Belikov Oleksandr, Roshchuk O., Belikova N., Sorokhan M., Belikova L., Bernik M., Iakimenko R., lytovchenko N.
DOI: 10.62610/RJOR.2026.3.18.1
ABSTRACT
Aim of the study To compare the performance of different adhesive fixation protocols for indirect ceramic restorations in terms of microtensile bond strength, thermal aging resistance, microleakage, failure modes, postoperative sensitivity, and 12-month clinical retention. Material and methods This combined in vitro (n = 120) and prospective clinical study (n = 80) evaluated four adhesive protocols: Group A (total-etch), Group B (universal adhesive in self-etch mode), Group C (self-adhesive resin cement), and Group D (Immediate Dentin Sealing [IDS]). Laboratory specimens underwent 10,000 thermocycles. Baseline and post-aging microtensile bond strength (µTBS), microleakage, and failure modes were assessed. Clinical retention and postoperative sensitivity were evaluated over 12 months. Statistical analysis included parametric and non-parametric tests and chi-square analysis (α = 0.05). Results Group D showed the highest baseline µTBS (41.63 ± 3.80 MPa), while Group C showed the lowest (22.18 ± 5.40 MPa). After aging, µTBS decreased significantly in all groups (p < 0.001), with reductions of 21.77%, 27.41%, 48.40%, and 22.62% in Groups A–D, respectively; differences in reduction were not significant (p = 0.291). Severe microleakage was absent in Group D, whereas Group C had the highest Score 2–3 penetration (63.3%; p < 0.001) and adhesive failures (70.0%). At 12 months, retention was 100.0%, 95.0%, 90.0%, and 80.0% in Groups D, A, B, and C, respectively (p = 0.140). Sensitivity was highest in Group A at 1 month (p < 0.001) and resolved by 6 months. Conclusions Within the study limitations, the IDS protocol was associated with the highest baseline bond strength, favorable post-aging performance, less severe microleakage, and the highest observed clinical retention. Group C showed the greatest bond-strength reduction and lowest observed retention.
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