In vitro study demonstrates increased pull-out retentive force in glass-infiltrated pediatric zirconia crowns, suggesting improved cement retention for primary tooth restorations.
Background Prefabricated zirconia crowns are increasingly used in pediatric dentistry, but reliable cement retention remains challenging. Glass infiltration may create an etchable, silica-containing internal surface when combined with appropriate conditioning procedures; however, its effect on crown retention remains unclear. This study compared the pull-out retentive force of three pediatric zirconia crown and surface-treatment protocols. Methods Twenty-four specimens were allocated equally into three groups ( n = 8 per group) according to crown type and internal surface protocol: Kids Zirconia Crown (Shinhung, Seoul, South Korea) with no additional surface pretreatment (KZC), KKU KidCrown (Khon Kaen University, Khon Kaen, Thailand) without glass infiltration and treated with 50 μm Al₂O₃ airborne-particle abrasion (KKC-NG), and glass-infiltrated KKU KidCrown treated with 9.5% hydrofluoric acid etching for 60 s followed by ceramic primer application (KKC-GI). Standardized 3D-printed resin abutments simulating primary maxillary right central incisors were used for cementation. All crowns were cemented with self-adhesive resin cement, stored for 24 h, and tested using a universal testing machine at a crosshead speed of 1.0 mm/min until crown dislodgement. Pull-out retentive force was recorded in newtons and analyzed using one-way ANOVA followed by Tukey’s post-hoc test (α = 0.05). After pull-out testing, one specimen from each group was examined stereomicroscopically to qualitatively assess the failure mode. Results Mean retentive force differed among protocols (F(2, 21) = 6.95, p = 0.005). KKC-GI showed the highest value (216.51 ± 40.84 N) and was significantly higher than KKC-NG (136.91 ± 66.52 N; p = 0.012) and KZC (134.44 ± 37.81 N; p = 0.010); KKC-NG and KZC did not differ ( p = 0.995). Stereomicroscopic examination of the specimen from each group showed mixed adhesive and cohesive failure features. Conclusions Within the limitations of this in vitro study, the KKC-GI protocol, which incorporated glass infiltration followed by hydrofluoric acid etching and ceramic primer application, demonstrated the highest immediate pull-out retentive force among the tested protocols. These findings suggest that, under controlled laboratory conditions, this combined surface-treatment protocol may enhance the initial retention of pediatric zirconia crowns and provide a rationale for further clinical validation.
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