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). Kruskal–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.
Highlights
In restorative dentistry, usually compromised larger posterior cavities either biomechanically or aesthetically have to be restored using partial indirect restorations and adhesive technology
The Immediate Dentin Sealing (IDS) technique consists of the application of dental bonding agent immediately after tooth preparation and before impression taking, instead of Delay Dentin Sealing (DDS) that represents a common clinical practice where the dentin adhesive is applied just before cementing the restoration in a second visit [4]
The purpose of this work was to compared the adhesion to dentine (micro-tensile bond strength) of LavaTM Ultimate CAD/CAM restorations cemented with eight universal adhesives and a three-step etch-and-rinse adhesive and their corresponding resin cements using two IDS approaches in comparison with DDS
Summary
Usually compromised larger posterior cavities either biomechanically or aesthetically have to be restored using partial indirect restorations and adhesive technology. Its clinical success depends on factors such as the composition of the indirect restoration material and the adhesive cementation procedure [1,2,3]. The Immediate Dentin Sealing (IDS) technique consists of the application of dental bonding agent immediately after tooth preparation and before impression taking, instead of Delay Dentin Sealing (DDS) that represents a common clinical practice where the dentin adhesive is applied just before cementing the restoration in a second visit [4]. Collagen of the hybrid layer is guarded against collapsing, and subsequently, the bonding procedures of indirect restorations result in higher bond strength values [5], improving marginal sealing, reducing post-cementation sensitivity, and improving cavity adaptation of indirect restoration It increases patient comfort during the provisional restoration stage with limited need for anesthesia in the cementing appointment of definitive restoration [6,7,8]
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