Effect of Two Immediate Dentin Sealing Approaches on Bond Strength of Lava™ CAD/CAM Indirect Restoration

Abstract

The objective of this work was to compare the micro-tensile bond strength (µTBS) of CAD/CAM (Computer-Aided Design/ Computer-Aided Manufacturing) specimens cemented with different pairing of adhesives and resin-cements using two Immediate Dentin Dealing (IDS) approaches in comparison with Delay Dentin Sealing (DDS). Coronal dentin from 108 molars were divided into nine groups (n = 12) depending on the adhesive/resin-cement (A-C) assigned. Lava™ Ultimate (4 × 10 × 10 mm) was cemented according to different strategies: IDS1(cementation after dentin sealing), DDS (dentin sealing and cementation at 2-weeks), IDS2 (immediate dentin sealing and cementation at 2-weeks). Samples were sectioned and tested until failure to determine the µTBS. Failure mode was categorized as dentin/cement (DC), at Lava™ Ultimate/cement (LC) and hybrid (H). Kruska–Wallis and Mann–Whitney U tests and influence of the type of failure on the µTBS by survival analysis with competing risk was explored. Mostly, µTBS values were equal or higher in IDS2 than DDS. In general, A-Cs that showed higher µTBS, have high percentages of LC failure. Survival analysis with competing risk between DC + H and LC values showed that some A-Cs would significantly increase the µTBS values for IDS2. A-Cs with the highest adhesion values showed a high percentage of fractures at the LC interface, suggesting that the adhesion at the adhesive/dentin interface would be higher.

Immediate Dentin Sealing for Adhesive Cementation of Indirect Restorations: A Systematic Review and Meta-Analysis

“…Thus, a total of 22 studies were considered in the qualitative analysis. One study was excluded from the quantitative analysis because data on bond strength were not available [ 26 ], giving 21 studies considered for the meta-analysis [ 12 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

“…A meta-analysis of the 21 in vitro studies was conducted [ 12 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ], and separate analyses for immediate and aged bond strength were performed. Separate subgroups were analyzed for each aging time considering the type of adhesive used.…”

Appropriate Immediate Dentin Sealing to Improve the Bonding of CAD/CAM Ceramic Crown Restorations

“…Immediate dentin sealing (IDS) is known to be useful for improving the bonding state and reduce both gap formation and postoperative dentin sensitivity of metal-free CAD/CAM restorations [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. IDS can be performed by the single application of an all-in-one adhesive system [ 4 , 6 , 11 , 12 , 13 , 14 ] or by the combined application of both the adhesive system and a flowable resin composite [ 4 , 5 , 14 , 15 ].…”

“…Immediate dentin sealing (IDS) is known to be useful for improving the bonding state and reduce both gap formation and postoperative dentin sensitivity of metal-free CAD/CAM restorations [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. IDS can be performed by the single application of an all-in-one adhesive system [ 4 , 6 , 11 , 12 , 13 , 14 ] or by the combined application of both the adhesive system and a flowable resin composite [ 4 , 5 , 14 , 15 ]. Although IDS with an adhesive system alone has been reported to improve the bond strength of the resin cement to dentin [ 16 ], the combined approach yields improved bonding of the CAD/CAM ceramic restoration due to the stress-breaking function of the flowable resin composite [ 10 ].…”

“…Previous studies have examined the bonding performance of IDS without any stress or under thermal cycling stress conditions [ 6 , 11 , 18 , 19 ]. Only Feitosa et al [ 20 ] evaluated bonding under a cyclic loading condition.…”