Immediate dentin sealing in indirect restorations of dental fractures in paediatric dentistry

AIM: At present, two different clinical procedures to ensure the adherence of indirect tooth restorations to the dental tissues are available: a traditional method based on a delayed dentin sealing (DDS) and an innovative approach that contemplates an immediate dentin sealing (IDS). In this study the authors highlight the advantages of the latter method (IDS), decribing the operating phases of this procedure used in paediatric dentistry to perform indirect restorations of dental fractures. MATERIALS AND METHODS: The operating phases of indirect composite restorations of dental fractures in paediatric patients are described, introducing an innovative procedure that recommends the immediate application of the dental adhesive (IDS) on the exposed dentin before the subsequent operating phases of tooth preparation, dental impression and adhesive cementation of the restoration. RESULTS: The immediate application of the dental adhesive (IDS) on the freshly cut exposed dentin, before taking the dental impression, protects the dental pulp from bacterial contamination and prevents post-operative sensitivity. At the same time, this procedure provides an ideal substrate for formation of a hybrid layer with excellent adhesion properties. CONCLUSION: Both methods (DDS and IDS) allow the formation of an adequate hybrid layer to seal the dentin in the interdiffusion area, although SEM images of samples treated with the two methods reveal clear ultrastructural differences between the different interfaces