Substantial in-vitro and emerging clinical evidence supporting immediate dentin sealing

Abstract

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.

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

“…Furthermore, the resulting hybrid layer (HL) was stable, especially when filled adhesive was applied for IDS [ 14 ]. After tooth preparation, IDS reduces the formation of microleakage between dentin surface and restoration, thus lessening bacterial contamination and pulpal sensitivity [ 15 , 47 ]. Consequently, better adaptation of the restoration to the cavity surface could be expected [ 13 ].…”

“…IDS demands hybridization of the freshly dentinal surface closely after preparing the tooth and before the luting processes [ 12 , 13 ]. This technique provides adhesion to a freshly cut and uncontaminated dentin, which is ideal for bonding [ 14 , 15 ]. In addition, the technique prevents the bacterial invasion and dentin sensitivity during the provisional phase [ 16 ].…”

Ventajas clínicas del SDI y Resin Coating en los procesos adhesivos, una nueva visión

“…Además, mejora la supervivencia de las carillas cerámicas laminadas y reduce la hipersensibilidad post cementación en restauraciones de cobertura total. El éxito del SDI está íntimamente relacionado con la correcta selección del adhesivo de resina, el manejo cuidadoso del aceite antes de la toma de impresión convencional y la buena limpieza del cemento provisional (19).…”

Effect of temporary cements and their removal methods on the bond strength of indirect restoration: a systematic review and meta-analysis

“…With the advances in adhesive technology and prosthetic material, the demand for indirect restoration is increasing with the advantages of superior aesthetic and mechanical properties over direct restoration [ 1 ]. However, during the first visit, indirect restoration involves multiple procedural steps including tooth preparation, impression making, and temporary restoration [ 2 , 3 ]. After an inevitable delay of fabricating laboratory restoration, at the second visit, the temporary restoration and cement are removed, and the final restoration is luted by a luting system [ 4 ].…”

“…In addition, various strategies for minimizing the negative effects of temporary cement have been proposed, including effective removal ways and optimal selection of temporary cements, which have been shown to affect bond strength substantially [ 2 , 5 ]. The contamination of blood or saliva could be resolved by primer re-application or water rinsing [ 10 ], but additional removal ways were required to clean temporary cement.…”