The Effect of Immediate Dentin Sealing on the Marginal Adaptation and Microleakage of Indirect Restorations: A Systematic Review and Meta-Analysis

Résumé fourni par la source

INTRODUCTION AND AIMS: Despite the recognized benefits of immediate dentin sealing (IDS), its effectiveness in enhancing marginal integrity still remains uncertain. Optimal marginal adaptation and minimum microleakage are crucial factors for the long-term clinical success of an indirect restoration. This study aimed to review the literature and compare the efficacy of IDS and delayed dentin sealing (DDS) techniques in improving marginal adaptation and reducing microleakage of indirect restorations. METHODS: A comprehensive literature search was conducted through databases such as MEDLINE, Web of Science, EMBASE, and SCOPUS using keywords relevant to the PICOS model. All relevant studies published from inception till February 2025, without any language restrictions, were retrieved. In vitro studies that compared the marginal adaptation and/or microleakage of indirect bonded restorations after IDS and DDS application were eligible for inclusion. After data extraction, risk of bias assessment using the QUIN tool was performed. Random-effects meta-analyses were used to compare the amount of dye penetration and marginal gap between the two techniques. RESULTS: A total of 580 articles were initially retrieved. After removing duplicate or irrelevant studies, 60 eligible studies were selected for full-text review, and finally, 11 studies met the inclusion criteria and were included in the present systematic review. All studies were categorized to have a moderate risk of bias. According to the meta-analysis, there was no statistically significant difference between the IDS and DDS protocols regarding marginal microleakage (standardized mean difference: 0.11 and P = .806) and marginal gap formation (standardized mean difference: 0.12, P = .627) of indirect restorations. CONCLUSION: According to the current in vitro evidence, IDS did not significantly outperform DDS in reducing microleakage or improving marginal adaptation in indirect restorations. CLINICAL RELEVANCE: Clinicians may use either IDS or DDS techniques without compromising marginal sealing. Selection should be based on other factors such as bond strength requirements and clinical expertise.