This study investigated the effects of a hydrofluoric acid (HA; solution of hydrogen fluoride [HF] in water)-based smart etching (SE) solution at an elevated temperature on yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics in terms of bond strength and morphological changes.
Eighty sintered Y-TZP specimens were prepared for shear bond strength (SBS) testing. The bonding surface of the Y-TZP specimens was treated with 37% phosphoric acid etching at 20°C–25°C, 4% HA etching at 20°C–25°C, or HA-based SE at 70°C–80°C. In all groups, zirconia primers were applied to the bonding surface of Y-TZP. For each group, 2 types of resin cement (with or without methacryloyloxydecyl dihydrogen phosphate [MDP]) were used. SBS testing was performed. Topographic changes of the etched Y-TZP surface were analyzed using scanning electron microscopy and atomic force microscopy. The results were analyzed and compared using 2-way analysis of variance.
Regardless of the type of resin cement, the highest bond strength was measured in the SE group, with significant differences compared to the other groups (
Bond strength significantly improved when a heated HA-based SE solution was applied to the Y-TZP surface, and the etched Y-TZP surface was more irregular and had higher surface roughness.
When we use the total-etch dentin adhesive system for composite resin restorations, gel or liquid acid etchant such as 37% phosphoric acid is commonly used. Thirty seven percentage phosphoric acid is very powerful erosive agent, and can cause severe harmful effects when it contacts with an oral mucosa and facial skin.
This case describes iatrogenic chemical burn on facial skin caused by phosphoric acid which was happened during composite resin restorative procedure.
Chemical burn by acid etchant can be evoked by careless handling of remnant and syringe. In order to prevent these iatrogenic injuries, we should check the complete removal of the etching agent both in intra and extra-oral environments after etching and rinsing procedure and it is necessary to use of the rubber dam or isolation instruments.
If accidental burn were occurred, immediate wash with copious water. And bring the patient to the dermatologist as soon as possible.