Immediate Dentin Sealing in Indirect Restorations: Biological Rationale, Clinical Protocol, and Contemporary Evidence

Immediate dentin sealing (IDS) is a newly developed adhesive procedure that involves sealing of freshly exposed dentin's surface immediately after preparation and before fabrication and placement of an indirect restoration. Nowadays, the technique has become more and more popular in modern adhesive dentistry, which attempts to achieve optimum dentin bonding in ideal clinical conditions. IDS promotes hybrid layer formation and, when applied before provisionalization, may enhance the quality and longevity of the dentin-resin bond. The current evidence suggests that IDS can improve the bond between dentin and indirect restorations and may help to decrease dentin hypersensitivity after restoration placement. A sealed dentin surface can also offer protection against contamination by bacteria, mechanical irritations, and other conditions that may be met during the provisional phase. Also, IDS can help with better adaptation of indirect restorations and more predictable resin cementation by maintaining the integrity of the adhesive interface. Clinical issues, such as choosing an adhesive system, handling an oxygen-inhibited layer, ensuring proper polymerization, and avoiding buildup of too much adhesive, are critical in order to have predictable results. While there are differences in clinical protocols and long-term evidence is somewhat mixed, the available literature is encouraging IDS as a biologically valid and clinically viable approach for indirect adhesive restorations. In conclusion, IDS is a useful tool in current restorative dentistry, especially when achieving high dentin bond strength, reducing post-preparation sensitivity, and preserving the intact dentin surface is paramount.