Clinical Performance of Zirconia Veneers Bonded with MDP-Containing Polymeric Adhesives: A One-Year Randomized Controlled Trial

Acid-etched zirconia has emerged as a high-strength alternative to traditional glass ceramics for laminate veneers in aesthetic dentistry. This randomized, double-blind controlled clinical trial aimed to evaluate the one-year clinical performance of zirconia veneers etched with a hydrofluoric-nitric acid mixture and bonded using a 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing polymeric adhesive system, compared to lithium disilicate veneers. Fifty-two patients were treated with either translucent zirconia or lithium disilicate veneers, and restorations were bonded using light-cured resin-based adhesives. Clinical parameters, including veneer survival, esthetics, marginal adaptation, postoperative sensitivity, and periodontal health, were assessed using modified United States Public Health Service (USPHS) criteria and periodontal indexes at 2 weeks, 6 months, and 12 months. Both materials showed high survival rates with no statistically significant differences in clinical outcomes. One zirconia veneer debonded early but was successfully rebonded without fracture, while one lithium disilicate veneer fractured upon debonding. The findings support the viability of acid-etched zirconia veneers bonded with polymer-based adhesives as a durable and esthetic restorative option. The study highlights the clinical relevance of polymeric bonding systems in enhancing zirconia veneer performance and reinforces their role in modern adhesive dentistry.