Curr Oral Health Rep
DOI 10.1007/s40496-016-0108-9
DENTAL RESTORATIVE MATERIALS (M ÖZCAN, SECTION EDITOR)
The Role of Silane Coupling Agents and Universal Primers
in Durable Adhesion to Dental Restorative Materials - a Review
Muhammad Zakir 1 & Usman Ashraf 1 & Tian Tian 1 & Aifang Han 1 & Wei Qiao 1 &
Xiaozhuang Jin 1 & Meng Zhang 1,2 & James Kit-Hon Tsoi 1 & Jukka Pekka Matinlinna 1
# Springer International Publishing AG 2016
Abstract One of the most important aspects in the field of
dentistry is adhesion. Adhesion can be enhanced through dif-
ferent mechanisms, most commonly by chemical and me-
chanical modifications of dental material surfaces. One exam-
ple of chemical adhesion utilizes primers or bonding agents
containing coupling agents. Universal primers which are
(mainly organophosphate-based monomers) and silane cou-
pling agents are the most effective and most widely used for
unifying dissimilar materials. Other than improving adhesion,
Silanes have many other applications in dentistry. They have
been found also to enhance the mechanical properties of ma-
terials either by adhesion or by becoming a constituent of
dental materials itself. Universal primers, on the other hand,
are utilized in bonding between different dental materials such
as ceramics, metals, alloys, as well as to resin composites.
Unfortunately, these primers, coupling agents, and bonding
agents have, in general, poor hydrolytic stability. They are
susceptible to humid oral environment, which invariably ren-
der them potentially unstable in the humid oral environment as
saliva is always present. Improving their hydrolytic stability
should therefore result in stronger adhesion for dental mate-
rials and dental prosthesis with a better clinical survival rate.
This article is part of the Topical Collection on Dental Restorative
Materials
* Muhammad Zakir
mzakir@hku.hk; zakirnoormohd@gmail.com
1
Dental Materials Science, Faculty of Dentistry, University of Hong
Kong, 4/F, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR,
People’s Republic of China
2
Institute of Biomedicine and Biotechnology, Shenzhen Institutes of
Advanced Technology, Chinese Academy of Sciences,
Shenzhen, People’s Republic of China
Keywords Silane . Coupling agents . Primers . Bonding
agents . Fillers . Ceramics . Composites . Silica
Introduction
Adhesion, defined as Bsticking of two surfaces intimately
together,^ is a very important phenomenon not only in den-
tistry but also in daily life. Generally speaking, adhesion is
about unifying two or more dissimilar materials which do not
have a natural affinity to each other, with or without the help
of another coupling material. This adhesion mechanism can
also be broadly divided into two main categories: mechanical
and chemical adhesions. Mechanical adhesion (retention) can
be established when a material is subjected to surface modifi-
cation, increasing the surface roughness by either forming
macro- or micro-porosities. This type of adhesion relies on
mechanical interlocking to increase retention and provides
quite a good, durable form of bonding. As for chemical adhe-
sion, it involves modification of the surface chemistry. During
the process of adhesion, two dissimilar surfaces are connected
by a chemically active material, which is usually liquid and
has bonding affinity to both surfaces.
The key to success in dental adhesion involves various
factors, e.g., contact angle, purity or cleanliness of the bonding
surfaces, and presence of any debris and biofilms on the sur-
face. Dental adhesion involves both mechanical and chemical
adhesion aspects. In particular, chemical adhesion is achieved
with the help of coupling agents or primers, which play a very
important role in dentistry.
Numerous coupling agents such as organomettalic com-
pound, which includes titanates, zirconates, silanes, phos-
phates, zircoaluminates, thiones, and thiols are used in various
industries. Some of them are used (or have been attempted) in
the dental field. In general, coupling agents are synthetic

functional compounds which wet the substrate surfaces, in-
creasing the surface-free energy, the adhesive strength of resin
cements interfaced with tooth structures, metallic and ceramic
prosthesis and not limited to crown, bridges, inlays, and
onlays. Silane coupling agents (silanes), because of their good
performance and biocompatibility, are the most broadly used
coupling agents in dentistry. Hydrophobic silane monomers
need to be dissolved in alcohol-water solvent and, activated by
an addition of acid which makes the initially hydrophobic
silane molecules hydrophilic, i.e., they will contain silanol,
−Si–OH. They condense and finally set to form a hydrophobic
siloxane (polysiloxane) film having different reactivity de-
pending on the silane.
Chemically speaking, silanes are synthetic organic-
inorganic silicon compounds and can be further divided into
two types: functional and non-functional (Fig. 1). Functional
silanes have reactive functional groups at both molecular ends
which may react with two chemically dissimilar surfaces. On
the other hand, non-functional silanes have only non-reactive
groups which react with, for example, inorganic surfaces.
Some non-functional silanes may be used for cross-linking
[1•, 2•, 3]. Organo-silicon compounds contain synthetic direct
≡Si–H and ≡Si–C bonds [1•]. Given this, silanes are one of the
mostly broadly and widely studied coupling agents and have a
very wide range of applications. They could be used, inter alia,
to coat building materials, silanize silicon surface for micro-
chip fabrication, water and oil repellent coatings, and as opti-
cal coatings.
Dental applications of silanes are mainly related to
hydroxylated (−OH) surfaces, in particular using 3-
methacryloxypropyltrimethoxysilane (MPS or y-MPS) to
coupling reactions. It is one of the most commonly used silane
due to its reactivity and ability to yield good, durable adhesion
between the relevant substrates [4•, 5•, 6••]. An example is
resin composites, where the silanized coating on the glass
filler particles allow chemical bonding with the resin matrix
and thus producing a dental resin composite with improved
mechanical properties [5•, 6••, 7•, 8•]. E-glass fibers used in
fiber-reinforced resin composites (FRCs) are also silanized.
Fibers increase the strength and enhance the mechanical prop-
erties of removable prosthesis and periodontal splints [9, 10].
In terms of cementation, adhesive resin cements are used to
bond primed (acid etched and silanized) porcelain and silica-
coated metals. This is also applicable for repairs of fractured
and chipped ceramics or metals [11••, 12, 13]. Adhesion
O OH
CH3
X
O P
R (CH2)n Si X
H2C O
X OH
a O
b bers have been attempted or used as the fiber filler
Fig. 1 General molecular structures of a silane and b MDP
Curr Oral Health Rep
promotion or surface functionalization process may also be
achieved by using two-bottle adhesive systems. Interestingly,
in such a system, the non-hydrolyzed silane needs to be mixed
with the other component, consisting of water, acetic acid, and
ethanol before application on the bonding surface [1•, 2•]. It is
noteworthy that such silanes would become murky or milky if
they are not used once opened, or if the bottles were left open
without a cap. This is also why single-bottle silanes (which are
already in pre-hydrolyzed form) should always be stored in
dark and cold. This review gives a brief introduction regarding
how and where silanes are used in dentistry.
Applications
Direct Restorative Materials
Particulate Fillers
Modern-day dental resin composites are composed of resin
matrix; free radical initiator; inhibitor; filler particles (e.g.,
lithium aluminosilicate, silica, or boron silicate); and silane
coupling agents [14]. A silane coupling agent is used to ensure
durable bonding between the filler particles and the resin ma-
trix. An experimental resin with silanized filler particles has
been reported by Lin et al. to have higher diametral compres-
sive and tensile bond strength than resin composites with non-
silanized filler particles [15]. Silanization of filler particles
promotes wettability and dispersion, as well as decreasing
the viscosity between fillers and liquid resin components;
hence, improving the physical and mechanical properties of
resin composites [16]. Additionally silanization of aluminosil-
icate filler particles results in a stronger resin matrix and filler
bond than without silanization. Some studies further suggest
that water uptake by silanized filler particles is considerably
lower than non-silanized filler particles [17].
In various studies, silanization of filler particles with differ-
ent silanes like MPS, 3-mercaptopropyltrimethoxysilane
(MEPS), or amino-silanes with different surface modification
methods were contrasted and compared to each other regard-
ing the degree of interfacial bonding using various tests. The
results showed that MPS had a profound effect against wear
resistance and hydrolytic degradation of resin composites. On
the other hand, certain experiments have also shown that the
same surface treatment does not always significantly affect the
wear resistance [18].
Fibers as Fillers
In dental fiber-reinforced composites (FRcs), glass, quartz,
polyethylene, polyester, carbon/graphite, and polyaramid fi-
(reinforcement) whereas the polymetric matrix may consists
Curr Oral Health Rep
of various acrylic monomers. Effective reinforcement depends
on good and reliable adhesion between the filler and the ma-
trix. The use of fiber fillers can modify the material in terms of
improving the mechanical properties such as flexural strength,
impact strength, flexural modulus, failure strain, and fracture
toughness. However, if their adhesion to the matrix is too
weak, the fillers may even weaken the material as the regions
with weak adhesion act as stress concentration points.
Moreover, such voids at the fiber-matrix interface may accu-
mulate and absorb water and microorganisms.
In the situation where direct fiber-matrix bonding is essen-
tially weak due to their dissimilar nature, silanization is always
mandatory. Vallittu summarized the mechanism of
silanization on different fiber types as forming a Bmatrix-R-
Si-O–fiber^ structure, in which BR^ represents the organo-
functional groups in the silane molecule, BSi^ the silicon at-
om, and BO^ the oxygen atom [19]. Alongside with providing
a chemical bond, silanes can re-activate and wet silanized
surfaces, which could enhance the resistance of the interface
to hydrolysis and protect the fiber filler from damage during
handling [20].
It is worth pointing out that a silane selected for adhesion
promotion, should chemically and sterically match the types
of fiber and resin to be bonded. For example, polyester fibers
react readily with epoxy or melamine groups in the organic
matrix, but if these functional groups are not present in the
matrix, a silane with these functional groups should be applied
as an intermediate to strengthen adhesion. One example is
polyethylene (PE) fibers which are inert and lack reliable ad-
hesion to the resin matrix at their interface, due to the non-
polar nature and low surface energy of the PE fibers. This has
been a challenge in dental materials research for years, and
various treatments have been attempted to modify the surface
conditions of polyethylene fibers, including chemical modifi-
cation, chemical grafting, oxygen plasma, high energy laser,
UV, gamma irradiation, corona discharge, and silane treatment
[21–27]. Recently Bahramian et al. used MPS on the corona-
treated polyethylene fibers, and obtained good, positive re-
sults in the fiber-matrix adhesion [27]. Therefore, it is impor-
tant that a proper silane with the complementary surface
chemistry be chosen for optimal adhesion.
Bonding of a fiber reinforced composite (e.g., a fiber post)
to resin cement greatly relies on the adhesion of fiber to the
resin cement. Clinically, etching on the bonding surface of the
composite is always recommended to expose the fibers.
Efforts have been done to improve the efficiency of
silanization. For example, Kim et al. [28] proposed applying
a non-organo-functional cross-linking silane, 1,2-bis(-
triethoxysilyl)ethane (BTSE) blended with a normal organo-
functional silane (such as MPS), whereas Samimi et al. [20]
suggested removing extra silane from the silanized fiber post
surface with warm water and warm air to achieve a stronger
and hydrolytically stable bonding to resin cement. In the study
of Fonseca et al. [29], an increase in the flexural and compres-
sive strength of the composite was observed after heat treat-
ment on the silanized pure glass fibers. Oliveira et al. [30]
showed an improved bonding to the glass fiber post with
combined use of silane and adhesive. Thus, silanization of
glass fibers appears to be a common and standard procedure
to reinforce adhesion interface. Effects of silane in some inor-
ganic dental materials are shown in Table 1 [2•].
Nowadays, in the development of materials in dentistry, the
utilization of other fibers, in particular micro-fibers, as filler
components in composite materials has been suggested. For
example, dispersion of carbon nanotubes in the silane could
increase the interfacial shear strength by 26.3 % [31]. Wang
et al. have shown that silanized zirconia micro-fibers could
improve the fracture toughness in bis-GMA-based dental resin
composite [32••]. This being said, silanes appear to have great
potential and wide applications as coupling agents for many
other kinds of fibers other than glass for reinforcement. Given
this, new types of fiber reinforced composites could be
invented for clinical use.
Indirect Restorative Materials
Glass Ceramics
In addition to being used as a coupling agent to reinforce
fillers in resin composites, silanes also plays an important role
in resin-substrate bonding. Such substrates include ceramic
restorations and their repair, and silica = coated porcelain-
fused metal (PFM) or some other silica-coated metal restora-
tions [2•].
Although silane coupling agents are able to promote adhe-
sion between resin cement and ceramics and metals, the bond
it is not 100 % stable over time and is susceptible to moisture.
A study reveals that adhesion is relatively weaker with non-
silica-based materials (e.g., alumina, zirconia, and non-silica-
coated metal alloy materials) compared to silica-based ce-
ramics [33••]. This implies that a suitable surface pre-
treatment protocol is required before silanization in order for
better (more durable) adhesion promotion. Indeed, some pre-
treatment methods such as silica-coating before silanization
has been proven to improve the adhesion, i.e., significantly
increased bond strengths have been obtained in vitro [33••, 34,
35].
In particular, several silane coupling agents have used to
acid (hydrofluoric acid) etch glass ceramics to enhance the
chemical bonding between resin composite and ceramics
[36–40]. As aforementioned, MPS is the most commonly used
silane for resin-ceramic bonding. In addition, it was worth
noting that functional silanes such as MPS blended with 1,2-
bis(trimethoxysilyl)ethane (BTSE) could significantly in-
crease the resin to leucite-reinforced ceramic shear bond ad-
hesion strength after thermo-cycling [41]. Thus, silanes and

Table 1 Effect of silane coupling agents with some substrates [2•]
Effect of silane coupling agents with some substrates [2].
Greater adhesion
Less adhesion
their blends are very effective in promoting adhesion for glass
ceramics.
Silanes have been shown to reduce the contact angle and
hence, they increase the wettability of glass ceramic surface
[42••, 43]. Under normal clinical circumstances, the silane
layer is found to be around 10∼50-nm thick [44••]. If silane
layers are successively applied on the surface, cohesive de-
struction of layers might occur [45••]. As a self-assembled
ultra-thin film, silane has a weaker mechanical strength than
resin and ceramic, and is regarded as the weakest point in the
resin-ceramic joint adhesion system. Thus, in order to achieve
Curr Oral Health Rep
Silica
Quartz
Glass
Silicon
Titanium, Chromium
Steel
Nickel
Zinc
Gypsum
satisfactory adhesion, a reduction of the silane coating thick-
ness on the ceramic surface is recommended. For example,
heat treatment by using a hot air stream has been shown to
reduce the silane coating thickness [46••, 47]. This could in-
crease the micro-tensile bond strength between leucite-
reinforced ceramic and resin cement significantly. Heat treat-
ment has been shown to enhance bonding performance of
silanes such as 3-methacryloxypropylmethyldimethoxy silane
(MPS), 3-methacryloxypropyltriethoxysilane (MTES), and 3-
acryloxypropyltrimethoxysilane (ACPS) [48]. Nonetheless,
another study showed that the heat treatment of silane did
Curr Oral Health Rep
improve the bond strength, but not statistically significantly
[49]. Thus, to optimize the bond between resin and ceramic,
the chemical composition of primer seems to play a greater
role than heat treatment [39].
Furthermore, it is not only the silane monomers, but also
other primer ingredients that could have considerable effect on
adhesion [40, 41, 43]. It was suggested that 10-
methacryloyloxydecyl dihydrogen phosphate (MDP) (Fig. 1)
has the potential to improve bonding between zirconia and
resin composite cement. However, a recent study showed a
contrasting result, where glass ceramics treated solely with
silane solutions exhibited better bonding with resin cements
than ceramics treated with a primer containing both silane and
MDP [50]. With regards to hydrochloric acid (HCl) addition
to primers, a significant increase in the shear bond strength
between resin composite and a leucite-reinforced ceramic after
thermo-cycling was observed. It was postulated that HCl
might act as an effective accelerator during the hydrolysis
reaction of the methoxy part of the silane [41].
MPS is commonly used in dentistry as pre-hydrolyzed
form in a single bottle. One study discovered that when the
silane was applied to the surface of leucite-reinforced ceramic,
there was no significant difference in the tensile bond strength
when a pre-activated silane solution was used. It was based on
MPS, acetic acid, and ethanol, even when they were stored for
up to 1 year at room temperature [51]. However, pre-
hydrolyzed silane solutions in a single bottle have relatively
short shelf lives. It must be stressed that the solution is no
longer usable when it has turned cloudy or milky after opening
[2•].
Oxide Ceramics
Oxide ceramics including alumina (Al2O3) and zirconia
(ZrO2) are popular in dental restorations due to their superior
esthetic and high-fracture resistance properties [52–56]. A
small amount of yttria (Y2O3) is usually added to zirconia to
improve the properties of fracture toughness, cohesion, flex-
ural strength. and wear resistance, forming yttria tetragonal
zirconia polycrystals (TZP) [57].
Resin composite cements have several advantages,
allowing for shade matching, better marginal adaptation,
higher flexural strength, and fracture resistance. Therefore,
they are widely used for cementation of ceramic restorations
to achieve strong adhesion [58, 60]. Both micro-mechanical
interlocking and chemical bonding are required [58, 60, 61].
A silane coupling agent is often used on the ceramic sur-
face before resin composite cement application. One function
of silane coupling agent is to increase the surface-free energy
of the ceramic surface [2•, 9, 59, 62–64]. Also, they are capa-
ble of forming a siloxane (polysiloxane) network (film) with
the silica phase in ceramics and, simultaneously, co-
polymerizing with the organic matrix of the resin composite
[19, 60, 65, 66]. While silanization is a well-recognized and
acknowledged pre-treatment step before resin composite ce-
ment bonding to feldspathic ceramics which contains a large
amount of silica. When alumina and zirconia ceramics are
used, silanization should be carried out only after these high-
strength ceramics are silica-coated [64] since these ceramics
are inherently silica free [67, 68]. This could be achieved by
grit-blasting the oxide ceramic surface with silica-coated alu-
mina particles under air compression [69••]. This method pro-
vides the oxide ceramic surface with an additional silica com-
ponent, so that the procedure of silanization could be facilitat-
ed. The oxide ceramic restoration may then be satisfactorily
and reliably cemented using resin composite cement.
Several studies have focused on the improvement of silane
coupling agent application [71, 79]. It was reported that a
silane coupling agent added to an adhesive phosphate mono-
mer primer can achieve superior long-term shear bond
strength for zirconia restorations with resin composite ce-
ments [70]. A study by Kitayama et al. revealed significantly
higher bond strengths obtained by using a novel single-
component silane coupling agent than using a mixture of a
dentine primer/and silane coupling agent [71].
Recently, some researchers have developed several universal
silane primers [72, 73]. A study by Aboushelib et al. applied
some novel primers 3-acryloyloxypropyltrimethoxysilane, 3-
isocyanatopropyltriethoxysilane, 3-styrylethyltrimethoxysilane,
and 3-methacryloyloxypropyltrimethoxysilane in combination
with the selective infiltration etching (SIE) surface pre-
treatment for resin-ceramic bonding [74•]. Such novel primers
contain some organo-functional groups and have the potential of
improving silane monomers function. Matinlinna et al. also
found an increase in the bond strength after these primers were
applied to silica-coated zirconia [75]. Such a blended silane sys-
tem was shown in a laboratory study [42••] to enhance the shear
bond (adhesion) strength between resin and zirconia, especially
after artificial speeded aging, thermo-cycling. Thus, it seems to
be that blended systems might be a promising solution to en-
hance adhesion, particularly with regards to dental ceramics.
Metals and Alloys
Along with polymers and non-metallic inorganic ceramics,
metals and alloys have contributed as a major source of ma-
terials in dentistry. Far back in the past, ancient people used to
replace tooth structures with ivory and gold. It is evident that
metals and their alloys nowadays have outstanding functional
performance, with appealing properties in brittleness, hard-
ness, wear resistance, etc. [76]. Along with their consistent
and reliable biocompatible properties, a variety of metals
and metal alloys are involved in a wide range of applications
in dental and medical restorations and appliances. In practice,
they are mainly casted for prosthetic uses. Their application is
not limited to onlays, inlays, partial crowns, full crowns,

bridges, endodontic posts, partial dental framework, arch
wires, brackets, and implant abutments. Different metallic
dental materials are named according to the abbreviation of
the principal components in that alloy. A general catalog of
popular alloys may be Co–Cr, Ni–Cr, Ni–Ti, dental silver
amalgam, commercially pure Ti, Au–Pd–Ag, Pd–Ag–Sn,
stainless steel, and so on.
The type of bonding between the atoms characterizes the
properties of metals. Here, the average bond length of metallic
bond is 0.4 nm. This being said, the average bond energy for
metallic bond is ca. 250 kJ/mol. Unlike covalent bonds in
polymers, mobility is achieved by the outer shell of metal
electrons. Thus, large amounts of electrons transfer and move
within the metal matter. This accounts for some special metal-
lic properties such as ductility, metallic luster, and thermal and
electrical conductivity. Longevity and biocompatibility are
ideal for many metals in use in dentistry.
In dentistry, bonding to metals is an essential step to utilize
them along with their said benefits [77••]. Though soldering
and welding are common bonding procedures in industry, they
are less practical for permanent restorations in the oral cavity.
Here, mechanical and chemical adhesions assume much great-
er importance. Application of metal primers, metal condi-
tioners, and coupling agents, e.g., silane is beneficial in adhe-
sion promotion to (in case of silanes, silica-coated) metals and
alloys. The technique of grit-blasting significantly optimizes
the bonding outcome by pre-treating the surface of metals.
The airborne particles could clean, roughen, or coat the metal
surface with silica particles. Common particle sizes include
30, 50, and 110 μm. Alumina or silica-coated alumina is the
main component of the particles. Through the silica-coating
the particles can be linked to silane coupling agent, thus
achieving a desirable bonding outcome. As grit-blasting is
suitable for noble and base metal alloys, both can be treated
and cemented [78••]. Alloy surfaces are cleaned and silica-
coated, followed by silane application with a fine, clean brush
and are allowed to dry. At this point, the interface is ready for
further immediate application of resin composite cement,
methyl methacrylates, and opaquer. In addition to the tribo-
chemical method (silica-coating), acid etching, and
electrolytical coating are possible alternatives to surface treat
before bonding. The optimal parameters for acid etching, in-
cluding etching time, acid type, concentration, and density
may vary among the different metals. For electrolyte coating,
tin crystal structures could form on the metal surface by tin-
plating after the grit-blasting. These are commendable ap-
proaches, yet contamination is possible at the interface with
both alternatives and the treated alloy surface does not differ
much from untreated cases, which is in contrast to grit-
blasting [47].
Akin to other bonding agents, an alloy primer usually
contains key components that could function and promote
adhesion between dissimilar materials, e.g., 6-[N-(4-
Curr Oral Health Rep
vinylbenzyl)propylamino]-1,3,5-triazine-2,4-dithione
(VBATDT) and 10-methacryloyloxydecyl dihydrogen phos-
phate (MDP). Monomers for bonding metal alloys with resin
composite are bi-functional in structure. The base metal alloy
surfaces are bonded to phosphoric acid group of MDP and resin
composite is bonded to the double bonds on the other end of the
MDP molecules. For bonding to noble metal alloys, one end of
VBATDT (Fig. 1) contains a methacrylate (or similar groups) for
resin bonding, whereas, the mercampto(thiol) groups (−SH) on
the other end of the primers are for bonding to metal alloys.
Additionally, MDP enhances the reaction between VBATDT
and precious metals. It is available for bonding resin composite
cement to dentine and ceramics, as well as bonding metals with
methylmethacrylate (MMA), a denture base material [79].
Hydroxyethylmethacrylate (HEMA) also enhances resin-metal
bonding. In some commercial brands, N-methacryloyl-5-
aminosalicylic acid (5-NMSA) and polymerization accelerators
are added into the commercial primer contents [80]. Also, 4-
methacryloxyethyl trimellitate anhydride (4-META) is a mono-
mer commonly used with methyl methacrylate (MMA)-tri-n-bu-
tyl borane (TBB) resin, yielding the 4-META/MMA-TBB resin
cement for bonding metals [81].
Silanes act as coupling agents similar to metal primers, for
bonding resin composites to silica-coated metals. Many
available products contain methacrylate silane such as
3-methacryloxypropyltrimethoxysilane (MPS) [4•].
Commercial MPS-based silanes usually contain ca.
1–2 wt% of silane dissolved in ethanol and water. A novel
acrylate silane system with a functional silane, i.e., (3-
acryloxypropyl) trimethoxysilane (ACPS) and a cross-
linking silane 1, 2-bis(triethoxysilyl)ethane (BTSE) have also
achieved appealing bonding ability. This is called a novel
silane system (NSS) [82].
Others
Acrylic polymers are among the most commonly used dental
restorative materials for decades. The reason for their popu-
larity in fabricating artificial teeth, denture base, and tempo-
rary crowns is their ease of handling, satisfactory esthetics,
chemical stability, and affordability. De-bonding of acrylic
teeth from the denture base is reported as the most common
type of failure in acrylic resin denture. Laboratory investiga-
tions have demonstrated that the application of silane coupling
agent could significantly increase the bonding strength of
acrylic denture base to acrylic teeth [83] or gingival shade
resin composite [84]. Silane coupling agents were also found
to be effective as the pre-treatment for bonding between auto-
polymerizing repair resin and nylon polymer denture base
material [85]. It was hypothesized that a silane coupling agent,
when used with dichloromethane, might result in morpholog-
ical change of the denture base resin and the coupling of resin
composite to the filler particles [84]. On the other hand, when
Curr Oral Health Rep
used as the pre-treatment for the bonding between acrylic resin
denture base and silicone-based soft liner, silane coupling
agents failed to achieve a significant improvement in the
bonding strength [86]. This was not a surprise as silicones
are hydrophobic.
Polyether ether ketone (PEEK) has been recognized as a fa-
vorable restorative material due to its notable mechanical prop-
erties, tooth color, biocompatibility, and stability [87, 88]. The
applications of PEEK include implant abutments, implant-
supported bar/clamp, and fixed dental restorations [89].
However, sufficient bonding strength of PEEK to titanium, zir-
conia, and resin composites cannot be achieved easily because it
is resistant to surface modification by various mechanical and
chemical treatments [90, 91]. Recent studies have showed that
the application of a primer containing methacrylate silane, phos-
phoric acid methacrylate, and sulfide methacrylate resulted in
significantly enhanced tensile bond strength of resin composites
on air-abraded PEEK [88, 92]. In contrast, a primer containing 3-
methacryloxypropyltrimethoxysilane, MDP, and ethanol did not
contribute to the bonding strength at all [88, 93]. The author
attributed this phenomenon to the occupied functional groups
of the bi-functional MDP monomer by the phosphate groups,
which impeded their further chemical reaction with the PEEK
substrate or the resin composites [88].
Companies like Kuraray and Ivoclar-Vivadent have al-
ready introduced silane primers into the dental market.
These primers contain the most commonly used phosphate
coupling agents MDP and MPS in a combination. MDP bonds
well with oxide ceramics and silanes bond well with silica-
based ceramics. They can be referred to as universal primers
as well in a way that they bond with most, if not all, types of
ceramics, including zirconia, porcelain, alumina, leucite, and
lithium di-silicate.
It can be said that MDP and MPS in a one-bottle system,
play a very important factor in resin-zirconia bonding [94].
The presence of a functional monomer (MDP) and bi-
functional monomer (silane, MPS) give good adhesion results
for both etchable and non-etchable ceramics in dentistry.
Some well-known commercial silane primers produce durable
adhesion for short and long terms when bonding zirconia with
resin composite cement [95]. The combination of such uni-
versal primers (chemical modifiers) alongside with modifica-
tions in the substrate surfaces would most probably improve
the longevity of dental prosthesis during their function in the
oral cavity.
Conclusion and Future Work
Many different types of primers are available for bonding
dissimilar materials together, and the great majority of the
most commonly used coupling agent is silane.
Commercially silane-based primers are also the most popular
compared to other coupling agents, such as zirconates, tita-
nates, phosphates, thiols, and zircon-aluminates. Silanes have
been introduced into dentistry after an extensive usage in in-
dustrial applications—and they will remain in dentistry, prob-
ably with expanding, new applications.
It has been seen in previous studies that silanes form a
weaker bond with non-silica-based ceramic materials. This,
along with the relatively low long-term hydrolytic stability
of the silanes might be a concern. This might be improved
by different surface conditioning methods or utilizing other
functional groups in silanes. These improvements could fur-
ther expand their applications in dentistry and possibly in oth-
er fields as well.
Acknowledements The authors would like to acknowledge and thank
Ms. Madeline Yon for proof reading the article.
Compliance With Ethical Standards
Conflict of Interest All the authors of this review article declare that
they have no conflict of interest.
Human and Animal Rights and Informed Consent This article does
not contain any studies with human or animal subject performed by any
of the authors.
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