Immediate dentin sealing of onlay preparations: thickness of pre-cured Dentin Bonding Agent and effect of surface cleaning

This study evaluated the thickness of Dentin Bonding Agent (DBA) used for "immediate dentin sealing" of onlay preparations prior to final impression making for indirect restorations. In addition, the amount of DBA that is removed when the adhesive surface is cleaned with polishing or air abrasion prior to final cementation was evaluated. For this purpose, a standardized onlay preparation was prepared in 12 extracted molars, and either OptiBond FL (Kerr) or Syntac Classic (Vivadent) was applied to half of the teeth and cured in the absence of oxygen (air blocking). Each tooth was bisected in a bucco-lingual direction into two sections, and the thickness of the DBA was measured under SEM on gold sputtered epoxy resin replicas at 11 positions. The DBA layer of each half tooth was treated with either air abrasion or polishing. The thickness of the DBAs was then re-measured on the replicas at the same positions. The results were statistically analyzed with non-parametric statistics (Mann-Whitney U test and Kruskal-Wallis test) at a confidence level of 95% (p=0.05). The film thickness of the DBA was not uniform across the adhesive interface (121.13 +/- 107.64 microm), and a great range of values was recorded (0 to 500 microm). Statistically significant differences (p<0.05) were noted, which were both material (OptiBond FL or Syntac Classic) and position (1 to 11) dependent. Syntac Classic presented a higher thickness of DBA (142.34 +/- 125.10 microm) than OptiBond FL (87.99 +/- 73.76 microm). The higher film thickness of both DBAs was at the deepest part of the isthmus (the most concave part of the preparation), while the lowest was at the line angles of the dentinal crest (the most convex part of the preparation). OptiBond FL presented a more uniform thickness around the dentinal crest of preparation; Syntac Classic pooled at the lower parts of the preparation. The amount of DBA that was removed with air abrasion or polishing was not uniform (11.94 +/- 16.46 microm), and a great range of values was recorded (0 to 145 microm). No statistically significant differences (p<0.05) were found either between different DBAs (OptiBond FL or Syntac Classic) or between different treatments (air abrasion or polishing). As far as the effect of different treatments at different positions, polishing removed more DBA from the top of the dentinal crest, but the difference was not statistically significant. Air abrasion removed less DBA from the corners of the dentinal crest (Positions 4 and 6) than the outer buccal part of the preparation (Positions 1 and 2). Neither air abrasion nor polishing removed the entire layer thickness of the DBA in the majority of the cases.