Effect of proanthocyanidin mediated immediate and delayed dentin sealing on the strength of premolars restored with composite resin inlay

Abstract

Background: Immediate dentin sealing (IDS) with proanthocyanidin (PA) could be used before cementation with a self-adhesive (SA) cement. The aim of this study was to assess the effect of PA treatment on acid-etched dentin before adhesive application, in IDS and delayed dentin sealing (DDS), on the strengthening property of SA-cemented composite resin inlay in premolars. Material and Methods: Eighty-four maxillary premolars were divided into 7 groups (n=12): 1) (Intact) Sound teeth served as controls; groups 2-7) After cavity preparation and fabrication of composite resin inlay, temporary inlays were made and cemented. After one week, the inlays were removed and composite inlays were luted with a self-adhesive resin cement as follows: 2) (SA) Without dentin-pretreatment; 3) (DDS) Etch-and-rinse adhesive before the cementation; 4) (DDS/PA) PA treatment of acid-etched dentin before the adhesive, followed by the cementation; 5) (Etch/PA) PA treatment of acid-etched dentin before the cementation; 6 and 7) (IDS and IDS/PA) Application of IDS without or with PA treatment, respectively, one week before the cementation. After thermo-mechanical aging, fracture resistance (FR) was tested. Data were analyzed using one-way ANOVA and Tamhane tests (α=0.05). Results: There was a significant difference between the study groups (P < 0.001). The IDS and IDS/PA groups yielded significantly higher FR compared to the SA group (P ≤ 0.003), but the DDS, DDS/PA and Etch/PA groups did not differ from the SA group (P > 0.05). The effect of PA on FR in the IDS and DDS techniques was not significant. Conclusions: IDS with or without PA treatment considerably improved the strength of premolars with self-adhesive-cemented inlay, while the value of only IDS with PA treatment reached the level of the sound teeth.