Brodine Prosthodontics

Bonding Protocols for Indirect All-Ceramic Restorations

Silica based ceramics (feldspathic, leucite-reinforced, lithium disilicate):

  1. Try-in restoration. Adjust as needed
  2. Hydrofluoric-acid etching
  3. Silane coupling agent
  4. Composite resin


Non-silica-based (alumina and zirconia):

Adequate resistance and retention form?

  • 10-20 deg. TOC
  • Minimal OC height = 4 mm for molars
  • Minimal OC Height = 3 mm for all other teeth
  • OC-FL dimension ratio of 0.4 or greater



Standard Cementation Protocol using:

  • Self-adhesive resin cement
  • Resin-modified glass-ionomer


APC Protocol:

  1. Try-in restoration adjust as needed
  2. A – Air-particle abrasion using 50-micron aluminum oxide at 2-bar
  3. P – Phosphate monomer (MDP) air dry
  4. C – Composite resin (dual or self-cure)




  • Goodacre CJ, Campagni WV, Aquilino SA. Tooth preparations for complete crowns: An art form based on scientific principles. J Prosthet Dent 2001;85:363-376.
  • Blatz MB, Alvarez M, Sawyer K, Brindis M. How to Bond Zirconia: The APC Concept. Compend 2016;37(9):611-618.
  • Sulaiman TA, Altak A, Awab A, Rodgers B, Lawson N. Cleaning Zirconia Surface Prior to Bonding: A Comparative Study of Different Methods and Solutions. J Prosthodont 2022;3:239-244.
  • Malament KA, Margvelashvili-Malament M, Natto ZS et al. Comparison of 16.9-year survival of pressed acid etched e.max lithium disilicate class ceramic complete and partial coverage restorations in posterior teeth: Performance and outcomes as a function of tooth position, age, sex, and thickness of ceramic material. J Prosthet Dent 2020; In press.