Abstract
ObjectiveThis 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 methodsThe 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.ResultsFollowing 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).ConclusionThere is low‐certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations.Clinical significanceThere is no clinical evidence to favor IDS over DDS when restoring teeth with indirect restorations.
Highlights
The use of advanced adhesive systems and resin cements has allowed dentists to restore posterior teeth with large defects using a minimally invasive approach, without the need to rely on retentive tooth preparation form and/or perform root canal treatment.[1]
No statistically significant differences were found between teeth restored with indirect restorations using the immediate dentin sealing (IDS) and delayed dentin sealing (DDS) approach for postoperative sensitivity (POS) (p > 0.05), neither at the baseline nor after 2 years of follow-up
There is low-certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations
Summary
The use of advanced adhesive systems and resin cements has allowed dentists to restore posterior teeth with large defects using a minimally invasive approach, without the need to rely on retentive tooth preparation form and/or perform root canal treatment.[1]. In an attempt to overcome functional and biological complications, applying a thin layer of a coating material or dentin bonding system with flowable composite resin on both enamel and dentin immediately after tooth preparation was suggested by Japanese clinicians in the early 1990s This technique is known as resin-coating technique.[10] Subsequently, Magne et al reported a similar approach, in which the application of dentin bonding agent is limited only to the exposed dentin and this approach became known as immediate dentin sealing (IDS).[11] Resin-coating technique and IDS are especially indicated to protect the pulp after preparation for indirect restoration, since pulp is indirectly exposed due to the presence of dentinal tubules, which connects it to the exposed surface. The aim of this article was to answer the following question: does IDS have an influence on POS and clinical parameters of indirect restorations? The primary outcome analyzed was POS, while the secondary outcome of interest were survival rates and clinical parameters used for assessing indirect restorations (retention, marginal adaptation/discoloration, surface texture, color, recurrent caries, anatomic shape, and pulp vitality)
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