IMMEDIATE DENTIN SEALING (IDS) FOR SHORT CLINICAL CROWNS: 12-MONTH RANDOMIZED CLINICAL TRIAL OF DEBONDING INCIDENCE, FUNCTION, AND SYMPTOMS VS CONVENTIONAL SELF-ADHESIVE CEMENTATION
IMMEDIATE DENTIN SEALING (IDS) FOR SHORT CLINICAL CROWNS: 12-MONTH RANDOMIZED CLINICAL TRIAL OF DEBONDING INCIDENCE, FUNCTION, AND SYMPTOMS VS CONVENTIONAL SELF-ADHESIVE CEMENTATION
Objective:This randomized clinical trial aimed to assess the clinical performance of Immediate Dentin Sealing (IDS)
compared to conventional self-adhesive cementation in restoring short clinical crowns with monolithic zirconia. The
study evaluated retention (debonding incidence and timing), functional outcomes (bite force, masticatory efficiency),
patient-reported sensitivity, clinical workflow (cement cleanup time), and overall satisfaction over 12 months.
Materials and Methods: Fifty patients with short clinical crown height (2.0–3.5 mm) were randomized into two groups: IDS (n=25) and control (n=25). All restorations used standardized monolithic zirconia crowns and CAD/CAM protocols.
IDS was performed using a three-step etch-and-rinse adhesive, while the control group received conventional selfadhesive cementation. Outcomes included time-to-debond (assessed via Kaplan-Meier survival analysis and Cox
regression), postoperative sensitivity (VAS), bite force, masticatory efficiency (ΔE* color mixing), cement cleanup time, and patient satisfaction. Welch’s t-tests and Fisher’s Exact Tests were used where appropriate; statistical significance was set at p < 0.05.
Results: Debonding incidence was lower in the IDS group (8%) than controls (24%), though not statistically significant (p = 0.2381). However, mean time-to-debond was significantly longer in the IDS group (90.5 vs. 58.7 days; p = 0.0412).
Postoperative sensitivity scores were significantly lower in the IDS group at both 1 week (p = 0.0016) and 1 month (p = 0.0001). Masticatory efficiency, measured via ΔE*, was significantly higher at all time points (1, 6, and 12 months; p < 0.01). Bite force increased over time in both groups, favoring IDS numerically but not statistically. Cement cleanup was significantly faster with IDS (p < 0.0001), and patient satisfaction scores were consistently higher (p < 0.01).
Conclusion: IDS offers superior clinical outcomes in restoring short clinical crowns, enhancing bond durability, reducing postoperative sensitivity, improving chewing efficiency, and expediting clinical workflow. These findings support the integration of IDS as a routine procedure in adhesive restorations for compromised abutments.
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