http://jap.or.kr J Adv Prosthodont 2015;7:224-32 http://dx.doi.org/10.4047/jap.2015.7.3.

224

The effect of IDS (immediate dentin sealing)

on dentin bond strength under various
thermocycling periods
Richard Leesungbok1, Sang-Min Lee2, Su-Jung Park1, Suk-Won Lee1, Do Yun Lee2, Byung-Jin Im2,
Su-Jin Ahn1*
1
Department of Biomaterials & Prosthodontics, Kyung Hee University Hospital at Gangdong, School of Dentistry,
Kyung Hee University, Seoul, Republic of Korea
2
Department of Prosthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul, Republic of Korea

PURPOSE. The purpose of this study was to find out the effect of immediate dentin sealing (IDS) on bond strength
of ceramic restoration under various thermocycling periods with DBA (dentin bonding agent system).
MATERIALS AND METHODS. Fifty freshly extracted human mandibular third molars were divided into 5 groups
(1 control and 4 experimental groups) of 10 teeth. We removed enamel layer of sound teeth and embedded them
which will proceed to be IDS, using All Bond II. A thermocycling was applied to experimental groups for 1, 2, 7,
14 days respectively and was not applied to control group. IPS Empress II for ceramic was acid-etched with
ceramic etchant (9.5% HF) and silane was applied. Each ceramic disc was bonded to specimens with Duo-link,
dual curable resin cement by means of light curing for 100 seconds. After the cementation procedures, shear
bond strength measurement and SEM analysis of the fractured surface were done. The data were analyzed with a
one-way ANOVA and Tukey multiple comparison test (α=.05). RESULTS. There were no statistically significant
differences between 4 experimental groups and control group, however the mean value started to decrease in
group 7d, and group 14d showed the lowest mean bond strength in all groups. Also, group 7d and 14d showed
distinct exposed dentin and collapsed hybrid layer was observed in SEM analysis. CONCLUSION. In the present
study, it can be concluded that ceramic restorations like a laminate veneer restoration should be bonded using
resin cement within one week after IDS procedure. [ J Adv Prosthodont 2015;7:224-32]

KEY WORDS: Immediate dentin sealing; SEM analysis; Dentin bonding; Thermocycling; Ceramic restoration

Introduction Many clinical studies demonstrate excellent long-term suc-

cess of ceramic restorations. In recent year, strong ceramic
Patient expect for improved esthetics has driven the advan- cores unioning esthetic veneering porcelains have become
cement of ceramic for use with fixed partial prostheses.1 popular as all ceramic restorations which have compensated
the brittleness of porcelain and unesthetic metal substruc-
Corresponding author: ture. The clinical success of all ceramic prosthesis depends
Su-Jin Ahn
Department of Biomaterials & Prosthodontics, Kyung Hee University on a number of factors, such as composition of the ceram-
Hospital at Gangdong, School of Dentistry, Kyung Hee University, ic material and the cementation procedure.2 Hence, bond-
149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea
Tel. 82 2 440 7519: e-mail, [email protected] ing to ceramic requires strict attention to detail for optimal
Received November 25, 2014 / Last Revision March 19, 2015 / Accepted
April 2, 2015
clinical outcomes.3
A vital importance is due to the adhesive strength and
© 2015 The Korean Academy of Prosthodontics
This is an Open Access article distributed under the terms of the Creative
durability of the complex formed between the three differ-
Commons Attribution Non-Commercial License (http://creativecommons. ent components: the resin cement, the ceramic surface and
org/licenses/by-nc/3.0) which permits unrestricted non-commercial use,
distribution, and reproduction in any medium, provided the original
the tooth surface especially in anterior laminate veneers.4,5
work is properly cited. In some cases, significant amounts of exposed dentin is
usually unavoidable during the preparation of anterior
This work was supported by the Basic Science Research Program of the
National Research Foundation of Korea (NRF) funded by the Ministry of
teeth,1,6 the protection is required during the period between
Science, ICT & Future Planning (NRF-2013R1A1A1061129). preparation and cementation for prevention of post-opera-

224 pISSN 2005-7806, eISSN 2005-7814

 The effect of IDS (immediate dentin sealing) on dentin bond strength under various thermocycling periods

tive sensitivity and bacterial invasion.2 They suggested the There are no studies available concerning the dentin bond
application of the dentin bonding agent immediately after strength on exposed sealed dentin with a long delay under
tooth preparation. This new technique of dentin bonding thermocycling.
agent application prevents the bacterial invasion and dentin The aim of this study was to evaluate the effect of IDS
sensitivity during the provisional states, and the technique is on dentin bond strength of lithium disilicate ceramic (IPS
concerned with increased bond strength in vitro. 7 Magne Empress II, Ivoclar) under various thermocycling periods
(2005) also recommended application of dentin adhesive to of 1, 2, 7, 14 days.
the freshly cut dentin when a significant area of dentin has
been exposed during preparation for indirect restoration. Materials and Methods
The dentin could be sealed immediately after tooth prepa-
ration with IDS prior to impression taking.3 For tooth preparation, freshly extracted sound human man-
IDS is the application of dentin bonding agent to fresh- dibular third molars stored in solution saturated with thy-
ly cut dentin when it is exposed during tooth preparation mol were used. The midcoronal dentin surfaces were creat-
for indirect restorations. IDS protects the dentin against ed after the removal of the occlusal half of the crown
bacterial leakage and tooth sensitivity before cementation using a low-speed diamond saw (Isomet: Buehler Ltd., Lake
of final prosthesis. An advanced protocol, IDS is devised Bluff, IL, USA). Each specimen was individually secured to
to address the challenges of preparation, provisionalization, a silicon mold (diameter: 25 mm, height: 15 mm) and self-
and the final cementation of indirect restorative proce- curing polyester resin (CH-304, Aekyung Chemical Co.,
dures. The general protocol of IDS includes the use of Ltd., Seoul, Korea) was poured to create a resin-embedded
filled three-step total etch systems, two-step total-etch sys- specimen block. The surface was wet polished to create
tems, and two-step self-etch systems incorporating low elas- hybrid layer with 320, 400 and 600 grit SiC abrasive papers.
tic liners.8 Total 50 specimens were prepared. The experimental
Especially prosthodontic patients, complex inlay, onlay groups were divided into four groups (10 specimens per
and veneer situations may require longer periods with pro- group) according to the thermocycling period (1, 4, 7, 14
visional restoration until the final ceramic restoration is days). The control group consisted of 10 specimens with-
delivered. 9 The provisional restoration must protect the out thermocycling.
pulp from thermal changes as well as from invasive micro- A total of 50 ceramic discs (diameter: 4 mm, height: 2
organisms in the mouth. However, it is difficult to take- mm) of lithium disilicate ceramic (IPS Empress II ingot,
stable and sealed provisionals as they detached easily during shade A1, Ivoclar Vivadent AG, Schaan, Liechtenstein)
temporary states, allowing microleakage of bacteria and were fabricated. The surfaces were etched with 9.5% hydro-
sensitivity.10 In addition, the bond strength between resin fluoric acid (HF) (Porcelain etchant, Bisco Inc., Schaumburg,
composite and a pre-treated ceramic restoration has been IL, USA) for 90 seconds and one layer of silane coupling
described to be negatively affected by external factors such agent (Porcelain primer, Bisco Inc., Schaumburg, IL, USA)
as thermocycling, fatigue and water sorption.11 Also, cement was applied and allowed to air dry for thirty seconds at
breakdown can bring about results as microleakage, margin- room temperature. The surface treatments of the ceramic
al discoloration, debonding, secondary caries, pulpal irrita- discs were according to the manufacturer�s instruction. The
tion, and decreased fracture load.12 materials used in this study are shown in Table 1.
We pose the clinical assumption that the dentin surface For immediate dentin sealing procedure, the dentin sur-
after IDS procedure is exposed to the oral environment and face was etched with 32% phosphoric acid (H3PO4) for 15
factors that could result in fatigue may influence the physi- seconds, followed by rinsing with distilled water and air
cal and mechanical properties of dentin bond strength. drying for 5 seconds. Then, five coat of dentin bonding

Table 1. Materials used in this study

Materials Product name Composition Manufacturer

4th Generation
DBA system All Bond II Bisco Inc., Shaumburg, USA
: 3-step total etching system
Resin cement Duo-link Dual cure resin cement Bisco Inc., Shaumburg, USA
Etchant UNI-ETCH 32% Phosphoric acid (15 sec) Bisco Inc., Shaumburg, USA
Ceramic disc IPS Empress II Lithium disilicate glass-ceramic Ivoclar Vivadent AG, Schaan, Liechtenstein
Ceramic etchant Porcelain etchant 9.5% Hydrofluoric acid (90 sec) Bisco Inc., Shaumburg, USA
Silane Porcelain primer Coupling agent (30 sec) Bisco Inc., Shaumburg, USA

*DBA: Dentin Bonding Agent

The Journal of Advanced Prosthodontics 225

 J Adv Prosthodont 2015;7:224-32

primer (3-step etch-rinse adhesive system; All Bond II, ing unit, Bisco Inc., Schaumburg, IL, USA) with a light
Bisco Inc., Shaumburg, IL, USA) with a light brushing intensity of 600 mW/cm2. The light was applied for 100
motion for 30 seconds was applied to the surface and air seconds (20 seconds each from occusal, buccal, lingual,
thinning for 3 seconds. After one coat of Pre-bond resin, mesial and distal aspects).
the layer was light polymerized (VIP Junior light curing The extrusion shear bond strength test (SBST)15,16 rep-
unit, Bisco Inc., Schaumburg, IL, USA) for 20 seconds at resents a confinement situation for the composite, and the
600mW/cm2. Ceramic disc was attached with dual-cured resulting interface would be more likely to present defects
resin cement (Duo-link, Bisco Inc., Shaumburg, IL, USA) that resemble clinical conditions. After the cementation
on IDS treated dentin surface. procedures, the specimens of control group and thermocy-
After then, the specimens of experimental groups were cled groups were stored in distilled water for 24 hours at
submitted to 1500 thermal cycles between 5ºC and 55ºC 37ºC. The SBST was conducted in a universal testing
(dwell time of 30 seconds) in a thermal cycling machine machine (Instron, Shimadzu, Japan) at a crosshead speed of
(Thermocycling testing machine, CDM-127, CDM, Korea) 1.0 mm/min.
for 1, 2, 7, 14 day (group 1d, 2d, 7d, 14d) (Table 2).13,14 For the scanning electron microscopy (SEM) analysis,
Control group (0d) was not thermocycled and the speci- the dentin surfaces of specimens from each group were air
mens were stored for 14 days in deionized water at room dried and gold coated with a sputter coater (IB-3 ION
temperature. coater, Elko Co., Tokyo, Japan) and examined under scan-
Ceramic discs after surface treatment with ceramic etchant ning electron microscope (Scanning Electron Microscopy,
and silane coupling agent were cemented to the surfaces of S-2300, Hitachi, Co., Ltd., Tokyo, Japan). The specimens
specimens with or without thermocycling with dual-cured were vertically sectioned using a low-speed diamond saw
resin cement (Duo-link, Bisco Inc., Shaumburg, IL, USA) under water lubrication to observe the interface of dentin-
(Fig. 1). The excess cement was removed with a disposable resin-ceramic.
microbrush, followed by light curing (VIP Junior light cur- Bond strength values were analyzed using one-way anal-
ysis of variance and followed by Tukey’s HSD multiple
comparison tests. Statistical analysis was conducted using
SAS software version 9.1 for windows (SAS Institute Inc.,
Cary, NC, USA). The significance level for all statistical
Table 2. Experimental design and groups used in this tests was set at 0.05.
study (d; day)

Thermocycling time Group Results

0 day (immediate) 0d (control) The values of the shear bond strength recorded in debond-
1 day 1d ing force (DF) for the specimens in all groups. The mean
2 days 2d values and standard deviation of shear bond strength are
7 days 7d
shown in Fig. 2. Two thermocycled groups had lower mean
14 days 14d
values than the control group. The analysis of variance
indicated no statistically significant difference in shear bond

14d

7d
Group

2d

1d

0d

0 20 40 60 80 100 120 140

DF (N)
Fig. 2. Mean value and Standard deviation of shear bond
Fig. 1. A diagram of specimen (A: porcelain disc, B: strength (unit; N). The 1 way ANOVA showed no
polyester resin, C: lower molar with exposed dentin, a: statistical difference was found among groups, but 14d
diameter; 4 mm, b: height; 2 mm, c: diameter; 25 mm, d: group showed significantly lower mean bond strength
height; 15 mm). than the control (d; day, DF; DebondingForce).

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 The effect of IDS (immediate dentin sealing) on dentin bond strength under various thermocycling periods

strength between all groups, however the mean value start- face. Especially, group 7d and 14d (Fig. 4D, Fig. 4E),
ed to decrease in group 7d, and group 14d showed the low- showed distinct exposed dentin, which suggests adhesion
est mean bond strength in all groups. failure between dentin and adhesive.
SEM micrograph of fractured surface of dentin side In Fig. 5, adhesive-resin cement (b) was found between
after SBST (original magnification ×100) are shown in Fig. 3. ceramic disc (a) and dentin covered with adhesive (c). The
SEM analysis of fractured surface in the control group, ther- specimens of groups 0d, 1d and 2d, uniform and thin adhe-
mocycled 1d and 2d groups demonstrated mostly undam- sive-resin cement layers were observed (Fig. 5A, Fig. 5B,
aged interface of overlaying resin cement on IDS surface Fig. 5C). An almost imperceptible transition seemed to take
(Fig. 3A, Fig. 3B, Fig. 3C). It confirmed that dentin was com- place at the ceramic disc–resin cement-dentin interface,
pletely covered with dentin bonding and adhesive resin where no gap was observed despite of some stresses gener-
cement, suggesting failure was not occurred between IDS ated by thermocycling. In group 7d (Fig. 5D), as compared
surface and resin cement. At the group 7d (Fig. 3D), two dis- with above three groups, thickening and peeling of adhe-
tinct areas were observed, there were exposed IDS surface sive-resin cement layer (b) was found. In group 14d (Fig.
and resin cement. Areas with detached resin cement has 5E), partially visible discontinuity of interface and linear
increased and founded widely. As shown in the Fig. 3E, most detachment between IDS surface and resin cement was
of resin cement has been detached from IDS surface. observed.
A representative SEM images of fractured surface of In Fig. 6, adhesive-resin cement (b) was found between
dentin side after SBST (original magnification ×400) are porcelain disc (a) and dentin covered with adhesive (c).
shown in Fig. 4, and showed similar pattern to SEM views Higher magnification examination shows similar pattern to
for original magnification ×100 (Fig. 3). The specimens of SEM views for original magnification ×100. Between group
groups 0d, 1d and 2d showed very small portion of 0d (control group) and thermocycled group 1d and 2d, no
detached resin cement and there were undamaged interface differences were found between adhesive-resin cement lay-
of overlaying resin cement on IDS surface (Fig. 4A, Fig. 4B, ers (b) with regard to form and thickness (Fig. 6A, Fig. 6B,
Fig. 4C). While in group 7d (Fig. 4D), showed a mixed fail- Fig. 6C). Adhesive interface remained intact and complete
ure surface, areas with remained resin cement and exposed continuity was observed. In group 7d (Fig. 6D), perceptible
IDS surface were found at the same time. In group 14d changes appeared in adhesion interface, in group 14d (Fig.
(Fig. 4E), extensive area of IDS surface was found. Most 6E), obvious gap between adhesive-resin cement layer (b)
of resin cement has been detached from IDS surface, sug- and dentin (c) was found. It showed adhesive failure between
gesting failure between existing resin cement and IDS sur- the IDS surface and resin cement.

Fig. 3. SEM micrograph of fractured surface after SBST (original magnification ×100). (a; detached surface of resin
cement, b; resin cement) (A) Group 0d, typical SEM micrograph of fractured surface after SBST from control group. (B)
Group 1d, mostly unharmed interface of overlaying resin cement is on dentin surface. (C) Group 2d, most of exposed
dentin is covered with resin cement (b), while detached surface of resin cement (a) is found in a small portion. (D)
Group 7d, dentin surface has increased due to larger detached surface of resin cement (a). (E) Group 14d, Most of resin
cement has detached from dentin surface.

The Journal of Advanced Prosthodontics 227

 J Adv Prosthodont 2015;7:224-32

Fig. 4. SEM micrograph of fractured surface after SBST (original magnification ×400). Closer examination shows similar
pattern to SEM views for original magnification ×100. (a; detached surface of resin cement, adhesive, b; resin cement,
c; exposed dentin) (A) Group 0d, typical SEM micrograph of fractured surface after SBST from control group. (B) Group
1d, small portion of detached resin cement and unharmed interface of overlaying resin cement is on dentin surface. (C)
Group 2d, most of exposed dentin is covered with resin cement (b), while detached surface of resin cement (a) is found
in a small portion. (D) Group 7d, larger detached surface of resin cement (a) reveals adhesive. (E) Group 14d, most of
resin cement has detached from dentin surface coated by adhesive (a). Exposed dentin (c), which suggests failure in
dentin, is clearly detectable in groups 7d and 14d.

Fig. 5. SEM micrograph of cross section of bonded porcelain disc to the specimen (original magnification, ×100). (a;
porcelain disc, b; adhesive-resin cement layer, c; dentin covered with adhesive) (A) Group 0d, (B) Group 1d, (C) Group
2d. A uniform and thin adhesive-resin cement layer (b) is observed (A-C). (D) Group 7d, as compared with other groups,
thickening and peeling of adhesive-resin cement layer (b) is found. (E) Group 14d, linear discontinuity between
adhesive-resin cement layer and dentin was observed.

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 The effect of IDS (immediate dentin sealing) on dentin bond strength under various thermocycling periods

Fig. 6. SEM micrograph of cross section of bonded porcelain disc to the specimen (original magnification ×1000).
Closer examination shows similar pattern to SEM views for original magnification x100. (a; porcelain disc, b; adhesive-
resin cement layer, c; exposed dentin, d; gap) (A) Group 0d, (B) Group 1d, (C) Group 2d, there are no differences
between adhesive-resin cement layers (b) of these groups in terms of form and thickness (A-C) (D) Group 7d, perceptible
changes appeared in IDS surface, (E) Group 14d, gap (d) is clearly detectable between adhesive-resin cement layer (b)
and dentin (c).

Discussion The sequential application of silane coupling agents to

previously HF-etched ceramic surface provides a chemical
Over the past twenty years, the field of esthetic prosth- bonding. Chemical bonding of silane is shown to be in cor-
odontics has substantially expanded to satisfy the needs of relation with increased durability of long-term bond poten-
the patients.8 Bonded ceramic restorations are a predictable tial and less with immediate mechanical bond strengths.19,20
and durable treatment option to re-establish the strength The preferred procedure for predictable bonding to silica-
and function of the teeth as well as esthetic.3 Especially, the based ceramics is acid etching with HF and the subsequent
success of the ceramic veneer is highly dependent on the application of silane coupling agents. With the improve-
strength and durability of the bond formed between the ment of esthetic restoration material, newly developed resin
three different components of the bonded veneer complex, cement which can provide both mechanical and chemical
as there are; the tooth surface, the luting composite and the bonding has been introduced.13,21-23 Application of a silane
ceramic veneer.9 There have been no studies regarding the coupling agent to HF-etched ceramic surfaces provides a
dentin bond strength and SEM analysis of immediate sealed strong chemical covalent bond between the hydroxyl group
dentin that is exposed with an extended delay under ther- of silane coupling agent and that of the silica of ceramic.
mocycling. When the silane primer is applied onto the porcelain sur-
Phosphoric acid etching causes dissolution of interpris- face, two hydroxyl groups (one from and silane and one
matic material in the enamel, producing a roughened enam- from the porcelain) will react slowly while liberating a water
el surface, and forms enamel resin tags. In recent years, the molecule to form a stable siloxane. The most commonly
research of increasing the bond strength between the den- used medium and high leucite-containing feldspathic porce-
tal materials and dental hard tissues have been proceeded, lains is etched with HF and makes preferential etching of
although most adhesive systems have provided clinically the glass phase of ceramic, leaving the less soluble crystal-
acceptable bond strengths.11 Mechanical adhesion requires line phase of leucite composition. This forms microme-
roughening to create sufficient surface activation. Common chanically retentive surfaces on porcelain. The preferential
surface treatment methods include sandblasting with alumi- etching provides many hydroxyl (OH) groups that can be
na, grinding, and abrasion with diamond instrument, 10,12 coupled with silane coupling agent for improved chemical
and acid etchingwith HF solution or ammonium bifluo- bonding with resin materials.24
ride.17,18 When preparing teeth for indirect bonded restorations,

The Journal of Advanced Prosthodontics 229

 J Adv Prosthodont 2015;7:224-32

IDS with a 3-step etch-and-rinse DBA, before impression A previously placed resin matrix is naturally cohesive with
taking, leads to increased microtensile bond strength com- monomers in freshly placed composite resin.32,33 Magne et
pared to delayed dentin sealing (DDS). The failure site was al.,5 reported that the bond strength of IDS teeth was not
observed with microscope (×30) and failure mode of cem- affected by up to 12 weeks of elapsed time prior to place-
entation was determined. If the failure was occurred entire- ment of the definitive restoration.
ly between the adhesive and dentin or continued from the In this present study, there was no statistically signifi-
adhesive into either the composite resin or dentine, it was cant difference in shear bond strength between all groups.
classified as an interfacial failure. And if the failure occurred As demonstrated by the shear strength bond results, the
exclusively within the resin composite or dentin, it was clas- mean shear bond strength varied from 82.7 to 93.93 N. The
sified as a substrate failure. IDS groups showed interfacial mean value started to decrease at day 7 and markedly decreased
failure that was generally two areas as typically mixed, with at day 14. In most of the studies regarding IDS, teeth were
both areas of failed adhesive resin and areas of cohesively restored with provisional restoration material and left in
failed dentin. For DDS specimens, it was hard to decide the place for a certain period of time. However, in this study,
exact nature of interfacial failure as the similar nature of we hypothesized that all-ceramic restoration such as lami-
the filled adhesive and hybrid layer.1 Magne (2005) demon- nate veneer crown is likely to be contaminated with a wide
strated that several reasonable motives supporting IDS. variety of things including temporary cement residues, sali-
First, immediately exposed dentin after preparation has an va and bacteria. We attempt to mimic extreme clinical con-
ideal surface for dentin bonding. 1 Confoun-ding results ditions when the provisional restoration is fractured or dis-
have been reported when the shear bond strength of dentin lodged before the delivery of the final restoration. In our
bonding agents was measured on dentin that had been con- study, after immediate dentin sealing, teeth were immersed
taminated with provisional cements prior to the bonding in saline solution without provisional restoration. Thus, the
procedure.2 Freshly cut dentin exists only immediately after result of shear bond strength in this study shows difference
tooth preparation. Secondly, Precuring of the DBA results from that of previous studies.
in increased bond strength. In recent studies on bond In conventional glass-ceramic restorations for prosthe-
strength of DBA, the infiltrating resin and adhesive layer sis, the adhesive technique is crucial for successful bonding.
are generally polymerized first (precuring), before compos- Considering limited flexural strength and the brittleness of
ite resin is incremented, which represents to generate glass ceramics, final adhesive cementation with luting com-
increased bond strength. If exposed dentin is sealed with- posite resin should be used to improve the fracture resis-
out delay, the DBA being covered and cured immediately tance. In this present study, IPS Empress II was tested
after the finish of tooth preparations, before the final which is widely used as a ceramic material of laminate
impression, generated higher bond strength25-27 and fewer veneer crown. IPS Empress II (Ivoclar Vivadent, Schaan,
gap formations.28,29 Liechtenstein) is a lithium-disilicate glass ceramic (SiO2-
IDS allows stress-free dentin bond development. When Li2O) manufactured through a combination of the lost-wax
indirect bonded restorations proceeded with IDS, because and heat-compression techniques. A glass-ceramic ingot is
of postponed placement of the restoration (intrinsic to plasticized at 920ºC and pressed into an investment mold
indirect techniques), the dentin bonding strengths can be under pressure and vacuum. Its predecessor, IPS Empress
improved without stress, resulting in considerably devel- (Ivoclar Vivadent), is a leucite-reinforced glass ceramic
oped restoration adaptation. 30 In addition, IDS reduced (SiO2-Al2O3-K2O) and is restricted in use of single unit com-
bacterial infiltration and sensitivity to dentin during provi- plete-coverage crown restoration due to its limited strength.
sional restoration. Based on the fact that provisional resto- IPS Empress 2 has increased flexural strength by a factor of
rations enable bacterial leakage and dentin sensitivity, previ- 3 over IPS Empress, and enables the use of 3-unit FPDPs in
ous researcher suggested dentin sealing in crown prepara- the anterior area, and the second premolar area.34-36
tions.31 This suggestion demonstrates even more advantages One way of evaluating the physical and mechanical
when using bonded ceramic restoration (e.g., veneers) given properties of the material is to subject them to an in vitro
the specific difficulty to obtain sealed and stable provision- simulation of the aging that would occur in the medium in
als. An important element in IDS is the advancement of an which they are used, by means of anaccelerated aging test
efficient resin-to resin bond between the new luting com- by thermocycling. Chang et al.37 reported that bond strength
posite resin and the adhesive resin coating. This condition of various adhesive systems is influenced by thermocycling.
is somewhat similar to a composite resin-composite resin The adverse effect of thermal cycling on the adhesive com-
repair.5 bination can be explained by the fact that materials with
For years, many believed that an oxygen-inhibited layer different lineal thermal expansion coefficients (LTEC) also
is essential prior to bonding additional layers of composite. presented different degrees of shrinkage and expansion.
The general understanding regarding the oxygen-inhibited That process facilitates the fatigue phenomenon of the
layer has been documented. Suh32 reported that an oxygen- materials, leading to rupture of the union between them.38
inhibited layer is not necessary for bonding with composite Mechanical fatigue alone could not deteriorate the interface
resin and Papachini33 identified that oxygen inhibition layer between the cements and the ceramic materials as much as
is not crucial to the success of composite-composite bond. it could for the humid condition with the presence of stress

230
 The effect of IDS (immediate dentin sealing) on dentin bond strength under various thermocycling periods

corrosion.39 Sobrinho et al. proved a reduction in strength bonded within one week after IDS procedure.
after fatigue in a wet environment for In-Ceram and IPS
Empress ceramic in comparison to the dry condition. 40 ORCID
Considering that final restoration is delivered one or two
weeks after the tooth preparation, the specimens were sub- Richard Leesungbok http://orcid.org/0000-0002-8381-723X
mitted to thermocycling until 14 days. At the groups 1d, 2d, Sang-Min Lee http://orcid.org/0000-0002-3887-4323
7d and 14d, the specimens were thermocycled 1,500 cycles Su-Jung Park http://orcid.org/0000-0002-4111-2231
(1 day), 3,000 cycles (2 days), 10,500 cycles (7 days), 21,000 Suk-Won Lee http://orcid.org/0000-0003-2726-3567
cycles (14 days) in baths at 5C and 55C, with 30-second Do Yun Lee http://orcid.org/0000-0002-8638-7423
dwell times. The results of the present study demonstrated Byung-Jin Im http://orcid.org/0000-0001-5661-2258
that thermal cycling negatively influenced the quality of Su-Jin Ahn http://orcid.org/0000-0003-2128-1561
adhesive resistance, promoting the decrease in union values
when the number of thermal cycles was increased.14,38,41-44 References
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was appeared, and in thermocycled group 14d, distinctive Prosthodont 2010;2:77-80.
failure on IDS surface were observed. SEM analysis of 4. Xie J, Powers JM, McGuckin RS. In vitro bond strength of
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