Ayşenur Altuğ Yıldırım, Beyza Arslandaş Dinçtürk, Cemile Kedici Alp
This in vitro study evaluated the shear bond strength (SBS) of resin cement to diabetic and non-diabetic dentin following immediate dentin sealing (IDS) or conventional bonding without IDS, under two cementation protocols: immediate cementation (IC) and one-week delayed cementation (DC) after provisionalization. From a biomimetic perspective, IDS represents a tissue-preserving adhesive approach aimed at maintaining a stable resin-dentin interface; however, systemic conditions such as diabetes mellitus may alter the dentin substrate and affect adhesive performance. A total of 120 extracted human molars were divided into diabetic (n = 60) and non-diabetic (n = 60) groups, each further categorized by adhesive strategy (IDS or without IDS) and cementation protocol (IC or DC). IDS was performed using a three-step etch-and-rinse adhesive system, and cementation was completed with a dual-cure resin cement. Differences in SBS were observed between diabetic and non-diabetic dentin, adhesive strategies, and cementation protocols. Across all conditions, IDS-treated specimens exhibited higher bond strength than those without IDS, and DC resulted in lower SBS than IC in both adhesive strategies. In all subgroups, non-diabetic dentin showed greater SBS than diabetic dentin. The highest SBS was recorded in the non-diabetic IDS-IC group, whereas the lowest was observed in the diabetic without IDS-DC group. Under the tested laboratory conditions, IDS-treated groups showed higher SBS than the corresponding groups without IDS, while the immediate cementation protocol resulted in higher SBS than the delayed cementation protocol.