Is immediate dentin sealing a mandatory or optional clinical step for indirect restorations?

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.