative materials, particularly those containing residual unreacted methacrylate groups [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. In addition, the used SARC contains 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and trimethoxysilane coupling agents, which may enhance interfacial bonding with restorative material. MDP can build ionic interactions with the organic components of 3D-printed resin materials and copolymerize with residual methacrylate groups, promoting a more cohesive polymer network. [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. The long hydrophobic character of the alkylene component of MDP also contributes hydrophobicity, limiting hydrolytic degradation and advancing long-term bond durability [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Additionally, silane content in SARC promotes chemical coupling with inorganic fillers, improved surface wettability, and enhanced micromechanical interlocking [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFindings of the current study showed that both material and surface treatment significantly affected the SBS values of additively manufactured definitive restorative materials prior to thermocycling assessments in all groups except S50. This may indicate that the 50 micron sandblasting has a more neutral effect on the surfaces of different materials which yielded similar SBS values in all tested groups [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the present study Crowntec HF group showed the lowest SBS values compared with the control and sandblasting groups before thermocycling. Hydrofluoric acid dissolves the glass matrix of the ceramic materials but it may not be as effective on resin based restorative materials [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This can be related to the high resin polymer content of the material and lower inorganic filler content. In addition, the Crowntec material contains barium glass, an inorganic component that does not react with HF as reported by Niizuma et al. [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. Parallel to the present study, in previous articles, SBS of CAD/CAM hybrid ceramic materials were tested after sandblasting and HF etching, and results showed that HF etching was not as effective as sandblasting [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. In the present study, after thermocycling, the SBS values of the Crowntec HF group increased. This can be explained by the effect of post polymerization induced by the increased temperature in thermocycling process which influenced the bond strength of the resin cement. Lankes et al. [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e] tested the SBS after different surface treatments on the resin based material and found that thermocycling significantly improved the SBS values, similar to the results of the present study. In contrast Mao et al. [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] studied different surface treatments on machinable and printable resin based materials and found that thermocycling did not show statistically significant differences on the SBS values.\u003c/p\u003e \u003cp\u003eIn literature, various particle sizes have been investigated, however, optimal airborne-particle abrasion parameters for 3D-printed definitive restorative materials have not yet been established. The results of this study showed that the PC S110 group, demonstrated lower SBS values both before and after thermocycling when compared to the other materials with S110 surface treatment. This may be attributed to the reduction in physical properties associated with the use of larger alumina particle sizes during airborne-particle abrasion. A previous study has shown that increasing alumina particle size adversely affects physical properties of the resin based definitive restoration materials [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. After thermocycling, the PC S50 group demonstrated a statistically significant increase in SBS. This effect may be attributed to increased surface roughness and disruption of C\u0026ndash;C and C\u0026ndash;H polymer chains, which enhances the micromechanical interlocking and improves the wettability and penetration of the bonding agent into the polymer matrix, in addition, free radicals generated by polymer chain breakage may further strengthen chemical bonding with resin-based adhesive cements through chain transfer reactions [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe results of the present study showed that, Alias S110 group exhibited significantly higher SBS values when compared to the Alias C group before and after thermocycling. This may be explained by the material\u0026rsquo;s resin matrix characteristics. A UDMA-based resin matrix has been reported to exhibit lower maximum deformation and higher elastic recovery under identical loading conditions compared with Bis-EMA-based materials [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. As a result, this allows effective surface modification with sandblasting without substantial mechanical degradation, which may explain the favorable bonding performance observed after S110 treatment.\u003c/p\u003e \u003cp\u003eFailure mode analysis revealed a predominance of cohesive failures within the restorative materials both before and after thermocycling, suggesting that the interfacial bond strength may exceed the intrinsic cohesive strength of the materials [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. The higher incidence of adhesive failures observed in the C and HF-treated groups before thermocycling indicates that the surface modifications in these groups were less effective. In contrast, the increased occurrence of mixed failures in the S110 groups may reflect a more balanced distribution of stress between the adhesive interface and the restorative material. Cohesive failures within the resin cement were rare, indicating that cement integrity was not the limiting factor in bond performance. Overall, these findings are consistent with previous studies reporting that surface treatments enhance durable bonding and shift failure patterns toward cohesive modes in 3D-printed restorative materials following thermocycling [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe present study demonstrated that bond strength varied according to the type of restorative material, as materials respond differently to similar surface treatments due to variations in resin matrix compositions and the type and distribution of fillers. Selection of surface treatments should therefore be guided by the specific compositional and structural characteristics of the restorative materials. This approach may achieve more consistent adhesive outcomes and reduce the risk of interfacial complications such as microleakage or debonding. In this context, material-specific surface treatment protocols appear critical for ensuring the long-term clinical reliability of 3D-printed definitive restorative materials.\u003c/p\u003e \u003cp\u003eThis study has some limitations. The in vitro design and relatively small sample size cannot fully replicate the in vivo intraoral environment, where factors such as saliva and masticatory forces may influence material behavior. Only one resin cement was evaluated, which limits generalizability of the results. Other surface treatment methods. (eg. laser etching), were not included and may have produced different outcomes. Future studies should include larger sample sizes, different restorative materials, and a variety of surface treatment techniques. Moreover, long-term clinical studies are necessary to validate these findings under realistic clinical conditions\u003c/p\u003e"},{"header":"Conclusio","content":"\u003cp\u003eWithin the limitations of this in vitro study, both material type and surface treatment significantly affected the SBS of SARC to 3D-printed definitive restorative materials. Sandblasting generally improved bond strength and maintained adhesion after thermocycling, whereas the effectiveness of hydrofluoric acid etching was material-dependent and limited in resin based materials. Thermocycling did not adversely affect bond strength in surface-treated groups and, in some conditions, resulted in increased SBS values. These findings emphasize the significance of choosing appropriate surface treatment protocols compatible with material composition to enhance bond strength of 3D-printed definitive restorative materials.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e3D\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThree dimensional\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCAD/CAM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eComputer aided design and computer aided manufacturing\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDLP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDigital light processing\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHydrofluoric acid\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLED\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLight- emitting diode\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMSLA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMasked stereolithography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSARC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSelf- adhesive resin cement\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSBS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eShear bond strength\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSLA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStereolithography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSTL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStandard tessellation language\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eUltraviolet\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eVP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eVat photopolymerization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was granted by the Cyprus Health and Social Sciences University Research Ethics Committee (Approval No: KSTU//2024/354).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are availablefrom the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eİ.C.K. Investigation, Conceptualization, Methodology, Validation, Resources, Writing-Original Draft, Writing-Review\u0026amp; Editing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eY.A.S.A.H. Investigation, Reviewing and Editing.\u003c/p\u003e\n\u003cp\u003eA.İ. Investigation, Methodology, Reviewing and Editing.\u003c/p\u003e\n\u003cp\u003eS.T. Investigation, Conceptualization, Methodology, Validation, Reviewing and Editing, Project administration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCengiz-Yanardag E, Kurtulmus Yilmaz S, Karakaya I, Ongun S. Effect of Different Surface Treatment Methods on Micro-Shear Bond Strength of CAD-CAM Restorative Materials to Resin Cement. J Adhes Sci Technol 2019;33:110\u0026ndash;23. https://doi.org/10.1080/01694243.2018.1514992.\u003c/li\u003e\n\u003cli\u003eAwada A, Nathanson D. 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Bond strength of self-adhesive resin cement to definitive resin crown materials manufactured by additive and subtractive methods. Dent Mater J 2025;44:41\u0026ndash;51. https://doi.org/10.4012/dmj.2024-111.\u003c/li\u003e\n\u003cli\u003eLankes V, Reymus M, Liebermann A, Stawarczyk B. Bond strength between temporary 3D printable resin and conventional resin composite: influence of cleaning methods and air-abrasion parameters. Clin Oral Investig 2022;27:31\u0026ndash;43. https://doi.org/10.1007/s00784-022-04800-7.\u003c/li\u003e\n\u003cli\u003ePalomeque S, Loguercio AD, Arrais CAG, S\u0026aacute;nchez C, Pulido C. Three-dimensionally printed and milled composite materials for definitive restorations. Part 2: Effect of surface treatment on the bond strength of light-polymerized resin cement and surface morphology. J Prosthet Dent 2025:S0022391325007656. https://doi.org/10.1016/j.prosdent.2025.09.033.\u003c/li\u003e\n\u003cli\u003eLee S-E, Bae J-H, Choi J-W, Jeon Y-C, Jeong C-M, Yoon M-J, et al. Comparative Shear-Bond Strength of Six Dental Self-Adhesive Resin Cements to Zirconia. Materials 2015;8:3306\u0026ndash;15. https://doi.org/10.3390/ma8063306.\u003c/li\u003e\n\u003cli\u003eBourgi R, Etienne O, Holiel AA, Cuevas-Su\u0026aacute;rez CE, Hardan L, Roman T, et al. Effectiveness of Surface Treatments on the Bond Strength to 3D-Printed Resins: A Systematic Review and Meta-Analysis. Prosthesis 2025;7:56. https://doi.org/10.3390/prosthesis7030056.\u003c/li\u003e\n\u003cli\u003eKilinc H, Sanal FA, Turgut S. Shear bond strengths of aged and non-aged CAD/CAM materials after different surface treatments. J Adv Prosthodont 2020;12:273. https://doi.org/10.4047/jap.2020.12.5.273.\u003c/li\u003e\n\u003cli\u003eNiizuma Y, Kobayashi M, Toyama T, Manabe A. Effect of etching with low concentration hydrofluoric acid on the bond strength of CAD/CAM resin block. Dent Mater J 2020;39:1000\u0026ndash;8. https://doi.org/10.4012/dmj.2018-398.\u003c/li\u003e\n\u003cli\u003eMao Z, Schmidt F, Beuer F, Yassine J, Hey J, Prause E. Effect of surface treatment strategies on bond strength of additively and subtractively manufactured hybrid materials for permanent crowns. Clin Oral Investig 2024;28:371. https://doi.org/10.1007/s00784-024-05767-3.\u003c/li\u003e\n\u003cli\u003ePalomeque S, Loguercio AD, Arrais CAG, S\u0026aacute;nchez C, Pulido C. Three-dimensionally printed and milled composite materials for definitive restorations. Part 2: Effect of surface treatment on the bond strength of light-polymerized resin cement and surface morphology. J Prosthet Dent 2025:S0022391325007656. https://doi.org/10.1016/j.prosdent.2025.09.033.\u003c/li\u003e\n\u003cli\u003eKang Y-J, Kim H, Lee J, Park Y, Kim J-H. Effect of airborne particle abrasion treatment of two types of 3D-printing resin materials for permanent restoration materials on flexural strength. Dent Mater 2023;39:648\u0026ndash;58. https://doi.org/10.1016/j.dental.2023.05.007.\u003c/li\u003e\n\u003cli\u003eAlnafaiy SM, Labban N, Albaijan R, AlKahtani RN, Al-Aali KA, Abozaed HW, et al. Evaluation of Shear Bond Strength and Failure Modes of Lithium Disilicate Ceramic Veneering Material to Different High-Performance Polymers. Polymers 2025;17:554. https://doi.org/10.3390/polym17050554.\u003c/li\u003e\n\u003cli\u003eKim J-E, Kim J-H, Shim J-S, Roh B-D, Shin Y. Effect of air-particle pressures on the surface topography and bond strengths of resin cement to the hybrid ceramics. Dent Mater J 2017;36:454\u0026ndash;60. https://doi.org/10.4012/dmj.2016-293.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Additive Manufacturing, Bond Strength, CAD/CAM, Cementation, Surface Treatment","lastPublishedDoi":"10.21203/rs.3.rs-9049343/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9049343/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDefinitive restorative materials using additive manufacturing techniques have gained popularity recently. This study investigates the effects of surface treatment and thermocycling on the bond strength between additively manufactured definitive restoration materials and self-adhesive resin cement (SARC).\u003c/p\u003e\u003ch2\u003eMaterials and Methods\u003c/h2\u003e \u003cp\u003eDisc-shaped specimens were fabricated using four 3D printable definitive resin materials: two composites (Crowntec (Crowntec), CRS Composite (CRS) and two ceramic-filled composites (Alias Dental Crown (Alias), Permanent Crown (PC). Each material group (n\u0026thinsp;=\u0026thinsp;24) was subdivided according to surface treatment: control (C; no treatment), 9% hydrofluoric acid\u0026ndash;etched (HF), 50 \u0026micro;m Al₂O₃\u0026ndash;sandblasted (S50), and 110 \u0026micro;m Al₂O₃\u0026ndash;sandblasted (S110). SARC was applied to the center of each specimen using teflon molds (\u0026Oslash;3 \u0026times; 3 mm). Shear bond strength (SBS) tests were performed after 24 h of storage in water at 37\u0026deg;C or after 10,000 thermocycles (n\u0026thinsp;=\u0026thinsp;12). Data were analyzed with the Kruskal\u0026ndash;Wallis and Mann\u0026ndash;Whitney U tests (α\u0026thinsp;=\u0026thinsp;0.05). Failure modes were examined microscopically and classified as adhesive, mixed, or cohesive.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eSBS values of Crowntec significantly decreased following HF treatment compared to other groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No significant differences were observed among surface treatments for CRS and PC (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, Alias demonstrated statistically significant increases in SBS compared to control after S110 treatment (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Following thermocycling, SBS values were affected by both material type and the surface treatments used. All surface-treated CRS and Alias groups had significantly higher SBS values than their respective controls (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Crowntec showed significant increases after HF and S50, whereas for PC only after S50. No significant differences were observed among control groups (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Failure mode analysis revealed mainly adhesive failures in the control groups, whereas the surface-treated groups had a mix of cohesive and adhesive failure patterns after thermocycling.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe application of surface treatments provided higher bond strength between the SARC and additively manufactured definitive restorative materials after 10,000 thermocycling.\u003c/p\u003e","manuscriptTitle":"Effect of different surface treatments on bond strength between additively manufactured definitive restorative materials","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-13 08:07:39","doi":"10.21203/rs.3.rs-9049343/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-04T23:47:23+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-30T18:32:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-25T02:39:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-22T07:49:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-20T11:01:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"262728751230425973296047055946506179100","date":"2026-03-15T18:57:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"161485642008294818634946493177196164481","date":"2026-03-12T14:27:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"34918752597001037369339612629925678149","date":"2026-03-12T14:27:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"109959198627561412818701664669962373168","date":"2026-03-11T08:22:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"285775841778406751454515248008668627124","date":"2026-03-10T17:45:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"209054187981871548137855550667156739861","date":"2026-03-10T14:29:57+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-10T14:18:08+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-10T12:03:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-09T14:22:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-09T14:21:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2026-03-06T10:14:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"802d6c5b-42a7-40af-adfa-ac2c3d4178fe","owner":[],"postedDate":"March 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-13T08:07:39+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-13 08:07:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9049343","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9049343","identity":"rs-9049343","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}