Department of Oral Rehabilitation, School of Dentistry, University of Anápolis, Anápolis, Brazil.
Department of Prevention and Oral Rehabilitation, School of Dentistry, University of Goiás, Goiânia, Brazil.
J Esthet Restor Dent. 2021 Jan;33(1):88-98. doi: 10.1111/jerd.12700. Epub 2021 Jan 6.
Immediate dentin sealing implies applying an adhesive system to dentin directly after tooth preparation, before impression. The technique is universal (inlays, onlays, veneers, crowns) and well documented clinically and experimentally. Different types of dentin bonding agents (DBAs) are available on the market. Major differences lie in the thickness of the hybrid layer and overlaying adhesive resin (filled vs. unfilled/lightly filled adhesives).
The objective of this work is to provide precise clinical instructions and present new experimental data about the bond strength of five DBAs (Optibond FL, Scotchbond MP, Single Bond Plus, Clearfil SE Bond, and Scotchbond Universal) used conventionally (dentin sealed at the time of restoration delivery) or with immediate dentin sealing, as well as with an additional flowable resin coating.
Seventy-five human molars were selected, restored/tested according the microtensile bond strength method. Fifteen groups (n=5) were obtained from the combination of the five DBAs and three application modes: delayed dentin sealing, immediate dentin sealing and immediate dentin sealing with flowable resin coating.
It appears that immediate dentin sealing was confirmed to significantly improve the bond strength of all tested adhesives. The use of a flowable resin coating reinforcement after immediate dentin sealing increased the microtensile bond strength of all unfilled/lightly filled adhesives (from 233% of increase for ScotchBond MP, up to 560% for Clearfil SE Bond) and maintained the performance of the 3-step golden standard adhesive. Optibond FL used with (52.51 MPa) or without (54.75 MPa) additional flowable resin coating and Clearfil SE Bond (45.64 MPa) used with flowable resin coating provided the best results.
The original immediate dentin sealing (IDS) technique implies the use of a filled DBA. With unfilled/lightly filled adhesives, it is suggested to reinforce IDS with an additional flowable resin coating. This seems especially paramount to the performance of simplified adhesive systems to protect the thin bonding interface from oxygen inhibition and preserve IDS layer during predelivery cleaning of the preparation. The clinical reinforcement of unfilled/lightly filled IDS with flowable resin composite is encouraged for more predictable bonding.
即刻牙本质封闭是指在牙体预备后、取印模前，将牙本质直接用粘接系统封闭。该技术具有普遍性（嵌体、高嵌体、贴面、全冠），并在临床和实验中有充分的记录。市场上有不同类型的牙本质粘接剂（DBA）。主要区别在于混合层的厚度和覆盖的粘接树脂（填充型与非填充/轻度填充型粘接剂）。
本研究的目的是提供精确的临床指导，并介绍五种牙本质粘接剂（Optibond FL、 Scotchbond MP、Single Bond Plus、Clearfil SE Bond 和 Scotchbond Universal）的新实验数据，这些粘接剂常规使用（修复体交付时进行牙本质封闭）或即刻牙本质封闭，以及额外的流动树脂涂层。
选择 75 颗人磨牙，根据微拉伸粘接强度法进行修复/测试。从 5 种 DBA 和 3 种应用模式（延迟牙本质封闭、即刻牙本质封闭和即刻牙本质封闭+流动树脂涂层）的组合中获得 15 个组（n=5）。
即刻牙本质封闭被证实可显著提高所有测试粘接剂的粘接强度。即刻牙本质封闭后使用流动树脂涂层增强剂可提高所有非填充/轻度填充粘接剂的微拉伸粘接强度（从 ScotchBond MP 的增加 233%，到 Clearfil SE Bond 的增加 560%），并保持 3 步金标准粘接剂的性能。Optibond FL 联合（52.51 MPa）或不联合（54.75 MPa）额外流动树脂涂层和 Clearfil SE Bond（45.64 MPa）联合流动树脂涂层提供了最佳效果。
原始的即刻牙本质封闭（IDS）技术使用填充型 DBA。对于非填充/轻度填充的粘接剂，建议使用额外的流动树脂涂层来增强 IDS。对于简化的粘接系统，这似乎尤为重要，以保护薄的粘接界面免受氧抑制，并在修复体预备的预交付清洁期间保护 IDS 层。建议在非填充/轻度填充 IDS 中使用流动树脂复合材料进行临床增强，以获得更可预测的粘接效果。
