***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The aim of this study was to evaluate the effect of different surface treatments : s and blasting , liners , and different laser irradiations on shear bond strength ( SBS ) of pre-sintered zirconia to veneer ceramic . BACKGROUND DATA The SBS between veneering porcelain and zirconium oxide ( ZrO2 ) substructure was weak . Various surface treatment methods have been suggested for zirconia to obtain high bond strength to veneering porcelain . There is no study that evaluated the bond strength between veneering porcelain and the different surface treatments on pre-sintered ZrO2 substructure . METHODS Two hundred specimens with 7 mm diameter and 3 mm height pre-sintered zirconia blocks were fabricated . Specimens were r and omly divided into 10 groups ( n=20 ) according to surface treatments applied . Group C , untreated ( Control ) ; Group E , erbium : yttrium-aluminum-garnet ( Er : YAG ) laser irradiated ; Group N , neodymium : yttrium-aluminum-garnet ( Nd : YAG ) laser irradiated ; Group SB , s and blasted ; Group L , liner applied ; Group NL , Nd : YAG laser irradiated+liner applied ; Group EL , Er : YAG laser irradiated+liner applied ; Group SN , s and blasted+Nd : YAG laser irradiated ; Group SE , s and blasted+Er : YAG laser irradiated ; and Group SL , s and blasted+liner applied . The disks were then veneered with veneering porcelain . Before the experiment , specimens were steeped in 37 ° C distilled water for 24 h. All specimens were thermocycled for 5000 cycles between 5 ° C and 55 ° C with a 30 sec dwell time . Shear bond strength test was performed at a crosshead speed of 1 mm/min . The fractured specimens were examined under a stereomicroscope to evaluate the fracture pattern . RESULTS Surface treatments significantly changing the topography of the yttrium-stabilized tetragonal zirconia ( Y-TZP ) ceramic according to scanning electron microscopic ( SEM ) images . The highest mean bond strength value was obtained in Group SE , and the lowest bond strength value was observed in NL group . Bond strength values of the other groups were similar to each other . CONCLUSIONS This study shows that s and blasting+Er : YAG , s and blasting , Er : YAG+liner , s and blasting+Nd : YAG , and Er : YAG laser treatment on pre-sintered ZrO2 substructure increased the bond strength to veneering porcelain , compared with other surface treatments . After different surface treatments , there was no difference in surface roughness of pre-sintered zirconia to compare after sintering ; sintering enhanced the bond strength within the limitations of present study OBJECTIVE This study investigated the mechanism of action at the interface between a commercially available Y-TZP  and its veneering ceramic after final firing . Particular attention was paid , from a microstructural point of view , to evaluating the effects of different surface treatments carried out on the zirconia . METHODS In total , 32 specimens of presintered zirconia Y-TZP ( LavaFrame , 3 M ESPE , Germany ) were cut with a low-speed diamond blade . The specimens were divided in two major groups , for testing after fracture or after mirror finishing , and were sintered following the manufacturer 's instructions . Each major group was then r and omly divided into four subgroups , according to using or not using the dedicated framework modifier , with or without a preliminary silica coating ( CoJet , 3 M ESPE ) . A suitable veneering ceramic was used for each group ( Lava Ceram Overlay Porcelain , 3 M ESPE ) . A detailed microstructural study of the interfaces of the zirconia-veneering ceramic was performed using a scanning electron microscope equipped with an energy-dispersive X-ray spectrometer to evaluate chemical variation at the interfaces . RESULTS When the framework modifier was not applied on the Y-TZP surface , microdetachments , porosities , and openings in the ceramic layer were observed at the interlayers . A degree of diffusion of different elements through the interfaces from both the zirconia and veneering layers was detected . CONCLUSIONS Application of the framework modifier can increase the wettability of the zirconia surfaces , allowing a continuous contact with the veneering layer . The micro- analysis performed showed the presence of a reaction area at the interface between the different material s. CLINICAL SIGNIFICANCE the increase of the wettability of the zirconia surface could improve the adhesion at interface with the veneering ceramic and reduce the clinical failure as chipping or delamination OBJECTIVES The aim of this study was to compare the effects of three different surface treatments in enhancing  porcelain zirconia bonding . METHODS Totally , 160 densely sintered zirconia specimens were prepared and r and omly divided into four study groups : control ( no treatment , Group C ) , s and blasting ( Group S ) , s and blasting followed by regeneration firing ( Group SH ) , and laser irradiation ( pulse mode ) on a CO₂ laser system ( Group L ) . After surface treatment , porcelain powders were veneered on zirconia surface . Half of the specimens in each group were evaluated without aging ( initial shear bond strength - initial SBS ) , and the other half was tested after being stored in water for one month ( aging SBS ) . X-ray diffractometry ( XRD ) was used to observe any crystallographic transformation at zirconia surface . Results were statistically analyzed using analysis of variance ( ANOVA ) and Turkey test ( = 0.05 ) . RESULTS The initial average SBS values of Group S , Group SH , and Group L were 31.3 ± 5.7 MPa , 29.2 ± 7.0 MPa and 32.1 ± 7.5 MPa , respectively . The differences among these three groups were not significant . The control group had significantly lower value , 24.8 ± 6.7 MPa , than those of Group S and Group L. Furthermore , there was no significant difference between initial and aging values in each group . XRD analysis showed that s and blasting  caused tetragonal to monoclinic phase transformation . Regeneration firing reversed such a transformation . However , crystallographic transformation could not be detected in laser treated specimens . SIGNIFICANCE Both s and blasting and laser irradiation  increased porcelain zirconia bond strength . The presented new modified laser pre-treatment might be an alternative way to s and blasting for improving zirconia/porcelain integration 
    Output:
    
Surface treatment in Y-TZP improved the values of SBS between the Y-TZP and veneer ceramic .
The associations between two or more treatments also showed positive effect on the bond strength due the cumulative effect of the treatments