Surface Pretreatment Protocols For Indirect/Semi-Direct Dental Restorations: A Cross-Sectional Survey and Expert Consensus

TL;DR

This study surveyed dental professionals in German-speaking countries to understand how they use surface pretreatment protocols for dental restorations and found that access to specific equipment influences their practices.

Contribution

The study provides insights into current practices and expert consensus on surface pretreatment protocols for dental restorations in German-speaking countries.

Findings

Approximately half of participants use airborne particle abrasion (APA) in their practice.

Preferences for APA settings correlate with age, experience, and profession.

Standardized protocols and training are recommended to improve APA use in dental care.

Abstract

To investigate, via questionnaire, how protocols for adhesive luting workflows of dental restorations are applied in three German-speaking countries.

A 47-item questionnaire gathered data on airborne particle abrasion (APA) unit characteristics, parameters, operating procedures, pretreatments in adhesive luting workflows for restorations, and participant demographics. The survey was distributed via trade journals, expert associations, universities, technical schools, and social media. Marginal absolute and relative frequencies were analyzed (95% confidence intervals), with Chi-squared tests comparing observed and expected frequencies (P<0.05). Twenty-three experts voted on 23 recommendations regarding APA parameters and other pretreatments for bonding restorations.

A total of 267 participants completed the survey. Access to an APA unit was linked to a higher likelihood of performing APA before placement. Approximately half of the participants used APA in their practice. For zirconia restorations, 47.2% applied alumina APA at 50 µm/0.1 MPa, while 36.7% used the same settings for polymer-based restorations. For alloys, 37.5% employed 110 µm/0.2 MPa. These preferences correlated with age (≥30 years), experience (≥10 years), profession (dental technician/dentist), prior instruction/training, and daily APA use. Adhesives with MDP were used for zirconia (63.8%) and those with silane for silicate-based ceramics (55.9%). Agreement on recommendations ranged between 52% and 100%, with 21/23 reaching an average of 93%.

Access to APA influenced clinical decisions and the feasibility of adhesive luting workflows. Adequate APA equipment in dental facilities is essential for quality care. Standardized protocols, training, and education across dental professions are necessary to enhance understanding and proper use of APA.

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