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Background Immediate Dentin Sealing (IDS) is a technique that applies an adhesive layer immediately after tooth preparation, prior to the placement of indirect restorations. This method is gaining attention due to its potential to improve the bond strength and mechanical properties of restorations, particularly in the posterior region where restorations endure significant masticatory forces. The objectif of this systematic review and meta-analysis is to evaluate the effect of IDS on the fracture strength of indirect posterior restorations. Methods Following PRISMA guidelines, a comprehensive literature search was conducted in four databases: Web of Science, Scopus, Cochrane Library, and PubMed. Inclusion criteria focused on in vitro studies involving human teeth with indirect posterior restorations, published between 2014 and 2023. Studies using IDS were compared to those using conventional methods. The risk of bias was assessed using the Cochrane Collaboration’s tool, and a meta-analysis was performed with a random-effects model. The standard mean difference and 95% confidence intervals were calculated to compare fracture strength, with I 2 statistics assessing heterogeneity. Forest and funnel plots were employed to visualize results and publication bias, respectively. Discussion The results indicate that IDS generally enhances the fracture strength of indirect posterior restorations, particularly with ceramic materials like lithium disilicate. However, the effectiveness of IDS varies depending on the material and restoration type. While some studies demonstrated improved fracture resistance with IDS, others showed minimal benefit, especially with composite restorations. Additionally, IDS improved marginal adaptation and internal fit but increased the risk of severe failures, such as root fractures. Systematic review registration PROSPERO: CRD42024584545 (Registered on 08/09/2024).

This study aimed to evaluate the effect of try-in paste contamination on the bond strength of lithium disilicate glass–ceramic to dentin treated with immediate (IDS) or delayed (DDS) dentin sealing techniques. Occlusal halves of 33 molars were decapitated and divided into three groups (n = 10). Lithium disilicate discs (3 × 5 mm) were prepared. For Group A, the provisional crown was applied over dentin and was soaked in distilled water. Lithium disilicate discs were cemented following dentin conditioning with a three-step etch and rinse adhesive. In Group B (IDS), the three-step adhesive was applied to dentin. The dentin surfaces were conditioned only in the final cementation for Group C (DDS). The intaglio surfaces of test groups were contaminated with try-in paste. All specimens were thermally cycled 3000 times at 5–55 °C and were subjected to shear tests. An additional three specimens for each group were contaminated with try-in paste and subjected to the same surface cleaning as the test specimens were examined with SEM/EDS. The adhesive surfaces were also examined with SEM/EDS for try-in paste remnants. Group C showed a significant decrease in bond strength values compared to Group B and Group A (5.84 ±1.4 MPa, 11.45 ±2.4 MPa, and 10.29 ±2.5 MPa, respectively). No statistically significant difference was detected between Group B and Group A (p ≥ 0.05). The SEM-EDS analyses revealed obstructions of the dentinal tubules in the try-in-paste-contaminated specimens. Immediate dentin sealing application enhanced the bonding strength of lithium disilicate to the try-in-paste-contaminated dentin. Try-in paste contamination over dentin negatively influenced the bonding process. [ABSTRACT FROM AUTHOR]

Compare the impact of immediate dentin sealing (IDS) application methods, various adhesive systems, and surface conditioners to the dentin bond strength. A literature search was conducted in PubMed, Cochrane, and Scopus databases for scientific articles on IDS from January 2013 to October 2022. The search strategy was based on PICOS criteria. The quality assessment tool comprised five aspects: presence of control group, standardized specimens, failure mode analysis, specification of the manufacturer details, and sample size calculation. The electronic database search yielded 639 articles and the manual search yielded 62 studies. When the duplicates were excluded, 319 records were left. After title and abstract screening, 242 records were removed, and 77 articles proceeded to full-text review. Out of the identified studies, 52 were excluded due to insufficient data, and 25 studies were included for qualitative synthesis. The authors found that all the reviewed studies had a high RoB in the aspect of sample size estimation. In general, the quality of evidence according to the RoB was considered moderate. IDS incorporation enhances the bonding efficiency of the resin restorations to the dentin. The application of an adhesive system in conjunction with a flowable resin or a three-step etch-and- rinse adhesive system increases bond strength. [ABSTRACT FROM AUTHOR]

In this study, we evaluated the effect of four different strategies for bonding a CAD/CAM resin nanoceramic restoration (Lava Ultimate, 3M) to the dentin surface using a universal adhesive (Scotch Bond Universal, 3M) and adhesive resin cement (RelyX Ultimate, 3M) on the shear bond strength (SBS) and failure mode. The strategies comprised: (i) immediate sealing, immediate bonding; (ii) immediate sealing, bonding after 2 weeks with provisional restoration; (iii) immediate sealing with flowable resin composite reinforcement and bonding after 2 weeks with provisional restoration; and (iv) no immediate sealing, and bonding after 2 weeks with provisional restoration. After bonding, all the specimens were thermocycled, shear tests were performed using a universal testing machine, and failure modes were determined using stereomicroscope and scanning electron microscopy. The highest mean SBS was recorded with immediate sealing, immediate bonding strategy. Most adhesive failures with exposed dentinal tubules were noted in specimens exposed to bonding after 2 weeks with no immediate sealing, which was associated with the lowest SBS. Mixed failures predominated in all immediate dentin sealing groups. Immediate sealing with universal adhesives improves SBS, particularly in the single‐visit approach, which has shown significantly better performance, whereas the provisional phase has a negative effect. [ABSTRACT FROM AUTHOR]

Objective: The use of immediate dentin sealing (IDS) following tooth preparation for indirect restorations is well‐supported by laboratory studies. The inclusion of IDS as a mandatory clinical step, it must be firmly supported by evidence from randomized clinical trials (RCT). The objective of this study is to assess whether IDS should be added as a mandatory procedure in all indirect restorations, taking into consideration clinically significant outcomes for the patient, such as restoration longevity and hypersensitivity. Materials and Methods: A bibliographic search was carried out in the PubMed. In addition, a manual search was conducted in the references of literature reviews. Results: Data from four RCT were included. Two studies assessed preparations for full crowns, and two assessed preparations for partial restorations. Data from full crown preparations were subjected to a meta‐analysis, revealing a reduction in hypersensitivity incidence in the IDS group 1 week after restoration cementation. With respect to hypersensitivity, IDS seems to offer advantages exclusively during the provisional phase and up to 1 week following the cementation of the final restoration. One study has shown no difference on longevity. Conclusion: The use of IDS should be considered as an elective clinical step during the rehabilitation with indirect restorations. Clinical Significance: IDS is an elective clinical step that should be considered in patients and preparations with a higher risk of sensitivity between appointments. [ABSTRACT FROM AUTHOR]

Immediate dentin sealing (IDS) is a method of improving the bond strength of indirect dental restorative materials to dentin and belongs to the biomimetic protocols of contemporary dentistry. The purpose of this systematic review was to evaluate the effect of IDS on the bond strength of resin-based CAD/CAM materials to dentin. PubMed and MEDLINE, Scopus, and the Web of Science were searched by two individual researchers, namely for studies that have been published in English between 1 January 2005 and 31 December 2023 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The inclusion criteria encompassed articles related to in vitro studies, measuring the bond strength through microtensile bond strength (μ-TBS), micro-shear bond strength (μ-SBS), tensile bond strength (TBS) or shear bond strength (SBS) tests after the use of the IDS technique. The included restorative materials comprised resin-based CAD/CAM materials bonded to dentin. A total of 1821 studies were identified, of which 7 met the inclusion criteria. A meta-analysis was not deemed appropriate due to the high level of diversity inthe publications and techniques. The use of IDS yielded higher bond strength outcomesin various experimental conditions and resin-based CAD/CAM materials. Overall, IDS in CAD/CAM restorations may contribute to better clinical outcomesand improved restoration longevity due to this property. [ABSTRACT FROM AUTHOR]

Context: Seal the dentin of the pulp chamber during endodontic treatment to avoid interfering with the restorative treatment performed afterward. Aims: The aim was to evaluate the effect of three adhesive systems applied in different bonding strategies (etch-and-rinse, self-etch, and universal adhesive) and time-point application (immediately after the cavity access preparation or after endodontic obturation) on the hybrid layer formation and dentinal penetrability. Materials and Methods: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used and the time-point application: Adper Scotchbond Multi-purpose (AS), Clearfil SE (CF) and Scotchbond Universal (SU) in strategy of immediate endodontic sealing (IES) or delayed endodontic sealing (DES). In IES-AS, IES-CF, and IES-SU groups, dentin sealing was performed immediately after the cavity access, while in DES-AS, DES-CF, and DES-SU, after root canal obturation. The specimens were sectioned in the long axis, in a buccal-lingual direction, and the dentinal penetrability of the adhesive systems was evaluated using confocal microscopy images. Hybrid layer formation was analyzed by scanning electron microscopy images. Statistical Analysis Used: Dentinal penetrability data were analyzed with the ANOVA test and the Kruskal-Wallis test was performed for hybrid layer data (a = 0.05). Results: IES-CF showed the lowest dentinal penetrability (P < 0.05), while the other protocols were similar to each other (P > 0.05). No significant differences were found between groups regarding the hybrid layer formation (P > 0.05). Immediate and DES protocols do not influence the hybrid layer formation, regardless of the bond strategy used. Conclusions: Sealing the pulp chamber dentin before endodontic treatment can improve the bond strength of the final restoration but the formation of the hybrid layer was not influenced by the bond strategy. [ABSTRACT FROM AUTHOR]

The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the fracture resistance, failure modes, and reparability of molars restored with laboratory-processed resin composite (Ceramage, SHOFU Inc., Kyoto, Japan) onlays above or below the cementoenamel junction (CEJ) in the presence or absence of immediate dentin sealing (IDS). Methodology: Forty extracted sound human molars were selected and divided into four groups: 1) Below CEJ with IDS, 2) Below CEJ without IDS, 3) Above CEJ with IDS, and 4) Above CEJ without IDS. Standardized mesioocclusal (MO) onlay preparations were made with the reduction of mesiobuccal and mesio-palatinal cusps. Butt-joint preparation was used in the proximal box area extending 1 mm below the CEJ (Groups 1 and 2) or 1 mm above the CEJ (Groups 3 and 4). In Groups 1 and 3, IDS was applied immediately after tooth preparation. After cementation (Variolink N, Ivoclar Vivadent AG, Schaan, Liechtenstein), the specimens were thermally aged (20000 cycles, 5-55 ºC) and then subjected to load to failure (1 mm/min). The failure types and reparability of the onlays were recorded, and the data were analyzed using two-way ANOVA and Fisher's exact tests. Results: The restorations in Group 4 showed the highest mean fracture strength compared to Group 1 (p=0.038), Group 2 (p=0.008), and Group 3 (p=0.019). The interaction between the level of proximal extension and the presence of IDS did not influence fracture mode or reparability (p>0.05). Conclusion: No difference in the fracture strength of resin composite onlays below CEJ with or without IDS was found; however, not using IDS for resin composite onlays above CEJ appears to be preferable. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of try-in paste contamination on the bond strength of lithium disilicate glass–ceramic to dentin treated with immediate (IDS) or delayed (DDS) dentin sealing techniques. Occlusal halves of 33 molars were decapitated and divided into three groups (n = 10). Lithium disilicate discs (3 × 5 mm) were prepared. For Group A, the provisional crown was applied over dentin and was soaked in distilled water. Lithium disilicate discs were cemented following dentin conditioning with a three-step etch and rinse adhesive. In Group B (IDS), the three-step adhesive was applied to dentin. The dentin surfaces were conditioned only in the final cementation for Group C (DDS). The intaglio surfaces of test groups were contaminated with try-in paste. All specimens were thermally cycled 3000 times at 5–55 °C and were subjected to shear tests. An additional three specimens for each group were contaminated with try-in paste and subjected to the same surface cleaning as the test specimens were examined with SEM/EDS. The adhesive surfaces were also examined with SEM/EDS for try-in paste remnants. Group C showed a significant decrease in bond strength values compared to Group B and Group A (5.84 ±1.4 MPa, 11.45 ±2.4 MPa, and 10.29 ±2.5 MPa, respectively). No statistically significant difference was detected between Group B and Group A (p ≥ 0.05). The SEM-EDS analyses revealed obstructions of the dentinal tubules in the try-in-paste-contaminated specimens. Immediate dentin sealing application enhanced the bonding strength of lithium disilicate to the try-in-paste-contaminated dentin. Try-in paste contamination over dentin negatively influenced the bonding process.

Immediate dentin sealing (IDS) is a method of improving the bond strength of indirect dental restorative materials to dentin and belongs to the biomimetic protocols of contemporary dentistry. The purpose of this systematic review was to evaluate the effect of IDS on the bond strength of resin-based CAD/CAM materials to dentin. PubMed and MEDLINE, Scopus, and the Web of Science were searched by two individual researchers, namely for studies that have been published in English between 1 January 2005 and 31 December 2023 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The inclusion criteria encompassed articles related to in vitro studies, measuring the bond strength through microtensile bond strength (μ-TBS), micro-shear bond strength (μ-SBS), tensile bond strength (TBS) or shear bond strength (SBS) tests after the use of the IDS technique. The included restorative materials comprised resin-based CAD/CAM materials bonded to dentin. A total of 1821 studies were identified, of which 7 met the inclusion criteria. A meta-analysis was not deemed appropriate due to the high level of diversity inthe publications and techniques. The use of IDS yielded higher bond strength outcomesin various experimental conditions and resin-based CAD/CAM materials. Overall, IDS in CAD/CAM restorations may contribute to better clinical outcomesand improved restoration longevity due to this property.

The objective of this study was to assess the influence of immediate dentin sealing (IDS) on the fatigue behavior of laminate occlusal veneers fabricated with CAD/CAM lithium disilicate ceramic and resin composite. Forty sound human molars were prepared and randomly divided into 4 groups (n = 10): RC–IDS+ (IDS and resin composite occlusal laminate veneer); RC–IDS- (resin composite occlusal laminate veneer without IDS); LD–IDS+ (IDS and lithium disilicate laminate veneer); LD–IDS- (lithium disilicate occlusal laminate veneer without IDS). The restorations were obtained using a digital workflow. After surface conditioning and bonding, thermocycling and accelerated fatigue tests (20 Hz, 5000 cycles with an initial load of 300 N, step-size of 100 N for 10,000 cycles, up to 1000 N, and then a step-size of 50 N until failure) were conducted. Fatigue data were recorded for both outcomes (crack or fracture) and statistically analyzed. Fractographic and adhesive interface analysis were conducted. The indirect resin composite groups showed better fatigue behavior compared to lithium disilicate. IDS only had a positive effect for the survival of resin composite restorations for the 'fracture' outcome. Evident presence of micro-gaps at the adhesive interface in the LD–IDS- group could be noted. Immediate dentin sealing improved fatigue resistance behavior of resin composite occlusal veneers. However, this effect was not observed in lithium disilicate veneers. • Occlusal veneers of CAD/CAM resin composite perform better under fatigue than ceramic veneers. • IDS positively influences the fatigue behavior of resin composite occlusal laminate veneers. • IDS promotes a more homogeneous adhesive interface between the agent and dentin/restorative material. • Micro-gaps were visualized at the adhesive interface to dentin in the absence of IDS for LD restorations. [ABSTRACT FROM AUTHOR]

The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures.

Objectives: For a conventional indirect restoration, temporary cementation inevitably contaminated collapsed dentin collagen. The purpose of this review was to evaluate the optimal strategy for minimizing its negative effects. Material and methods: Databases such as PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for in vitro studies, involving the influence of immediate dentin sealing (IDS), different temporary cements, and their removal strategies on dentin bond strength. The meta-analysis used the inverse variance method with effect method of the standardized mean difference and statistical significance at p ≤ 0.05. The I2 value and the Q-test were used to assess the heterogeneity. Results: A total of 14 in vitro trials were subjected to the meta-analysis. Within the study's limitations, we assumed that IDS eliminated the negative effects of temporary bonding, achieving the comparable immediate bond strength with the control (p = 0.46). In contrast, under delayed dentin sealing (DDS), temporary cementation statistically decreased bond strength (p = 0.002). Compared with resin-based and non-eugenol zinc oxide cements, polycarboxylate and calcium hydroxide cements performed better on bond strength with no statistical difference from the control group (p > 0.05). Among the removal methods of temporary cements, the Al2O3 abrasion restored the decreased bond strength (p = 0.07) and performed better than hand instruments alone (p = 0.04), while pumice removal slightly reduced the bond strength in contrast with the control group (p = 0.05, 95% CI = − 1.62 to 0). Conclusions: The choices of IDS, polycarboxylate and calcium hydroxide temporary cements, Al2O3 abrasion removal method were feasible and efficient to enhance the bond strength. Clinical relevance: It is worthwhile applying IDS technique, polycarboxylate and calcium hydroxide temporary cements during indirect restoration. The Al2O3 abrasion of cleaning dentin can minimize the negative effects of temporary cement. [ABSTRACT FROM AUTHOR]

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This study aimed to use quantitative and qualitative evaluations based on micro-tensile bond strength (μTBS) to clarify the appropriate immediate dentin sealing (IDS) approach for improving the bonding of CAD/CAM ceramic crown restorations. Forty-eight extracted human molars were prepared to obtain standardized abutment specimens and divided into three groups: no IDS (group C: control), IDS performed by a single application of an all-in-one adhesive system (group A), and IDS performed by the combined application of an adhesive system and a flowable resin composite (group F). All specimens were restored with a ceramic crown fabricated by a chair-side CAD/CAM system and were divided into no-stress and stressed groups. After cyclic loading (78.5 N; total, 3 × 105 cycles; 90 cycles/min) on the specimens in the stressed group, all specimens were sectioned. The μTBS values for the occlusal and mesioaxial walls were measured (n = 16) and analyzed statistically. The quantitative bonding performance of groups A and F were superior to that of group C, regardless of the cyclic loading and abutment wall conditions. Group F showed the maximum bond strength and the highest bond durability in the qualitative bonding performance even under the cyclic loading condition simulating clinical mastication. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of the (undergraduate) operator on the survival and success rate of posterior partial lithium disilicate restorations., Materials and Methods: Patients who received at least one posterior partial lithium disilicate restoration between 2009-2019 by undergraduates at the Center for Dentistry and Oral Hygiene in Groningen were included. Operator- (academic year (4 th , 5 th , 6 th year)), patient- (presence of a nightguard, caries risk, age), tooth- (endodontic status, inlay/onlay, position of the restoration outline) and technique-related factors (cement type, rubber dam use, Immediate Dentin Sealing) on the survival and success rate were analyzed using multilevel Cox regression (p < 0.05)., Results: In total, 637 restorations were placed in 373 patients. On the level of survival, 100 restorations failed during the observation period (median follow-up: 70 months, interquartile range 48-99 months): 26 extractions, 61 restoration replacements and 13 biological complications. The overall 5- and 10-year cumulative survival rates were 89.1% (95% CI: 86.5%-91.7%) and 77.6% (95% CI: 73.1%-82.5%) respectively. Multilevel Cox regression showed a medium to high caries risk (HR: 1.57; 95% CI: 1.21-2.04) and an approximal outline located within 3 mm of the bone (HR: 1.52; 95% CI: 1.05-2.22) as significant risk factors for failure. The academic year had no statistically significant effect., Conclusion: The 10-year survival and success of lithium disilicate posterior partial indirect restorations placed by undergraduates was not significantly affected by the academic year of the operator., Clinical Significance: When a clear treatment protocol is followed, patient and tooth related factors rather than academic year of the operator appear to have a significant influence on the quality of posterior partial lithium disilicate restorations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

This study evaluated the effects of immediate dentin sealing (IDS) using different universal adhesives on microtensile bond strength (μTBS) of pretreated monolithic translucent tetragonal polycrystalline zirconia-based CAD/CAM restoration to dentin and microscopic morphological alterations. Mid-coronal dentin were obtained from 32 human molars and randomly allocated into 8 groups according to the presence/absence of IDS, universal adhesives for IDS (Single Bond Universal/SBU, Clearfil Quick Bond/CUQ, Optibond Universal/OBU) and zirconia surface pretreatments (tribochemical silica coating-30 μm CoJet particles/TSC, sandblasting-50 μm Al 2 O 3 /SB): Group TSC, Group TSC+SBU, Group TSC+CUQ, Group TSC+OBU, Group SB, Group SB+SBU, Group SB+CUQ, Group SB+OBU. CAD/CAM restorations (Lava Plus High Translucency Zirconia Disc) were produced, luted, and subjected to 10.000 thermocycles (5°C-55°C). Zirconia-dentin bars (2 × 2 × 8 mm) were subjected to μTBS test (n = 16). Surface morphology of zirconia and zirconia-dentin interfaces were analyzed under SEM (n = 1). Two-way ANOVA and Bonferroni tests were used for statistical analyses (p < 0.05). Regarding the presence of IDS, Group TSC + OBU showed statistically higher μTBS than Group TSC (p < 0.05). Comparing the IDS applied groups, Group TSC+OBU and Group SB+OBU showed statistically higher μTBS than Group TSC+CUQ and Group SB+CUQ, respectively (p < 0.05). According to the surface pretreatments, no significant differences in μTBS were found (p > 0.05). A thick, intact hybrid layer with long resin tags were observed for Group TSC+OBU and Group SB+OBU. After tribochemical silica coating or sandblasting pretreatments of monolithic zirconia, IDS procedure with Optibond Universal could affect the bond strength to dentin and morphological appearance, positively., (© 2024 Wiley Periodicals LLC.)

The application of resin adhesive to freshly cut dentin after teeth preparation, the so-called immediate dentin sealing (IDS) has been suggested as an alternative to the delayed dentin sealing (DDS), a technique in which resin adhesive is applied just before final bonding of indirect restorations.The aim of this review is to demonstrate the evidence of the claimed advantages made by the proponents of IDS technique.The results of this review revealed substantial in-vitro evidence supporting the IDS benefits including improved bond strength, reduced dentin permeability, improved restorations’ adaptation, and increased fracture strength of the restorations. Clinical studies have shown that IDS improves survival of ceramic laminate veneers bonded to prepared teeth with increased exposure of dentin. Moreover, it has been shown that IDS reduces post-cementation hypersensitivity in full coverage restorations, which is characterized by exposure of a large number of dentinal tubules. The selection of filled resin adhesive that is capable of producing thick adhesive layer appears to contribute to the success of the technique. Furthermore, careful management of the oxygen inhibition layer before conventional impression making and proper cleaning of the residual temporary cement used with provisional restorations appears to affect the outcome of the restorations.

Providing a long-term survival both for dental tissue and bonding restoration is one of the current therapeutic objectives. Objective. To use a combined technique of immediate dentin sealing (IDS) to a freshly cut dentin and indirect bonding restoration. Material and methods. Vital lateral teeth with extensive coronary destruction, with incorrectly adapted amalgam/composite fillings and deficient occlusal morphology were treated by applying IDS and all-ceramic onlay. Discussion. The clinical-technological algorithm used in our clinical cases is well-known and included tooth preparations, impression making, provisionalization, laboratory fabrication and adhesive cementation. In all cases, the vitality of the teeth was preserved and there were no signs of hypersensitivity in the near future after the final fixing of the all-ceramic onlay. Conclusions. The association of the IDS technique with indirect bonding onlay in the treatment of extensive coronary lesions of the molars allows preservation of their vitality, ensures their increased resistance over time, preservation of a stable occlusion and even periodontal protection by precise rendering of the crown morphology, occlusal and interproximal contacts.

Background/purpose: Ceramic restorations have been increasingly applied over recent years. But the performance of cement is still unknown after cementation. This study was aimed to compare the compressive strength and the performances of three different types of composite resin after lithium disilicate inlay cementation. Materials and methods: Twenty-four human maxillary premolars were embedded in resin blocks, finished a MOD inlay preparation and scanned with an extraoral scanner. Lithium disilicate ceramic inlays (IPS e.max, Ivoclar Vivadent, Liechtenstein) were fabricated according to the scanner's model. All the specimens were then etched, bonded, and cemented with three different composite resins. Right after 5000 thermal cyclings, the specimens were accepted compressive tests to evaluate the compressive strength and failure types. Moreover, the fracture fragments of the specimens were examined using scanning electron microscopy (SEM) to verify the fracture type. Results: Dual-cured resin cement (Rely X Ultimate) showed the highest compressive strength (1002 ± 508 N), followed by the light-cured flowable resin (Z350 XT) (971 ± 209 N) and light-cured bulkfill (Filtek Bulkfill) resin (581 ± 191 N). Type IV (root fracture) failures in the dual-cured resin cement group was 25%, and light-cured flowable resin was 37.5%. But none of type IV fracture was found in the light-cured bulkfill flowable group. Conclusion: Dual-cured resin cement demonstrates the highest compressive strength after ceramic inlay cementation. Light-cured bulkfill resin shows the lowest compressive strength, but catastrophic failure is absent in this group.

OBJECTIVES: The objective of this study was to observe and to measure the impact of corundum sandblasting on the thickness of the Immediate dentin sealing layer. METHODS: 20 recently extracted molars were collected and divided randomly into two groups. A standardized preparation was performed on each tooth and the Optibond FL dentin bonding agent (Kerr, Orange, USA) was applied on the prepared surface according to the manufacturer 's instructions. The surface was then partially sandblasted. RONDOflex plus 360 (KaVo, Bieberach an der Riss, Germany) and Airsonic Mini-Sandblaster (Hager&Werken, Duisburg, Germany) were used. Microscope observations were made. RESULTS: The arithmetic mean of the Optibond FL dentin bonding agent film thickness was 48.72 μm (Group 1=45.55 μm and Group 2=51.88 μm). The dentin bonding agent layer thickness was reduced to the average value of 17,12 μm by RONDOflex plus 360 sandblasting (Group 1). The zero value was recorded in 16 % of the locations. The Airsonic Mini-Sandblaster sandblasting changed the average thickness of the dentin bonding agent layer to 13.25 μm with 31 % of zero values (Group 2). CONCLUSION: The results of this research lead to a reflection on modifications of the immediate dentin sealing procedure (Tab. 4, Fig. 3, Ref. 28). [ABSTRACT FROM AUTHOR]

Objective: This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and clinical performance of indirect restorations. Materials and methods: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta‐analyses statement, and was guided by the PICOS strategy. Clinical trials in which adult patients received at least one indirect restoration cemented with IDS approach and one restoration cemented following the delayed dentin sealing (DDS) were considered. Results: Following title screening and full‐text reading, four studies met the inclusion criteria and were included for qualitative synthesis, while two studies were selected for quantitative synthesis. According to Risk of bias‐2 tool, two studies were classified as "some concerns" for the outcome POS. No statistically significant differences were found between teeth restored with indirect restorations using the IDS and DDS approach for POS (p > 0.05), neither at the baseline (very low certainty of evidence according to GRADE) nor after 2 years of follow‐up (low certainty of evidence according to GRADE). Conclusion: There is low‐certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations. Clinical significance: There is no clinical evidence to favor IDS over DDS when restoring teeth with indirect restorations. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the accelerated fatigue resistance of thick CAD/CAM composite resin overlays luted with three different bonding methods. Materials and Methods: Forty-five sound human second mandibular molars were organized and distributed into three experimental groups. All teeth were restored with a 5-mm-thick CAD/CAM composite resin overlay. Group A: immediate dentin sealing (IDS) with Optibond FL and luted with light-polymerizing composite (Herculite XRV). Group B: IDS with Optibond FL and luted with dual-polymerizing composite (Nexus 3). Group C: direct luting with Optibond FL and dual-polymerizing composite (Nexus 3). Masticatory forces at a frequency of 5 Hz were simulated using closed-loop servo-hydraulics and forces starting with a load of 200 N for 5000 cycles, followed by steps of 400, 600, 800, 1000, 1200 and 1400 N for a maximum of 30,000 cycles. Each step was applied through a flat steel cylinder at a 45-degree angle under submerged conditions. Results: The fatigue test generated one failure in group A, three failures in group B, and no failures in group C. The survival table analysis for the fatigue test did not demonstrate any significant difference between the groups (p = 0.154). The specimens that survived the fatigue test were set up for the load-to-failure test with a limit of 4600 N. The survival table analysis for the load-to-failure test demonstrates an average failure load of 3495.20 N with survival of four specimens in group A, an average failure load of 4103.60 N with survival of six specimens in group B, and an average failure load of 4075.33 N with survival of nine specimens in group C. Pairwise comparisons revealed no significant differences (p < 0.016 after Bonferroni correction). Conclusion: Within the limitations of this in vitro study, it can be concluded that although the dual-polymerizing luting material seems to provide better results under extreme conditions, light-polymerizing luting composites in combination with IDS are not contraindicated with thick restorations. [ABSTRACT FROM AUTHOR]

Preserving tooth structure has been for long the concern of most dentists; a full coverage crown is often needed in severely destructed teeth which in fact lead to further destruction of tooth structure. With the development of minimal invasive dentistry and the urge to preserve rather than to consume, along with the development of new bonding systems, mechanically retained full coverage crowns can be replaced with partial coverage onlays and overlays which depends completely on adhesion. In this article we have a case report about both onlay and overlay. [ABSTRACT FROM AUTHOR]

The purpose of this in vitro study was to evaluate the effect of immediate dentin sealing (IDS) with and without chlorhexidine (CHX) pretreatment on the shear bond strength (SBS) of dual-cure adhesive resin cement. Mid-coronal dentin surfaces were obtained from 75 human molars. They were randomly allocated into five groups in accordance to type of IDS [etch&rinse/ER (Adper Single Bond2) and universal/U adhesive systems (Single Bond Universal)] and presence of CHX application (n = 15): Group ER; Group ER + CHX; Group U; Group U + CHX; and Group C (no IDS). Dualcure adhesive resin cements were bonded with a cylinder-shaped Teflon mold. The SBS was measured using a universal test machine. Fracture type was evaluated with stereomicroscope. The resin/dentin interfaces were examined with an environmental scanning electron microscope. Data were statistically analyzed with two-way analysis of variance and Bonferroni tests (p < .05). Regarding the IDS treatment groups with/without CHX, there were no significant differences in SBS (p > .05). Group U + CHX showed significantly higher SBS than Group C (p < .05). Regarding the presence of CHX, no significant differences in SBS were found (p > .05). The prevalent failure mode was the mixed type for most of the groups. Group C exhibited an intact and regular hybrid layer with no resin tag, whereas longer and clear resin-tag formation was visible for Group U + CHX. CHX pretreatment improved the bond strength between adhesive resin cement and dentin when IDS treatment was performed with a universal adhesive system. [ABSTRACT FROM AUTHOR]

The application of resin adhesive to freshly cut dentin after teeth preparation, the so-called immediate dentin sealing (IDS) has been suggested as an alternative to the delayed dentin sealing (DDS), a technique in which resin adhesive is applied just before final bonding of indirect restorations. The aim of this review is to demonstrate the evidence of the claimed advantages made by the proponents of IDS technique. The results of this review revealed substantial in-vitro evidence supporting the IDS benefits including improved bond strength, reduced dentin permeability, improved restorations' adaptation, and increased fracture strength of the restorations. Clinical studies have shown that IDS improves survival of ceramic laminate veneers bonded to prepared teeth with increased exposure of dentin. Moreover, it has been shown that IDS reduces post-cementation hypersensitivity in full coverage restorations, which is characterized by exposure of a large number of dentinal tubules. The selection of filled resin adhesive that is capable of producing thick adhesive layer appears to contribute to the success of the technique. Furthermore, careful management of the oxygen inhibition layer before conventional impression making and proper cleaning of the residual temporary cement used with provisional restorations appears to affect the outcome of the restorations. [ABSTRACT FROM AUTHOR]

Ceramic restorations have been increasingly applied over recent years. But the performance of cement is still unknown after cementation. This study was aimed to compare the compressive strength and the performances of three different types of composite resin after lithium disilicate inlay cementation. Twenty-four human maxillary premolars were embedded in resin blocks, finished a MOD inlay preparation and scanned with an extraoral scanner. Lithium disilicate ceramic inlays (IPS e.max, Ivoclar Vivadent, Liechtenstein) were fabricated according to the scanner's model. All the specimens were then etched, bonded, and cemented with three different composite resins. Right after 5000 thermal cyclings, the specimens were accepted compressive tests to evaluate the compressive strength and failure types. Moreover, the fracture fragments of the specimens were examined using scanning electron microscopy (SEM) to verify the fracture type. Dual-cured resin cement (Rely X Ultimate) showed the highest compressive strength (1002 ± 508 N), followed by the light-cured flowable resin (Z350 XT) (971 ± 209 N) and light-cured bulkfill (Filtek Bulkfill) resin (581 ± 191 N). Type IV (root fracture) failures in the dual-cured resin cement group was 25%, and light-cured flowable resin was 37.5%. But none of type IV fracture was found in the light-cured bulkfill flowable group. Dual-cured resin cement demonstrates the highest compressive strength after ceramic inlay cementation. Light-cured bulkfill resin shows the lowest compressive strength, but catastrophic failure is absent in this group. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical performance of partial glass-ceramic (IPS e.max Press) posterior restorations. Materials and methods: A total of 765 restorations in 158 patients were placed between 2008 and 2018 and evaluated in a prospective study during regular dental care visits between 2015 and 2018. The restorations were luted with a conventional photo-polymerized resin composite (HFO) in conjunction with an Immediate Dentin Sealing procedure (IDS). Intra-oral photographs and radiographs were made and evaluated using USPHS criteria. Results: The mean observation time was 53.3 months (range 3–113 months). Three absolute failures occurred (tooth fractures, n = 2; apical re-infection, n = 1) all leading to the loss of the restored tooth. Repairable and salvageable failures occurred in 9 teeth (endodontic complications, n = 7; secondary caries, n = 1; debonding, n = 1). The survival and success rates according to Kaplan-Meier after 5 years cumulated to 99.6% and 98.6%, respectively. Location (premolar/molar and mandibula/maxilla), pre-restorative endodontic status (vital/devitalised) and extension of the indirect ceramic restoration (number of sides and cusps involved) did not significantly affect the cumulative success rate (log rank test, p > 0.05). The condition of the vast majority of the restorations remained unaffected for 5 years. Conclusions: Partial glass-ceramic posterior restorations (pressed lithium disilicate (IPS e.max press, Ivoclar Vivadent) luted by means of a conventional photo-polymerized resin composite in conjunction with the use of an IDS procedure have an excellent medium-term prognosis. Clinical relevance: Partial glass-ceramic posterior restorations can be considered as a highly reliable treatment option. Location and extension of the restoration and pre-restorative endodontic status do not affect success rate. [ABSTRACT FROM AUTHOR]

Background: Immediate dentin sealing implies applying an adhesive system to dentin directly after tooth preparation, before impression. The technique is universal (inlays, onlays, veneers, crowns) and well documented clinically and experimentally. Different types of dentin bonding agents (DBAs) are available on the market. Major differences lie in the thickness of the hybrid layer and overlaying adhesive resin (filled vs. unfilled/lightly filled adhesives). Objective: The objective of this work is to provide precise clinical instructions and present new experimental data about the bond strength of five DBAs (Optibond FL, Scotchbond MP, Single Bond Plus, Clearfil SE Bond, and Scotchbond Universal) used conventionally (dentin sealed at the time of restoration delivery) or with immediate dentin sealing, as well as with an additional flowable resin coating. Methods: Seventy‐five human molars were selected, restored/tested according the microtensile bond strength method. Fifteen groups (n=5) were obtained from the combination of the five DBAs and three application modes: delayed dentin sealing, immediate dentin sealing and immediate dentin sealing with flowable resin coating. Results: It appears that immediate dentin sealing was confirmed to significantly improve the bond strength of all tested adhesives. The use of a flowable resin coating reinforcement after immediate dentin sealing increased the microtensile bond strength of all unfilled/lightly filled adhesives (from 233% of increase for ScotchBond MP, up to 560% for Clearfil SE Bond) and maintained the performance of the 3‐step golden standard adhesive. Optibond FL used with (52.51 MPa) or without (54.75 MPa) additional flowable resin coating and Clearfil SE Bond (45.64 MPa) used with flowable resin coating provided the best results. Clinical Significance: The original immediate dentin sealing (IDS) technique implies the use of a filled DBA. With unfilled/lightly filled adhesives, it is suggested to reinforce IDS with an additional flowable resin coating. This seems especially paramount to the performance of simplified adhesive systems to protect the thin bonding interface from oxygen inhibition and preserve IDS layer during predelivery cleaning of the preparation. The clinical reinforcement of unfilled/lightly filled IDS with flowable resin composite is encouraged for more predictable bonding. [ABSTRACT FROM AUTHOR]

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Context: Seal the dentin of the pulp chamber during endodontic treatment to avoid interfering with the restorative treatment performed afterward., Aims: The aim was to evaluate the effect of three adhesive systems applied in different bonding strategies (etch-and-rinse, self-etch, and universal adhesive) and time-point application (immediately after the cavity access preparation or after endodontic obturation) on the hybrid layer formation and dentinal penetrability., Materials and Methods: Forty-eight sound molars were randomly distributed into six groups ( n = 10) according to the adhesive system used: Forty-eight sound molars were randomly distributed into six groups ( n = 10) according to the adhesive system used and the time-point application: Adper Scotchbond Multi-purpose (AS), Clearfil SE (CF) and Scotchbond Universal (SU) in strategy of immediate endodontic sealing (IES) or delayed endodontic sealing (DES). In IES-AS, IES-CF, and IES-SU groups, dentin sealing was performed immediately after the cavity access, while in DES-AS, DES-CF, and DES-SU, after root canal obturation. The specimens were sectioned in the long axis, in a buccal-lingual direction, and the dentinal penetrability of the adhesive systems was evaluated using confocal microscopy images. Hybrid layer formation was analyzed by scanning electron microscopy images., Statistical Analysis Used: Dentinal penetrability data were analyzed with the ANOVA test and the Kruskal-Wallis test was performed for hybrid layer data (α = 0.05)., Results: IES-CF showed the lowest dentinal penetrability ( P < 0.05), while the other protocols were similar to each other ( P > 0.05). No significant differences were found between groups regarding the hybrid layer formation ( P > 0.05). Immediate and DES protocols do not influence the hybrid layer formation, regardless of the bond strategy used., Conclusions: Sealing the pulp chamber dentin before endodontic treatment can improve the bond strength of the final restoration but the formation of the hybrid layer was not influenced by the bond strategy., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Conservative Dentistry and Endodontics.)

Purpose: This observational retrospective clinical study aimed to investigate the survival and success rates of partial indirect lithium disilicate restorations with margins extending above or beyond the cementoenamel junction (CEJ)., Methods: The study included patients who underwent partial indirect lithium disilicate restorations with immediate dentin sealing (IDS) between January 2008 and October 2018. All the restorations were placed in a single general dental practice following a standardized protocol. The impact of various predictive variables on the survival rates was assessed. Moreover, modified United States Public Health Service (USPHS) criteria were used to evaluate the survival quality., Results: Totally 1146 partial indirect lithium disilicate restorations in 260 patients were evaluated over an average period of 7.5 years. The cumulative survival and success rates were 97.3% and 95.3%, respectively. Margins extending beyond the cemento-enamel junction did not increase the risk of success or survival failure (P > 0.05). Patients with a high risk of caries, male sex, or non-vital teeth had a significantly higher risk of restoration failure (P < 0.05). Restorations with longer clinical service times exhibited marginally lower clinical quality (P < 0.001)., Conclusions: Partial indirect glass-ceramic restorations demonstrated survival and success rates of 97.3% and 95.3%, respectively, over an extended period. However, a higher risk of restoration failure existed in patients with a high caries risk for (pre)molars that had undergone endodontic treatment and in males. In terms of the risk of success or survival failure, comparable results were obtained for the positions of the restoration margin in relation to the cemento-enamel junction.

Immediate dentin sealing (IDS) involves applying an adhesive system to dentin directly after tooth preparation, before impression. This was considered an alternate to delayed dentin sealing (DDS), a technique in which hybridization is performed following the provisional phase and just before the indirect restoration luting procedure. This study aimed to compare the bond strength of restorations to dentin of the IDS and the DDS techniques throughout a systematic review and meta-analysis. The following PICOS framework was used: population, indirect restorations; intervention, IDS; control, DDS; outcomes, bond strength; and study design, in vitro studies. PubMed (MedLine), The Cochrane Library, ISI Web of Science, Scielo, Scopus, and Embase were screened up to January 2022 by two reviewers (L.H. and R.B.). In vitro papers studying the bond strength to human dentin of the IDS technique compared to the DDS technique were considered. Meta-analyses were carried out by using a software program (Review Manager v5.4.1; The Cochrane Collaboration). Comparisons were made by considering the adhesive used for bonding (two-step etch-and-rinse, three step etch-and-rinse, one-step self-etch, two-step self-etch, and universal adhesives). A total of 3717 papers were retrieved in all databases. After full-text assessment, 22 potentially eligible studies were examined for qualitative analysis, leaving a total of 21 articles for the meta-analysis. For the immediate bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p < 0.001). Taking into account the subgroup analysis, it seems that the use of the IDS technique with a two-step etch-and-rinse or a one-step self-etch adhesive system does not represent any advantage over the DDS technique (p = 0.07, p = 0.15). On the other hand, for the aged bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p = 0.001). The subgroups analysis shows that this improvement is observed only when a three-step etch-and-rinse adhesive system (p < 0.001) or when a combination of an adhesive system plus a layer of flowable resin (p = 0.01) is used. The in vitro evidence suggests that the use of the IDS technique improves the bond strength of dentin to resin-based restorations regardless of the adhesive strategy used. The use of a three-step etch-and-rinse adhesive system or the combination of an adhesive system plus a layer of flowable resin seems to considerably enhance the bond strength in the long term.

Aim: The aim of this study was to compare the adhesion of glass-ceramic overlays to tooth structure, under the effect of shear forces, using different bonding systems. Materials and Methods: Thirty healthy lower third molars were selected and randomly allocated into three groups (n = 10). Group 1: overlays bonded to tooth structure using Panavia V5 with immediate dentin sealing (IDS); Group 2: overlays bonded using Panavia V5 without IDS; and Group 3: overlays bonded using heated composite combined with a bonding agent with IDS. All the restorations were made of glass-ceramic (Suprinity, Vita). The restored teeth were then stored in distilled water for 7 days and at room temperature. Shear forces were applied using a universal testing machine. Load and displacement were recorded at intervals of 0.1 s. A statistical analysis was used to compare the groups. Results: The mean resistance to fractures ± standard deviation obtained for the Groups 1, 2, and 3 was, respectively, 15.7440 ± 2.13, 12.0750 ± 1.41, and 8.33364 ± 2.85 MPa. The analysis of variance was highly significant (P < 0.001) allowing us to reject the null hypothesis of equality between the three groups. Comparisons between pairs also provided significant results. Conclusion: Bonding using Panavia V5 with IDS showed a better resistance to shear forces when compared to other bonding techniques. The application of IDS increased the adhesion.

This study examined the influences of clinical application of immediate dentin sealing (IDS) and temporary restoration (TR) on prepared abutment surfaces on the bonding of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic crown restorations after cyclic loading. Standardized abutments were prepared in 60 human mandibular premolars. Dentin surfaces of half of the specimens were sealed with adhesive and flowable composite, while those of the other half were not sealed. A half of both sealed and non-sealed specimens were restored using a temporary cement and temporary crown. Each individual CAD/CAM ceramic crown was fabricated and cemented to an individual abutment. The restored specimens were subjected to cyclic loading, and the micro tensile bond strengths (µ-TBS) were measured. IDS contributed to an increase in the bond strength, whereas TR did not affect the bond strength. IDS restoration without TR yielded the maximum bond reliability in achieve specific µ-TBS values for the restoration and ensuring durability against debonding. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of three different types of dentin protective membranes (HyC, SBU and S3) on dentin adhesive properties. Methods Fresh isolated molar teeth were collected, and smooth dentin surface was obtained after embedding, cutting and polishing. In the control group, dentin protective membrane was not applied, while the remaining three groups were coated with three different types of dentin protective membranes, and the preformed resin prosthesis was cemented with resin cement. A strip dentin-resin sample with a cross-sectional area of 0.9mm×0.9mm was obtained by a precision cutting machine. The tensile force was tested at the loading speed of 0.5mm/min with a universal testing machine until the dentin-resin strip was broken. The maximum tensile force during the loading process was automatically recorded by the computer, and the microstructure and fracture mode of the section were observed by a scanning electron microscope. Results After coating dentin protective membranes, the tensile strength of each experimental group was significantly increased compared with that of the control group (P<0.05), and the tensile strength of group HyC was significantly smaller than that of group SBU and group S3 (P<0.05). The tensile fracture mode shown by microstructure observation was mainly interfacial failure. Conclusion Different types of dentin protective membranes can increase the adhesive properties between dentin and resin prosthesis. SBU and S3 can improve the adhesion strength more significantly than HyC. [ABSTRACT FROM AUTHOR]

In this prospective clinical trial the survival, success rate and patient satisfaction of ceramic laminate veneers with special interest on existing restorations, immediate dentin sealing and endodontically treated teeth was evaluated. A total of 104 patients (mean age: 42.1 years old) received 384 feldspathic ceramic laminate veneers on maxillary anterior teeth. Veneer preparations with incisal overlap were performed using a mock up technique. Existing resin composite restorations of acceptable quality were not removed but conditioned using silica coating and silanization. Immediate dentin sealing (IDS) was applied when more than 50% of dentin was exposed during preparation. Endodontically treated teeth were not excluded. After adhesive cementation, restorations were evaluated by calibrated evaluators at baseline and final follow-up using modified USPHS criteria. 225 Laminate veneers were bonded onto teeth without existing restorations, 159 on teeth with pre-existing resin composite restorations, 87 to teeth with more than 50% of exposed dentin surface and 43 to endodontically-treated teeth. In total, 19 failures were observed in form of debonding (n = 3), fracture (n = 15) and extraction due to endodontic complications (n = 1). In teeth with more than 50% of dentin exposure, a significant increase in survival rate was observed when IDS was used (96.4% versus 81.8%). No significant difference was found between teeth with and without pre-existing composite resin restorations (84.6% versus 95.5%) or between vital and non-vital teeth (95.6% versus 88.1%). Laminate veneers luted to endontically-treated teeth had a significant mis-match in color compared to vital teeth. Patients who smoked presented with significantly more marginal discoloration, but no intervention was needed. Patients scored favorably values on the Oral Health Impact Profile questionnaire and were generally satisfied with the treatment. In this clinical trial, the ceramic laminate veneers had a relatively high survival rate. Teeth with more than 50% of dentin exposure significantly benefit from IDS. Pre-existing restorations or endodontic treatments do not have an effect on the survival rate of ceramic laminate veneers. However, smoking habits and previous endodontic treatments negatively affect the success rate due to color changes. Clinical Trial Registration Number: NCT03645551 [ABSTRACT FROM AUTHOR]

Abstract The aim of this study was to evaluate the influence of chemical and physical processes at the resin-composite and composite-cement interface as a function of the resin composite's water exposure on the bond strength (BS) between these two components. The free-radical concentration was studied using electron paramagnetic resonance (EPR), while the chemical changes at the resin composite's surface were studied using attenuated total-reflection FTIR spectroscopy (ATR-FTIR). The free-radical concentration in the studied samples dropped to 10% in 24 h, indicating that prolonged BS values do not correlate with the free-radical concentration. An alternative bonding mechanism between the resin composite and the composite cement was proposed, based on the formation of an interpenetrating polymer network (IPN) layer at the interface. As proven using ATR-FTIR spectroscopy, changes occurred at the resin composite's surface as a consequence of water exposure, comprising the diffusion of water molecules into the resin composite. These changes reduced the diffusion rate of the composite cement's phosphorus-containing monomers into the resin composite, as shown by the linescan SEM-EDS analysis of phosphorus, thus reducing the thickness of the IPN layer at the interface and consequently reducing the BS between both components. This study reveals that the concentration of free radicals at the surface of the resin composite is only relevant immediately after the polymerisation to the bond strength between the resin composite and the composite cement. Therefore, an alternative explanation is given by applying the theory of the formation of a gradient IPN at the interface between the resin composite and the adhesive cement by changes in the rate of diffusion of the adhesive cement's monomers into the resin composite as a function of the resin composite's exposure to water. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare the adhesion of glass-ceramic overlays to tooth structure, under the effect of shear forces, using different bonding systems. Materials and Methods: Thirty healthy lower third molars were selected and randomly allocated into three groups (n = 10). Group 1: overlays bonded to tooth structure using Panavia V5 with immediate dentin sealing (IDS); Group 2: overlays bonded using Panavia V5 without IDS; and Group 3: overlays bonded using heated composite combined with a bonding agent with IDS. All the restorations were made of glass-ceramic (Suprinity, Vita). The restored teeth were then stored in distilled water for 7 days and at room temperature. Shear forces were applied using a universal testing machine. Load and displacement were recorded at intervals of 0.1 s. A statistical analysis was used to compare the groups. Results: The mean resistance to fractures ± standard deviation obtained for the Groups 1, 2, and 3 was, respectively, 15.7440 ± 2.13, 12.0750 ± 1.41, and 8.33364 ± 2.85 MPa. The analysis of variance was highly significant (P < 0.001) allowing us to reject the null hypothesis of equality between the three groups. Comparisons between pairs also provided significant results. Conclusion: Bonding using Panavia V5 with IDS showed a better resistance to shear forces when compared to other bonding techniques. The application of IDS increased the adhesion. [ABSTRACT FROM AUTHOR]

This study evaluated the microshear bond strength (μSBS) of a composite resin cement to a pre-hybridized dentinal substrate exposed to two kinds of temporary materials; the influence of different cleaning techniques was investigated. Dentinal surfaces were conditioned with an etch-and-rinse adhesive system to obtain an immediately-sealed (IDS) layer. Each surface was divided into quadrants and covered (1) with an eugenol-free (NE_Group) or (2) with a resin-based provisional agent (CL_Group). After storage, the temporary cement was removed by using one of the following methods: (1) Hand-scaler [S]; (2) Alumina air-abrasion [SB]; (3) Glycine-powder air-abrasion [Gly]; (4) D-Limonene chemical solvent [Or]. A new IDS layer was then created; polyethylene tubes were placed on dentin surfaces and filled with a dual-cure resin cement. A universal testing machine was used for the μSBS tests; conditioned surfaces were analyzed at SEM. Means and SD were calculated; a two-way ANOVA (a: 0.05) was performed to detect significant differences among groups. For NE groups, mean μSBS values (MPa) were: 21.6 ± 6.6 [NE_NoT]; 20.7 ± 4.5 [NE_Or]; 20.1 ± 6.6 [NE_SB]; 19.1 ± 5.3 [NE_S]; 17.8 ± 2.2 [NE_Gly]. No significant differences were found among tested treatments within NE (p: 0.5493). For CL groups, mean μSBS values (MPa) ranged from 15.8 ± 2.8 (CL_S50) to 19.4 ± 2.9 (CL_Gly). Cleaning of the substrate with glycine air-abrasion statistically improved μSBS values with respect to aluminum-oxide (CL_SB: 15.8 ± 2.8) or scaling (CL_S: 16.0 ± 2.4). The application of the IDS technique was effective for preservation of freshly-cut dentin from adverse effects of temporary materials. Glycine air-abrasion is suggested when a temporary resin cement is adopted. [ABSTRACT FROM AUTHOR]

This study assessed the bond strength of a resin cement when Immediate Sealed Dentin (ISD) was contaminated by different temporary cements applying a microshear test. Forty-eight fragments of third molar crowns were mounted in acrylic resin and worn until the dentin was exposed. The substrates were sealed with a 3-step conventional adhesive system and divided into four groups (n=12): Control (without temporary cement) and three groups that used different temporary cements - Provy, RelyX Temp NE, and Provitemp. The temporary cements were removed after 7 days of storage. Resin cement RelyX ARC was applied to the contaminated substrates. Microshear bond strength was evaluated using a universal testing machine (0.5 mm/min). Data was analyzed with ANOVA and a Dunnett post-hoc test (p

Objectives To evaluate the efficiency of immediate dentin sealing and the effects of different bonding protocols on the fracture strength of CAD/CAM occlusal veneers bonded to exposed dentin. Methods Ninety-six extracted maxillary premolars were initially divided into three main groups with 32 specimens each: without immediate dentin sealing, immediate dentin sealing/total etching and immediate dentin sealing/selective etching. Teeth were identically prepared in the dentin to receive occlusal veneers of 0.8 mm thickness, milled from lithium disilicate ceramic blocks (IPS e.max CAD). Each main group was later subdivided, according to the pre-cementation surface etching protocol (total/selective), into two subgroups with 16 specimens each. All restorations were adhesively bonded using a resin cement (Variolink Esthetic). Half of the specimens of each subgroup were subjected to thermo-dynamic loading in a chewing simulator with 1,200,000 cycles at 10 kg load. The other half and the surviving specimens were subjected to quasi-static loading until failure. Statistical analysis was performed using three-way ANOVA and Tukey's post-hoc tests. Results All specimens except one survived the artificial aging. A significantly higher fracture strength of restorations (p ≤ 0.001) was obtained when immediate dentin sealing was followed regardless of the etching method with values ranging from a minimum of 1122 ± 336 N to a maximum of 1853 ± 333 N. Neither the pre-cementation treatment nor the artificial aging had a statistical significant effect on the fracture strength. Significance Immediate dentin sealing protocol is recommended whenever dentin is exposed during the preparation for thin glass-ceramic occlusal veneers. [ABSTRACT FROM AUTHOR]

Purpose Limited information is available on the effect of Immediate Dentin Sealing (IDS) on the fracture strength of indirect partial posterior restorations. This study evaluated the effect of IDS on the fracture strength and failure types of two indirect restorative materials. Materials and methods Standard MOD inlay preparations were made on sound molars (N=40, n=10 per group) and randomly divided into four groups to receive the inlay materials with and without the application of IDS: Group L-IDS-: Li 2 Si 2 O 5 (Lithium disilicate, IPS e.max) without IDS; Group L-IDS+: Li 2 Si 2 O 5 with IDS; Group MR-IDS-: Multiphase resin composite (MR, Lava Ultimate) without IDS; MR-IDS+: MR with IDS. Inlays made of L were etched with 5% hydrofluoric acid, and MR inlays were silica coated. After silanization, they were cemented using adhesive resin cement (Variolink Esthetic DC). The specimens were thermo-mechanically aged (1.2×10 6 cycles, 1.7 Hz, 8000 cycles, 5–55 °C) and then subjected to load to failure (1 mm/min). Failure types and locations of debondings were classified. Data were statistically analyzed using ANOVA, Mann Whitney U-test and Chi-square tests (α=0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m) and shape (0), values were calculated. Results After aging conditions, no apparent changes were observed in marginal integrity but occlusal wear facets were more common with MR than with L (p<0.001). Material type and the application of IDS significantly affected the results (p=0.013). While group L-IDS- showed the lowest mean fracture strength (1358±506 N) among all groups (p<0.05), application of IDS significantly increased the results significantly (L-IDS+: 2035±403 N) (p=0.006). MR groups with and without IDS, did not show significant difference (MR-IDS-: 1861±423, MR-IDS+: 1702±596 N) (p=0.498). When materials without IDS are compared, L showed significantly lower results than that of MR (p=0.035). With the application of IDS, no significant difference was noted between L and MR materials (p=0.160). Weibull distribution presented the highest shape (0) for L-IDS+ (5.66) compared to those of other groups (3.01–4.76). Neither the material type (p=0.830), nor the application of IDS (p=0.54) affected the severity of the failure types. In 95% of the cases, the IDS layer left adhered on the tooth surface after fracture tests. In groups where no IDS was used, resin cement remained on the tooth surface in 44% of the cases (p=0.001). No significant differences were observed between the materials with respect to cement remnants or IDS after fracture (p=0.880). The incidence of repairable failure types (83%) was more common with L than with MR (75%) material (p>0.05). Conclusion Immediate dentin sealing improves adhesion, and thereby the fracture strength of inlays made of lithium disilicate but not that multiphase resin composite. [ABSTRACT FROM AUTHOR]

To examine the bonding state of metal-free CAD/CAM onlay restorations made from two popular resin composite blocks and a typical glass-ceramic block after cyclic loading, with and without immediate dentin sealing (IDS). Standardized mesial-distal-occlusalbuccal (MODB) cavities in 24 extracted human molars were prepared. The intra-cavity dentin surfaces of half of the cavities were immediately sealed with all-in-one adhesive and flowable composite, while those of the other half were not. All cavities were scanned, from which CAD/CAM onlays were fabricated from three types of block and cemented with an adhesive resin cement system. The restored specimens were subjected to cyclic loading and the intra-cavity microtensile bond strength was measured. IDS improves not only the internal bond strength, but also the bond reliability of metal-free CAD/CAM onlay restorations. The resin composite block seems to be more effective than a typical glass-ceramic block for achieving both high bond strength and excellent bond reliability. [ABSTRACT FROM AUTHOR]

Objective: This study evaluates the effects of immediate dentin sealing (IDS) on the fracture resistance of lithium disilicate overlays using three different types of resin-luting agents (preheated composite, dual-cure adhesive resin, and flowable composite)., Materials and Methods: Forty-eight maxillary first premolars of equal size were prepared using a butt joint preparation design. The teeth were separated into two primary groups, each with 24 teeth: Group DDS - delay dentin sealing (DDS) (non-IDS) teeth were not treated. Group IDS - dentin sealing was applied immediately after teeth preparations. Each group was subsequently separated into three separate subgroups of eight teeth. Subgroups DDS+Phc and IDS+Phc - cemented with preheated composite (Enamel plus HRi, Micerium, Italy), subgroups DDS+Dcrs and IDS+Dcrs - cemented with dual-cured resin cement (RelyX Ultimate, 3M ESPE, Germany), and subgroups DDS+Fc and IDS+Fc - cemented with flowable composite (Filtek Supreme Flowable, 3M ESPE, USA). The fracture resistance of each sample was evaluated using a test of a single load till failure, which was automatically recorded in Newton by a computer-controlled universal testing system., Results: The fracture resistance of the subgroup IDS+Phc was the highest mean value, in which the overlay was cemented with preheated composite (1954 N), and the lowest mean was noted in the subgroup DDS+Fc, by which the overlay cemented with flowable composite without IDS (887 N). All IDS subgroups had a high mean fracture load. Both the Bonferroni test and the one-way ANOVA test identified a significant difference between all groups of 0.05., Conclusion: In general, teeth with IDS were stronger than teeth without IDS. When the preheated composite is used as a luting agent improves overall fracture resistance, followed by resin cement and flowable composite, respectively. However, the result showed that the ceramic overlays with and without IDS are strong enough to withstand the normal mastication force. Overlays was failed in a more catastrophic, irreparable mode of fracture than the clinical situation., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Conservative Dentistry and Endodontics.)

Purpose The aim of this article is to review available literature on the clinical procedure of immediate dentine sealing for indirect bonded restorations. Study selection More than 40 articles reporting the technique, studies, outcomes, etc. were reviewed after PUBMED/MEDLINE search, most of them addressing the specific situation of dentin bonding for indirect restorations. Results It is known that tooth preparation for indirect bonded restorations can result in significant dentin exposures. Immediate application and polymerization of the dentin bonding agent to the freshly cut dentin, prior to impression making is therefore recommended by some authors. Literature indicates that this procedure, immediate dentine sealing (IDS) , appears to achieve improved bond strength, fewer gap formations, decreased bacterial leakage, and reduces post-cementation sensitivity. This rational approach to adhesion is also reported to have a positive influence on tooth structure preservation, patient comfort, and long term survival of indirect bonded restorations. Conclusion In the extensive literature regarding advantages of using IDS technique significant differences have been shown when compared to Delayed Dentine Sealing. Although more research is required in this field, presently there are NO scientific reasons not to recommend IDS in routine practice. [ABSTRACT FROM AUTHOR]

Immediate dentin sealing (IDS) could avoid contamination of dentin from impression material and provisional cement but prior to final cementation of indirect restorations, removal of the provisional cement may damage the IDS. The objectives of this study were to investigate the effect of mechanical and air-particle cleansing protocols of provisional cement on IDS layer and subsequent adhesion of resin composite cement. The cuspal dentin surfaces of human third molars (N = 21,nquadrant = 84) were exposed by a low-speed diamond saw under water cooling and conditioned with an adhesive system based on the three-step etch and rinse technique (OptiBond FL). Provisional cement (Freegenol) was applied on each specimen. They were then randomly divided into six subgroups where the provisional cement was removed either by (1) air-borne particle abrasion with 50-μm Al2O3particles at 2 bar (AL2), (2) air-borne particle abrasion with 50-μm Al2O3particles at 3.5 bar (AL3.5), (3) air-borne particle abrasion with 30-μm SiO2particles at 2 bar (SL2), (4) air-borne particle abrasion with 30-μm SiO2particles at 3.5 bar (SL3.5), (5) prophylaxy paste (Cleanic) (PP) or (6) pumice-water slurry (PW) at 1500 rpm for 15 s. The dentin surface on each tooth was assigned to four quadrants and each quadrant received the cleansing methods in a clockwise sequence. The non-contaminated and non-cleansed teeth acted as the control (C). Two separate teeth, contaminated and cleansed according to six cleansing protocols, were allocated for scanning electron microscopy (SEM) analysis (×2000). The dentin surfaces in each quadrant received resin composite luting cement (Variolink II, Ivoclar Vivadent) incrementally in a polyethylene mould (diameter: 1 mm2; height: 4 mm) and photopolymerized. The specimens were stored in distilled water for 24 h at 37 °C until the testing procedures and then shear force was applied to the adhesive interface until failure occurred in a universal testing machine (0.5 mm/min). Microshear bond (μSBS) was calculated by dividing the maximum load (N) by the bonding surface area of the resin cement. Failure types were analysed using optical microscope and SEM. Data (MPa) were analysed using one-way ANOVA (α = 0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m) and shape (0), values were calculated. Mean μSBS results (MPa) showed a significant difference between the experimental groups (p = 0.011) and were in a descending order as follows: C (8 ± 2.3)a < AL2 (6.7 ± 2.4)b < PP (6.9 ± 2)b < PW (6.5 ± 2.1)b < AL3.5 (5.8 ± 1.1)b < SL2 (5.3 ± 1)b < SL3.5 (5.2 ± 1)b. Failure types were predominantly mixed failure type between the dentin and the adhesive resin which is a combination of adhesive and cohesive failures in the adhesive resin. Cohesive failure in the dentin was not observed in any of the groups. Weibull distribution presented lower shape (0) for C (3.9), AL2 (3.2), PP (3.5) and PW (3.6). SEM analysis showed rough surfaces especially in the air-abraded groups whereas mechanical cleansing methods presented smoother surfaces and partially covered by particle remnants all of which occluded the dentin tubuli. [ABSTRACT FROM PUBLISHER]