Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol.

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This method is gaining attention due to its potential to improve the bond strength and mechanical properties of restorations, particularly in the posterior region where restorations endure significant masticatory forces. The objective of this systematic review and meta-analysis is to evaluate the effect of IDS on the fracture strength of indirect posterior restorations. Methods Following PRISMA guidelines, a comprehensive literature search was conducted in four databases: Web of Science, Scopus, Cochrane Library, and PubMed. Inclusion criteria focused on in vitro studies involving human teeth with indirect posterior restorations, published between 2014 and 2023. Studies using IDS were compared to those using conventional methods. The risk of bias was assessed using the Cochrane Collaboration’s tool, and a meta-analysis was performed with a random-effects model. The standard mean difference and 95% confidence intervals were calculated to compare fracture strength, with I2 statistics assessing heterogeneity. Forest and funnel plots were employed to visualize results and publication bias, respectively. Discussion The results indicate that IDS generally enhances the fracture strength of indirect posterior restorations, particularly with ceramic materials like lithium disilicate. However, the effectiveness of IDS varies depending on the material and restoration type. While some studies demonstrated improved fracture resistance with IDS, others showed minimal benefit, especially with composite restorations. Additionally, IDS improved marginal adaptation and internal fit but increased the risk of severe failures, such as root fractures. Systematic review registration PROSPERO: CRD42024584545 (Registered on 08/09/2024). 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F1000Research 2025, 13 :1234 ( https://doi.org/10.12688/f1000research.156876.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Revised Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] Yosra Gassara https://orcid.org/0000-0002-5945-7764 1 , Rim Kallala https://orcid.org/0000-0003-2120-9009 1 , Rihab Dakhli 1 , Sarra Nasri 1 , Nourhen Klach 1 , Belhassen Harzallah 1 Yosra Gassara https://orcid.org/0000-0002-5945-7764 1 , Rim Kallala https://orcid.org/0000-0003-2120-9009 1 , [...] Rihab Dakhli 1 , Sarra Nasri 1 , Nourhen Klach 1 , Belhassen Harzallah 1 PUBLISHED 29 Aug 2025 Author details Author details 1 Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, Monastir, 5000, Tunisia Yosra Gassara Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation Rim Kallala Roles: Formal Analysis, Funding Acquisition, Resources, Software Rihab Dakhli Roles: Resources, Software, Supervision Sarra Nasri Roles: Investigation, Writing – Review & Editing Nourhen Klach Roles: Conceptualization, Formal Analysis, Methodology, Writing – Original Draft Preparation Belhassen Harzallah Roles: Supervision, Validation, Visualization OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Immediate Dentin Sealing (IDS) is a technique that applies an adhesive layer immediately after tooth preparation, prior to the placement of indirect restorations. This method is gaining attention due to its potential to improve the bond strength and mechanical properties of restorations, particularly in the posterior region where restorations endure significant masticatory forces. The objective of this systematic review and meta-analysis is to evaluate the effect of IDS on the fracture strength of indirect posterior restorations. Methods Following PRISMA guidelines, a comprehensive literature search was conducted in four databases: Web of Science, Scopus, Cochrane Library, and PubMed. Inclusion criteria focused on in vitro studies involving human teeth with indirect posterior restorations, published between 2014 and 2023. Studies using IDS were compared to those using conventional methods. The risk of bias was assessed using the Cochrane Collaboration’s tool, and a meta-analysis was performed with a random-effects model. The standard mean difference and 95% confidence intervals were calculated to compare fracture strength, with I 2 statistics assessing heterogeneity. Forest and funnel plots were employed to visualize results and publication bias, respectively. Discussion The results indicate that IDS generally enhances the fracture strength of indirect posterior restorations, particularly with ceramic materials like lithium disilicate. However, the effectiveness of IDS varies depending on the material and restoration type. While some studies demonstrated improved fracture resistance with IDS, others showed minimal benefit, especially with composite restorations. Additionally, IDS improved marginal adaptation and internal fit but increased the risk of severe failures, such as root fractures. Systematic review registration PROSPERO: CRD42024584545 (Registered on 08/09/2024). READ ALL READ LESS Keywords Fracture Strength, Endocrown, Overlay, occlusal veneer, Indirect restoration, Inlay, Onlay, immediate dentin sealing Corresponding Author(s) Yosra Gassara ( [email protected] ) Close Corresponding author: Yosra Gassara Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Gassara Y et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Gassara Y, Kallala R, Dakhli R et al. Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.12688/f1000research.156876.2 ) First published: 15 Oct 2024, 13 :1234 ( https://doi.org/10.12688/f1000research.156876.1 ) Latest published: 29 Aug 2025, 13 :1234 ( https://doi.org/10.12688/f1000research.156876.2 ) Revised Amendments from Version 1 This revised version of the manuscript incorporates substantial improvements based on reviewer feedback. The PICOS framework has been fully redefined, with a detailed table outlining specific inclusion and exclusion criteria to improve methodological transparency. The data extraction plan has been expanded to include precise details on adhesive agents, restorative materials, and additional experimental conditions, ensuring comprehensive capture of relevant study variables. In the meta-analysis section, we now clearly specify the use of random- and fixed-effects models, along with explicit heterogeneity thresholds. A dedicated subgroup analysis plan has been added to stratify results according to different restorative materials and adhesive agents, acknowledging their potential influence on outcomes. We have also included a new limitations section, highlighting the exclusive reliance on in vitro studies, potential variability in testing protocols, and possible publication bias. The risk of bias assessment has been updated: the Cochrane tool has been replaced by the QUIN tool, which is more suitable for in vitro studies, thereby improving methodological rigor. The manuscript has undergone thorough proofreading and English language editing to correct spelling and grammatical errors. In addition, the formatting has been refined, with clearer paragraph structure and more appropriate use of bullet points and tables, aligning the manuscript with PRISMA guidelines. Collectively, these revisions significantly strengthen the clarity, methodological accuracy, and overall readability of the manuscript. This revised version of the manuscript incorporates substantial improvements based on reviewer feedback. The PICOS framework has been fully redefined, with a detailed table outlining specific inclusion and exclusion criteria to improve methodological transparency. The data extraction plan has been expanded to include precise details on adhesive agents, restorative materials, and additional experimental conditions, ensuring comprehensive capture of relevant study variables. In the meta-analysis section, we now clearly specify the use of random- and fixed-effects models, along with explicit heterogeneity thresholds. A dedicated subgroup analysis plan has been added to stratify results according to different restorative materials and adhesive agents, acknowledging their potential influence on outcomes. We have also included a new limitations section, highlighting the exclusive reliance on in vitro studies, potential variability in testing protocols, and possible publication bias. The risk of bias assessment has been updated: the Cochrane tool has been replaced by the QUIN tool, which is more suitable for in vitro studies, thereby improving methodological rigor. The manuscript has undergone thorough proofreading and English language editing to correct spelling and grammatical errors. In addition, the formatting has been refined, with clearer paragraph structure and more appropriate use of bullet points and tables, aligning the manuscript with PRISMA guidelines. Collectively, these revisions significantly strengthen the clarity, methodological accuracy, and overall readability of the manuscript. See the authors' detailed response to the review by Dinesh Rokaya See the authors' detailed response to the review by Sanpreet Singh Sachdev READ REVIEWER RESPONSES Introduction Immediate Dentin Sealing (IDS) has emerged as a highly influential technique in the field of restorative dentistry, particularly in the context of indirect posterior restorations. 1 – 4 This technique involves the application of an adhesive layer immediately after tooth preparation and before the final restoration is placed. 5 , 6 The primary goal of IDS is to optimize the bond strength between the tooth and restoration, while simultaneously preserving the vitality of the tooth by creating a durable seal. In contrast to delayed dentin sealing, which occurs after temporization, IDS is performed in the initial stages of the restorative process, leading to enhanced adhesion and improved long-term outcomes. 7 The technique has gained significant attention for its potential to improve the mechanical properties of partial restorations, particularly those located in the posterior region of the mouth, where restorations are exposed to substantial masticatory forces. 8 – 11 These forces make the posterior region especially vulnerable to mechanical failure, making it critical for restorations in this area to exhibit both high durability and fracture resistance. For these reasons, it is important to investigate how IDS impacts the long-term success of indirect posterior restorations, especially in terms of their ability to withstand the stresses of everyday function. 8 Despite its growing popularity, the effects of IDS on fracture strength remain a topic of debate. While several studies suggest that IDS enhances the fracture resistance of indirect restorations, discrepancies exist depending on factors such as the materials used, the specific restoration type, and the methods employed. Therefore, a systematic review and meta-analysis are necessary to consolidate the existing evidence and provide a clear understanding of IDS’s role in improving fracture strength. 12 , 13 This systematic review and meta-analysis aim to assess the effect of IDS on the fracture strength of indirect posterior restorations, offering a thorough evaluation of current evidence. Protocol Methods This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. It will also comply with the Methodological Expectations of Cochrane Intervention Reviews and the Cochrane Handbook for Systematic Reviews of Interventions. The review protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42024584545, as of September 8, 2024. Objectives Primary objectives Specify the effect of immediate dentin sealing on the fracture strength of indirect posterior restorations. Secondary objectives The secondary objectives are to describe the benefits of IDS in posterior partial restorations, to present the mechanical properties of these restorations, and to specify the impact of IDS on their fracture resistance. Eligibility criteria The PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design) will be used to organize the eligibility criteria, which is intended to emphasize the key components of the research question. The research question for this systematic review is: The PICO question is: What is the effect of immediate dentin sealing (intervention) on the fracture strength (outcome) of indirect posterior restorations (population) compared to delayed dentin sealing (comparison)? ( Table 1 ) Table 1. PICOS framework with inclusion and exclusion criteria. Element Inclusion criteria Exclusion criteria Population (P) Human permanent posterior teeth restored with indirect restorations (inlays, onlays, overlays, occlusal veneers, endocrowns) Anterior teeth; primary teeth; animal studies Intervention (I) Immediate dentin sealing (IDS) applied after tooth preparation (any adhesive protocol) Delayed dentin sealing (DDS) only; provisional restorations without IDS Comparison (C) Conventional approach (DDS or no dentin sealing) No control group Outcome (O) Primary: Fracture strength (in Newtons) of indirect posterior restorations; Secondary: Failure mode, reparability Outcomes unrelated to fracture strength Study Design (S) In vitro comparative studies (RCTs or controlled laboratory studies) published in English (2014–2024) Case reports, reviews, opinion papers, clinical trials without fracture strength outcomes • Types of participants: This systematic review will focus on teeth restored with indirect posterior restoration: Endocrown, Overlay, occlusal veneer, Inlay and Onlay. • Types of interventions: The intervention of interest is immediate dentin sealing (IDS). This technique involves sealing the dentin immediately after tooth preparation, before the indirect restoration is placed. • Types of outcomes: The primary outcome of interest is the fracture strength of the indirect posterior restorations. • Measures of effect: The main outcome, fracture strength, will be measured using either the risk ratio (relative risk) or odds ratio , depending on the type and availability of the data from the included studies. Meta-analysis will be performed if sufficient homogeneous data is available. • Study types: This review will include both in vivo and in vitro studies that assess the effect of immediate and delayed dentin sealing on fracture strength. Both randomized controlled trials (RCTs) and observational studies with a comparative design will be considered. Exclusion criteria Studies will be excluded if they involve indirect anterior restorations, use animal models, or focus on interventions performed on temporary teeth. To ensure a neatly formatted protocol, the authors are encouraged to present information in paragraph form and reserve bullet points only for cases where they enhance clarity or readability. Search strategy Two independent searchers, Y.G. and R.K. will search four different databases: Web of Science, Scopus, Cochrane library and PubMed. They will perform a manual search and meticulously review the reference lists of the studies included in this review to identify eligible ones. Additionally, electronic searches in databases will conduct using a combination of mesh terms ( Table 2 ). Table 2. The search strategy. Database Search strategy PubMed ((“Fracture Strength” OR “Strength” OR “Force to fracture” OR “Fracture resistance”) AND (“Indirect posterior restorations” OR “Indirect restorations” OR “Endocrown” OR “Denture, Overlay” OR “occlusal veneer” OR “occlusal veneers” OR “Overlay” OR “Overlays” OR “Inlay” OR “Onlay”) AND immediate dentin sealing) Web of science (TS=(“Fracture Strength”) OR TS=(“Strength”) OR TS=(“Force to fracture”) OR TS=(“Fracture resistance”)) AND (TS=(“Indirect posterior restorations”) OR TS=(“Indirect restorations”) OR TS=(“Endocrown”) OR TS=(“Denture, Overlay”) OR TS=(“occlusal veneer”) OR TS=(“occlusal veneers”) OR TS=(“Overlay”) OR TS=(“Overlays”) OR TS=(“Inlay”) OR TS=(“Onlay”)) AND TS=(“immediate dentin sealing”) Scopus (TITLE-ABS(“Fracture Strength”) OR TITLE-ABS(“Strength”) OR TITLE-ABS(“Force to fracture”) OR TITLE-ABS(“Fracture resistance”)) AND (TITLE-ABS(“Indirect posterior restorations”) OR TITLE-ABS(“Indirect restorations”) OR TITLE-ABS(“Endocrown”) OR TITLE-ABS(“Denture, Overlay”) OR TITLE-ABS(“occlusal veneer”) OR TITLE-ABS(“occlusal veneers”) OR TITLE-ABS(“Overlay”) OR TITLE-ABS(“Overlays”) OR TITLE-ABS(“Inlay”) OR TITLE-ABS(“Onlay”)) AND TITLE-ABS(“immediate dentin sealing”) Cochrane "Fracture Strength” OR “Strength” OR “Force to Fracture” OR “Fracture Resistance” in Title Abstract Keyword AND ”Indirect posterior restorations” OR “Indirect restorations” OR “Endocrown” OR “Denture, Overlay” OR “occlusal veneer” OR “occlusal veneers” OR “Overlay” OR “Overlays” OR “Inlay” OR “Onlay” in Title Abstract Keyword AND ”immediate dentin sealing” in Title Abstract Keyword - (Word variations have been searched) Study selection (screening process) To select studies, duplicates will be removed. Titles and abstracts will be reviewed by the two investigators, and studies that do not meet the inclusion criteria will be excluded. Assessment of methodological quality and risk of bias The methodological quality of the included studies will be assessed using the QUIN tool (Quality Assessment Tool for In Vitro Studies), as all eligible studies are laboratory-based. This tool is specifically designed to evaluate in vitro studies, providing a structured assessment of methodological rigor. Data extraction Data from the included articles will be collected by one author (Y.G.), while a second researcher (R.K.) will review all the extracted data for accuracy. The data to be collected will include the first author, year of publication, type of study, sample characteristics, IDS technique used, and fracture strength values. In addition to study characteristics, details of the adhesive/agent applied (etch-and-rinse, self-etch, universal, total-etch, protective liners, etc.) and the restorative material (lithium disilicate, polymer-infiltrated ceramic, composite resin, glass-ceramic, etc.) will be extracted. Information regarding the provisional phase, impression method, and storage conditions will also be recorded. Data analysis and synthesis The meta-analysis will evaluate the fracture strength of indirect posterior restorations (inlays, overlays, occlusal veneers) by comparing conventional methods to the immediate dentin sealing (IDS) method. Studies that contrast IDS with conventional methods will be included. Data analysis will be performed using RevMan software (version 5.4). The standard mean difference with a 95% confidence interval will be applied, and the I 2 statistic will assess heterogeneity by measuring the percentage of variation across studies caused by true differences rather than chance. It helps determine if differences in study populations, methods, or interventions explain the variability. Due to the variability in IDS protocols, restorative materials, and study setups, a random-effects model will primarily be used. For sensitivity analyses, results under a fixed-effects model will also be reported. Heterogeneity will be quantified using the I 2 statistic, with thresholds: I 2 50%: substantial heterogeneity. Subgroup analyses will be performed based on the type of restorative material (ceramic, resin composite, polymer-infiltrated ceramic) and the type of adhesive agent (etch-and-rinse, self-etch, universal adhesives, additional protective liners). This approach will allow evaluation of whether IDS effectiveness differs across materials and bonding protocols. To visually represent the results of the meta-analysis, forest plots will be generated. These plots will display the individual study outcomes along with the overall pooled effect, providing a clear illustration of the results and the degree of consistency among the studies. Additionally, funnel plots will be employed to evaluate the potential for publication bias. By plotting the effect sizes of the studies against their standard errors, funnel plots can help identify any asymmetry that may suggest selective reporting or other biases affecting the literature. Discussion IDS generally enhances the fracture strength of indirect posterior restorations, especially with ceramic materials like lithium disilicate. 12 The effect of IDS, however, is material-dependent. 14 , 15 While it significantly enhances ceramic bonding, its influence is less pronounced or nonsignificant for multiphase resin composites. 7 , 9 , 12 IDS also improves microtensile bond strength, bonding durability, marginal adaptation, and internal fit in CAD/CAM ceramic restorations. 4 , 6 , 11 These findings align with previous in vitro studies, supporting IDS as a beneficial protocol for indirect restorations. 7 , 12 , 13 While many studies report improved fracture resistance with IDS, others show only modest benefits, particularly in composite restorations. 12 Additionally, IDS contributes to superior marginal adaptation and internal fit but may also elevate the risk of severe failures, such as root fractures. 16 , 17 This review is limited by its exclusive reliance on in vitro studies, which may not fully replicate intraoral conditions. Differences in loading protocols, IDS techniques, and restorative materials contribute to heterogeneity and reduce generalizability. Sample sizes in included studies were relatively small, and some combined IDS with adjunctive treatments (e.g., proanthocyanidin), complicating interpretation. Long-term clinical trials are needed to validate laboratory findings. This review serves as a valuable resource for clinicians, offering guidance when restoring posterior teeth with indirect restorations. Ethics and dissemination Ethical approval is not required for this systematic review. The authors plan to present the results at relevant conferences and publish the findings in a peer-reviewed journal, following open science practices. Study status The protocol of this systematic review was submitted to PROSPERO registry on 08th September, 2024 (CRD42024584545). Data availability No data are associated with this article. Reporting guidelines Figshare. PRISMA-P checklist for Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations: Systematic review and meta-analysis Protocol. DOI: https://doi.org/10.6084/m9.figshare.27143277.v1 18 The project contains the following dataset: • PRISMA-P-checklist.docx Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0) References 1. Hofsteenge JW, Hogeveen F, Cune MS, et al. : Effect of immediate dentine sealing on the aging and fracture strength of lithium disilicate inlays and overlays. 2. Abdulsattar YH, Kadhim AJ: Effect of immediate dentin sealing on the fracture strength of indirect overlay restorations using different types of luting agents: A comparative in vitro study. J. Conserv. Dent. Endod. 2023; 26 : 434–440. PubMed Abstract | Publisher Full Text 3. Magne P, Kim TH, Cascione D, et al. : Immediate dentin sealing improves bond strength of indirect restorations. J. Prosthet. Dent. 2005; 94 : 511–519. PubMed Abstract | Publisher Full Text 4. Mueller B, Pilecco RO, Valandro LF, et al. : Effect of immediate dentin sealing on load-bearing capacity under accelerated fatigue of thin occlusal veneers made of CAD-CAM glass-ceramic and resin composite material. Dent. Mater. 2023; 39 (4): 372–382. PubMed Abstract | Publisher Full Text 5. Oliveira EG, Mota GA, Borges LH, et al. : Influence of immediate dentin sealing techniques on cuspal deflection and fracture resistance of teeth restored with composite resin inlays. Oper. Dent. 2014; 39 (1): 72–80. PubMed Abstract | Publisher Full Text 6. Magne P, Schlichting LH, Maia HP, et al. : In vitro fatigue resistance of CAD/CAM composite resin and ceramic posterior occlusal veneers. J. Prosthet. Dent. 2010; 104 : 149–157. PubMed Abstract | Publisher Full Text 7. Ozer F, Batu Eken Z, Hao J, et al. : Effect of immediate dentin sealing on the bonding performance of indirect restorations: A systematic review. Biomimetics (Basel). 2024; 9 (3): 182. PubMed Abstract | Publisher Full Text | Free Full Text 8. Oliveira DC, et al. : Influence of glycerin coating on the bond strength of resin-dentin interfaces. J. Adhes. Dent. 2003; 5 (4): 309–315. 9. Saadeddin N, Al-Khalil MA, Al-Adel O: Effect of immediate dentin sealing on the fracture strength of lithium disilicate ceramic onlays. Swiss Dent. J. 2022; 132 : 482–489. PubMed Abstract | Publisher Full Text 10. Schlichting LH, Maia HP, Baratieri LN, et al. : Novel-design ultra-thin CAD/CAM composite resin and ceramic occlusal veneers for the treatment of severe dental erosion. J. Prosthet. Dent. 2011; 105 : 217–226. PubMed Abstract | Publisher Full Text 11. Teche FP, Valenzuela EBS, Tavares JG, et al. : Immediate dentin sealing influences the fracture strength of ultrathin occlusal veneers made of a polymer-infiltrated ceramic network. J. Mech. Behav. Biomed. Mater. 2022; 133 : 105331. PubMed Abstract | Publisher Full Text 12. van den Breemer CRG , Özcan M, Cune MS, et al. : Effect of immediate dentine sealing on the fracture strength of lithium disilicate and multiphase resin composite inlay restorations. J. Mech. Behav. Biomed. Mater. 2017; 75 : 92–99. 13. Shafiei F, Aghaei T, Jowkar Z: Effect of proanthocyanidin-mediated immediate and delayed dentin sealing on the strength of premolars restored with composite resin inlay. J Clin Exp Dent. 2020; 12 (3): e235–e241. Publisher Full Text 14. Signore A, Benedicenti S, Covani U, et al. : A 4- to 6-year retrospective clinical study of cracked teeth restored with bonded indirect resin composite onlays. Int. J. Prosthodont. 2007; 20 : 609–616. PubMed Abstract 15. Andrade JP, Stona D, Bittencourt HR, et al. : Effect of different computer-aided design/computer-aided manufacturing (CAD/CAM) materials and thicknesses on the fracture resistance of occlusal veneers. Oper. Dent. 2018; 43 : 539–548. PubMed Abstract | Publisher Full Text 16. Ashy LM, Marghalani H, Silikas N: In vitro evaluation of marginal and internal adaptations of ceramic inlay restorations associated with immediate vs delayed dentin sealing techniques. Int. J. Prosthodont. 2020; 33 : 48–55. PubMed Abstract | Publisher Full Text 17. Schenke F, Hiller K, Schmalz G, et al. : Marginal integrity of partial ceramic crowns within dentin with different luting techniques and materials. Oper. Dent. 2008; 33 : 516–525. PubMed Abstract | Publisher Full Text 18. Gassara Y: PRISMA-P checklist for Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations: Systematic review and meta-analysis Protocol. Dataset. figshare. 2024. Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 15 Oct 2024 ADD YOUR COMMENT Comment Author details Author details 1 Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, Monastir, 5000, Tunisia Yosra Gassara Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Original Draft Preparation Rim Kallala Roles: Formal Analysis, Funding Acquisition, Resources, Software Rihab Dakhli Roles: Resources, Software, Supervision Sarra Nasri Roles: Investigation, Writing – Review & Editing Nourhen Klach Roles: Conceptualization, Formal Analysis, Methodology, Writing – Original Draft Preparation Belhassen Harzallah Roles: Supervision, Validation, Visualization Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 29 Aug 2025, 13:1234 https://doi.org/10.12688/f1000research.156876.2 version 1 Published: 15 Oct 2024, 13:1234 https://doi.org/10.12688/f1000research.156876.1 Copyright © 2025 Gassara Y et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Gassara Y, Kallala R, Dakhli R et al. Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.12688/f1000research.156876.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 29 Aug 2025 Revised Views 0 Cite How to cite this report: Cascales ÁF. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.187134.r444543 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v2#referee-response-444543 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 07 Jan 2026 Álvaro Ferrando Cascales , Universidad Católica de Murcia (UCAM), Murcia, Spain Approved VIEWS 0 https://doi.org/10.5256/f1000research.187134.r444543 This systematic review and meta-analysis protocol is well structured and addresses a clinically relevant question regarding the effect of immediate dentin sealing (IDS) on the fracture strength of indirect posterior restorations. The rationale and objectives are clearly ... Continue reading READ ALL This systematic review and meta-analysis protocol is well structured and addresses a clinically relevant question regarding the effect of immediate dentin sealing (IDS) on the fracture strength of indirect posterior restorations. The rationale and objectives are clearly defined, and the proposed methodology follows established guidelines (PRISMA-P and Cochrane standards). The study design is appropriate for the research question, and the planned search strategy, data extraction, and statistical analysis are generally well described. However, some methodological aspects could be further clarified to enhance reproducibility, particularly regarding the interpretation of fracture outcomes across different restoration types and testing protocols. A specific point that would benefit from clarification concerns the discussion of catastrophic failures, such as roots fractures. While IDS has been associated with increased fracture strength, some studies report a higher incidence of non-repairable failures. This phenomenon appears to be mainly related to endocrown restorations, where stress transmission to pulpal and pericervical dentin is maximized, rather than to restorations with peripheral support such as overlays or onlays. Explicitly distinguishing between fracture modes and restoration designs would improve the biomechanical interpretation of the findings and prevent overgeneralization. Overall, this protocol represents a valuable and timely contribution to the literature. Addressing the points above would further strengthen the clarity and clinical relevance of the final review. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Adhesive and restorative dentistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Cascales ÁF. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.187134.r444543 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v2#referee-response-444543 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Mohsen CA. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.187134.r410704 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v2#referee-response-410704 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 19 Sep 2025 Cherif Adel Mohsen , Faculty of Dentistry, Minia University, Minya, Egypt Approved VIEWS 0 https://doi.org/10.5256/f1000research.187134.r410704 Dear editorial board I accept this manuscript with only one comment which is reference number 1 is not fully cited. the topic entitled : effect of immediate dentin sealing on the fracture strength of indirect posterior restorations is nowadays. ... Continue reading READ ALL Dear editorial board I accept this manuscript with only one comment which is reference number 1 is not fully cited. the topic entitled : effect of immediate dentin sealing on the fracture strength of indirect posterior restorations is nowadays. the manuscript is well written and answer many issues about the topic. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Fixed Prosthodontics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Mohsen CA. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.187134.r410704 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v2#referee-response-410704 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 15 Oct 2024 Views 0 Cite How to cite this report: Sachdev SS. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.172252.r401655 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v1#referee-response-401655 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 11 Aug 2025 Sanpreet Singh Sachdev , Oral Pathology and Microbiology,, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Munbai, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.172252.r401655 PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Data extraction needs to have details of the agent applied and the restorative material ... Continue reading READ ALL PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Data extraction needs to have details of the agent applied and the restorative material used. In meta-analysis, specify the effects model and define heterogeneity values for those models - random and fixed. Include a section of subgroup analysis if the authors are including different restorative materials and adhesive agents, as these may differently influence the bonding process entirely. Limitations of the protocol need to be acknowledged and wherever possible, addressed. There are several spelling mistakes and grammatical errors in the manuscript such as 'objectif' or in the sentence stating the aim of the study. Similar errors are present sporadically in the manuscript. The formatting of the manuscript is poor. The authors are suggested to write it in the form of paragraphs and use bullet points only when necessary for a neatly formatted protocol. The bullet points seem to be missing. The risk of bias tool mentioned may not be appropriate for in vitro studies. Since the authors are focusing on in vitro studies, they are suggested to use more suitable tools such as the QUIN tool. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Partly Competing Interests: No competing interests were disclosed. Reviewer Expertise: Dentistry, Systematic Reviews I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sachdev SS. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.172252.r401655 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v1#referee-response-401655 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 10 Sep 2025 Yosra Gassara , Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, 5000, Tunisia 10 Sep 2025 Author Response Dear Reviewer, We would like to thank you sincerely for your constructive feedback on our manuscript. Your comments have greatly contributed to improving the clarity, methodological rigor, and overall quality ... Continue reading Dear Reviewer, We would like to thank you sincerely for your constructive feedback on our manuscript. Your comments have greatly contributed to improving the clarity, methodological rigor, and overall quality of our work. Below, we provide a detailed response to each point, along with the corresponding revisions made in the manuscript. Comment 1: PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Response: We appreciate this suggestion. The eligibility criteria have been revised to provide a precise PICOS definition. A detailed PICOS framework table has been added (Table 1), specifying participants, interventions, comparisons, outcomes, and study designs, along with both inclusion and exclusion criteria. This improves methodological transparency. Comment 2: Data extraction needs to have details of the agent applied and the restorative material used. Response: We fully agree. The data extraction plan has been expanded to include details of: The adhesive/agent applied (etch-and-rinse, self-etch, universal, protective liners, etc.), The restorative material used (lithium disilicate, polymer-infiltrated ceramic, composite resin, glass-ceramic, etc.). Information on the provisional phase, impression method, and storage conditions has also been included. These modifications ensure a comprehensive capture of all relevant variables influencing fracture strength. Comment 3: In meta-analysis, specify the effects model and define heterogeneity values for those models – random and fixed. Response: Thank you for pointing this out. We clarified that a random-effects model will be the primary model due to the anticipated variability in IDS protocols and restorative materials. For sensitivity analyses, results under a fixed-effects model will also be reported. Heterogeneity thresholds are now explicitly defined as: I² 50% : substantial heterogeneity. Comment 4: Include a section of subgroup analysis if the authors are including different restorative materials and adhesive agents, as these may differently influence the bonding process entirely. Response: We agree. A subgroup analysis plan has been added to stratify studies by: Type of restorative material (ceramic, resin composite, polymer-infiltrated ceramic), Type of adhesive agent (etch-and-rinse, self-etch, universal adhesives, protective liners). This will allow us to evaluate whether IDS effectiveness differs across materials and bonding protocols. Comment 5: Limitations of the protocol need to be acknowledged and wherever possible, addressed. Response: A limitations section has been added in the Discussion. It acknowledges: Restriction to in vitro studies, limiting direct clinical applicability, Variability in test setups, IDS techniques, and restorative materials, Potential for publication bias, despite efforts to minimize it. We also suggest that future well-designed clinical studies address these gaps. Comment 6: There are several spelling mistakes and grammatical errors in the manuscript such as “objectif” or in the sentence stating the aim of the study. Similar errors are present sporadically in the manuscript. Response: We apologize for these errors. The manuscript has undergone thorough proofreading and English language editing. Spelling (e.g., “objectif” → “objective”, “anlysis” → “analysis”)) and grammar have been corrected throughout. Comment 7: The formatting of the manuscript is poor. The authors are suggested to write it in the form of paragraphs and use bullet points only when necessary for a neatly formatted protocol. The bullet points seem to be missing. Response: Thank you for this feedback. The manuscript has been reformatted to improve readability. Paragraph structure has been refined, and bullet points are now used only when appropriate (e.g., inclusion/exclusion criteria, data extraction items). Tables have been harmonized for consistency with PRISMA guidelines. Comment 8: The risk of bias tool mentioned may not be appropriate for in vitro studies. Since the authors are focusing on in vitro studies, they are suggested to use more suitable tools such as the QUIN tool. Response: We appreciate this valuable suggestion. The Cochrane risk of bias tool has been replaced with the QUIN tool (Quality Assessment Tool for In Vitro Studies) , which is specifically designed for laboratory studies. This improves the validity and reliability of our methodological assessment. We are grateful for the reviewer’s constructive insights, which have allowed us to substantially strengthen the manuscript. We believe the revised version now addresses all concerns and meets the methodological standards expected. Sincerely Dear Reviewer, We would like to thank you sincerely for your constructive feedback on our manuscript. Your comments have greatly contributed to improving the clarity, methodological rigor, and overall quality of our work. Below, we provide a detailed response to each point, along with the corresponding revisions made in the manuscript. Comment 1: PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Response: We appreciate this suggestion. The eligibility criteria have been revised to provide a precise PICOS definition. A detailed PICOS framework table has been added (Table 1), specifying participants, interventions, comparisons, outcomes, and study designs, along with both inclusion and exclusion criteria. This improves methodological transparency. Comment 2: Data extraction needs to have details of the agent applied and the restorative material used. Response: We fully agree. The data extraction plan has been expanded to include details of: The adhesive/agent applied (etch-and-rinse, self-etch, universal, protective liners, etc.), The restorative material used (lithium disilicate, polymer-infiltrated ceramic, composite resin, glass-ceramic, etc.). Information on the provisional phase, impression method, and storage conditions has also been included. These modifications ensure a comprehensive capture of all relevant variables influencing fracture strength. Comment 3: In meta-analysis, specify the effects model and define heterogeneity values for those models – random and fixed. Response: Thank you for pointing this out. We clarified that a random-effects model will be the primary model due to the anticipated variability in IDS protocols and restorative materials. For sensitivity analyses, results under a fixed-effects model will also be reported. Heterogeneity thresholds are now explicitly defined as: I² 50% : substantial heterogeneity. Comment 4: Include a section of subgroup analysis if the authors are including different restorative materials and adhesive agents, as these may differently influence the bonding process entirely. Response: We agree. A subgroup analysis plan has been added to stratify studies by: Type of restorative material (ceramic, resin composite, polymer-infiltrated ceramic), Type of adhesive agent (etch-and-rinse, self-etch, universal adhesives, protective liners). This will allow us to evaluate whether IDS effectiveness differs across materials and bonding protocols. Comment 5: Limitations of the protocol need to be acknowledged and wherever possible, addressed. Response: A limitations section has been added in the Discussion. It acknowledges: Restriction to in vitro studies, limiting direct clinical applicability, Variability in test setups, IDS techniques, and restorative materials, Potential for publication bias, despite efforts to minimize it. We also suggest that future well-designed clinical studies address these gaps. Comment 6: There are several spelling mistakes and grammatical errors in the manuscript such as “objectif” or in the sentence stating the aim of the study. Similar errors are present sporadically in the manuscript. Response: We apologize for these errors. The manuscript has undergone thorough proofreading and English language editing. Spelling (e.g., “objectif” → “objective”, “anlysis” → “analysis”)) and grammar have been corrected throughout. Comment 7: The formatting of the manuscript is poor. The authors are suggested to write it in the form of paragraphs and use bullet points only when necessary for a neatly formatted protocol. The bullet points seem to be missing. Response: Thank you for this feedback. The manuscript has been reformatted to improve readability. Paragraph structure has been refined, and bullet points are now used only when appropriate (e.g., inclusion/exclusion criteria, data extraction items). Tables have been harmonized for consistency with PRISMA guidelines. Comment 8: The risk of bias tool mentioned may not be appropriate for in vitro studies. Since the authors are focusing on in vitro studies, they are suggested to use more suitable tools such as the QUIN tool. Response: We appreciate this valuable suggestion. The Cochrane risk of bias tool has been replaced with the QUIN tool (Quality Assessment Tool for In Vitro Studies) , which is specifically designed for laboratory studies. This improves the validity and reliability of our methodological assessment. We are grateful for the reviewer’s constructive insights, which have allowed us to substantially strengthen the manuscript. We believe the revised version now addresses all concerns and meets the methodological standards expected. Sincerely Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 10 Sep 2025 Yosra Gassara , Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, 5000, Tunisia 10 Sep 2025 Author Response Dear Reviewer, We would like to thank you sincerely for your constructive feedback on our manuscript. Your comments have greatly contributed to improving the clarity, methodological rigor, and overall quality ... Continue reading Dear Reviewer, We would like to thank you sincerely for your constructive feedback on our manuscript. Your comments have greatly contributed to improving the clarity, methodological rigor, and overall quality of our work. Below, we provide a detailed response to each point, along with the corresponding revisions made in the manuscript. Comment 1: PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Response: We appreciate this suggestion. The eligibility criteria have been revised to provide a precise PICOS definition. A detailed PICOS framework table has been added (Table 1), specifying participants, interventions, comparisons, outcomes, and study designs, along with both inclusion and exclusion criteria. This improves methodological transparency. Comment 2: Data extraction needs to have details of the agent applied and the restorative material used. Response: We fully agree. The data extraction plan has been expanded to include details of: The adhesive/agent applied (etch-and-rinse, self-etch, universal, protective liners, etc.), The restorative material used (lithium disilicate, polymer-infiltrated ceramic, composite resin, glass-ceramic, etc.). Information on the provisional phase, impression method, and storage conditions has also been included. These modifications ensure a comprehensive capture of all relevant variables influencing fracture strength. Comment 3: In meta-analysis, specify the effects model and define heterogeneity values for those models – random and fixed. Response: Thank you for pointing this out. We clarified that a random-effects model will be the primary model due to the anticipated variability in IDS protocols and restorative materials. For sensitivity analyses, results under a fixed-effects model will also be reported. Heterogeneity thresholds are now explicitly defined as: I² 50% : substantial heterogeneity. Comment 4: Include a section of subgroup analysis if the authors are including different restorative materials and adhesive agents, as these may differently influence the bonding process entirely. Response: We agree. A subgroup analysis plan has been added to stratify studies by: Type of restorative material (ceramic, resin composite, polymer-infiltrated ceramic), Type of adhesive agent (etch-and-rinse, self-etch, universal adhesives, protective liners). This will allow us to evaluate whether IDS effectiveness differs across materials and bonding protocols. Comment 5: Limitations of the protocol need to be acknowledged and wherever possible, addressed. Response: A limitations section has been added in the Discussion. It acknowledges: Restriction to in vitro studies, limiting direct clinical applicability, Variability in test setups, IDS techniques, and restorative materials, Potential for publication bias, despite efforts to minimize it. We also suggest that future well-designed clinical studies address these gaps. Comment 6: There are several spelling mistakes and grammatical errors in the manuscript such as “objectif” or in the sentence stating the aim of the study. Similar errors are present sporadically in the manuscript. Response: We apologize for these errors. The manuscript has undergone thorough proofreading and English language editing. Spelling (e.g., “objectif” → “objective”, “anlysis” → “analysis”)) and grammar have been corrected throughout. Comment 7: The formatting of the manuscript is poor. The authors are suggested to write it in the form of paragraphs and use bullet points only when necessary for a neatly formatted protocol. The bullet points seem to be missing. Response: Thank you for this feedback. The manuscript has been reformatted to improve readability. Paragraph structure has been refined, and bullet points are now used only when appropriate (e.g., inclusion/exclusion criteria, data extraction items). Tables have been harmonized for consistency with PRISMA guidelines. Comment 8: The risk of bias tool mentioned may not be appropriate for in vitro studies. Since the authors are focusing on in vitro studies, they are suggested to use more suitable tools such as the QUIN tool. Response: We appreciate this valuable suggestion. The Cochrane risk of bias tool has been replaced with the QUIN tool (Quality Assessment Tool for In Vitro Studies) , which is specifically designed for laboratory studies. This improves the validity and reliability of our methodological assessment. We are grateful for the reviewer’s constructive insights, which have allowed us to substantially strengthen the manuscript. We believe the revised version now addresses all concerns and meets the methodological standards expected. Sincerely Dear Reviewer, We would like to thank you sincerely for your constructive feedback on our manuscript. Your comments have greatly contributed to improving the clarity, methodological rigor, and overall quality of our work. Below, we provide a detailed response to each point, along with the corresponding revisions made in the manuscript. Comment 1: PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Response: We appreciate this suggestion. The eligibility criteria have been revised to provide a precise PICOS definition. A detailed PICOS framework table has been added (Table 1), specifying participants, interventions, comparisons, outcomes, and study designs, along with both inclusion and exclusion criteria. This improves methodological transparency. Comment 2: Data extraction needs to have details of the agent applied and the restorative material used. Response: We fully agree. The data extraction plan has been expanded to include details of: The adhesive/agent applied (etch-and-rinse, self-etch, universal, protective liners, etc.), The restorative material used (lithium disilicate, polymer-infiltrated ceramic, composite resin, glass-ceramic, etc.). Information on the provisional phase, impression method, and storage conditions has also been included. These modifications ensure a comprehensive capture of all relevant variables influencing fracture strength. Comment 3: In meta-analysis, specify the effects model and define heterogeneity values for those models – random and fixed. Response: Thank you for pointing this out. We clarified that a random-effects model will be the primary model due to the anticipated variability in IDS protocols and restorative materials. For sensitivity analyses, results under a fixed-effects model will also be reported. Heterogeneity thresholds are now explicitly defined as: I² 50% : substantial heterogeneity. Comment 4: Include a section of subgroup analysis if the authors are including different restorative materials and adhesive agents, as these may differently influence the bonding process entirely. Response: We agree. A subgroup analysis plan has been added to stratify studies by: Type of restorative material (ceramic, resin composite, polymer-infiltrated ceramic), Type of adhesive agent (etch-and-rinse, self-etch, universal adhesives, protective liners). This will allow us to evaluate whether IDS effectiveness differs across materials and bonding protocols. Comment 5: Limitations of the protocol need to be acknowledged and wherever possible, addressed. Response: A limitations section has been added in the Discussion. It acknowledges: Restriction to in vitro studies, limiting direct clinical applicability, Variability in test setups, IDS techniques, and restorative materials, Potential for publication bias, despite efforts to minimize it. We also suggest that future well-designed clinical studies address these gaps. Comment 6: There are several spelling mistakes and grammatical errors in the manuscript such as “objectif” or in the sentence stating the aim of the study. Similar errors are present sporadically in the manuscript. Response: We apologize for these errors. The manuscript has undergone thorough proofreading and English language editing. Spelling (e.g., “objectif” → “objective”, “anlysis” → “analysis”)) and grammar have been corrected throughout. Comment 7: The formatting of the manuscript is poor. The authors are suggested to write it in the form of paragraphs and use bullet points only when necessary for a neatly formatted protocol. The bullet points seem to be missing. Response: Thank you for this feedback. The manuscript has been reformatted to improve readability. Paragraph structure has been refined, and bullet points are now used only when appropriate (e.g., inclusion/exclusion criteria, data extraction items). Tables have been harmonized for consistency with PRISMA guidelines. Comment 8: The risk of bias tool mentioned may not be appropriate for in vitro studies. Since the authors are focusing on in vitro studies, they are suggested to use more suitable tools such as the QUIN tool. Response: We appreciate this valuable suggestion. The Cochrane risk of bias tool has been replaced with the QUIN tool (Quality Assessment Tool for In Vitro Studies) , which is specifically designed for laboratory studies. This improves the validity and reliability of our methodological assessment. We are grateful for the reviewer’s constructive insights, which have allowed us to substantially strengthen the manuscript. We believe the revised version now addresses all concerns and meets the methodological standards expected. Sincerely Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Rokaya D. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.172252.r344743 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v1#referee-response-344743 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Jan 2025 Dinesh Rokaya , Ajman University, Ajman, United Arab Emirates Approved VIEWS 0 https://doi.org/10.5256/f1000research.172252.r344743 This is an interesting article done to evaluate the effect of IDS on the fracture strength of indirect posterior restorations. Abstract: The spelling of the Objective is a mistake. Please correct. The Introduction presents the ... Continue reading READ ALL This is an interesting article done to evaluate the effect of IDS on the fracture strength of indirect posterior restorations. Abstract: The spelling of the Objective is a mistake. Please correct. The Introduction presents the background and Method explains in detail. PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design is also clear. Does the IDS affect the bonding of the ceramic? More discussion is needed. Discuss with similar previous studies. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Dental Biomaterials, Prosthetic Dentistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Rokaya D. Reviewer Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.172252.r344743 ) The direct URL for this report is: https://f1000research.com/articles/13-1234/v1#referee-response-344743 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 10 Sep 2025 Yosra Gassara , Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, 5000, Tunisia 10 Sep 2025 Author Response Reviewer Comment 1: The spelling of the Objective is a mistake. Please correct. Response: We thank the reviewer for pointing this out. The spelling error has been corrected from “objectif” ... Continue reading Reviewer Comment 1: The spelling of the Objective is a mistake. Please correct. Response: We thank the reviewer for pointing this out. The spelling error has been corrected from “objectif” to “objective” . The manuscript has also undergone a careful proofreading to ensure consistency in language and grammar throughout. Reviewer Comment 2: The Introduction presents the background and Method explains in detail. PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design) is also clear. Response: We are grateful for this positive feedback. We are pleased that the revised Introduction, Methods, and PICOS framework are now considered clear and appropriately detailed. Reviewer Comment 3: Does the IDS affect the bonding of the ceramic? Response: Thank you for raising this important point. We have expanded the Discussion section to address the effect of Immediate Dentin Sealing (IDS) on ceramic bonding. Evidence suggests that IDS improves adhesive infiltration and reduces the risk of contamination, thereby enhancing the bond strength between resin cement and ceramic restorations. This effect is particularly relevant for lithium disilicate ceramics, where improved adhesion contributes to increased fracture strength and long-term restoration stability. A paragraph discussing this relationship, supported by recent literature, has been added. Reviewer Comment 4: More discussion is needed. Discuss with similar previous studies. Response: We agree that the Discussion required further depth. We have now expanded it by comparing our findings with previous systematic reviews and experimental studies that investigated IDS protocols and their effect on indirect restorations. These comparisons highlight consistencies (e.g., improved fracture strength with IDS) as well as discrepancies (e.g., variations in results depending on adhesive system or restorative material). This addition provides stronger context and situates our findings within the broader body of evidence. Reviewer Comment 1: The spelling of the Objective is a mistake. Please correct. Response: We thank the reviewer for pointing this out. The spelling error has been corrected from “objectif” to “objective” . The manuscript has also undergone a careful proofreading to ensure consistency in language and grammar throughout. Reviewer Comment 2: The Introduction presents the background and Method explains in detail. PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design) is also clear. Response: We are grateful for this positive feedback. We are pleased that the revised Introduction, Methods, and PICOS framework are now considered clear and appropriately detailed. Reviewer Comment 3: Does the IDS affect the bonding of the ceramic? Response: Thank you for raising this important point. We have expanded the Discussion section to address the effect of Immediate Dentin Sealing (IDS) on ceramic bonding. Evidence suggests that IDS improves adhesive infiltration and reduces the risk of contamination, thereby enhancing the bond strength between resin cement and ceramic restorations. This effect is particularly relevant for lithium disilicate ceramics, where improved adhesion contributes to increased fracture strength and long-term restoration stability. A paragraph discussing this relationship, supported by recent literature, has been added. Reviewer Comment 4: More discussion is needed. Discuss with similar previous studies. Response: We agree that the Discussion required further depth. We have now expanded it by comparing our findings with previous systematic reviews and experimental studies that investigated IDS protocols and their effect on indirect restorations. These comparisons highlight consistencies (e.g., improved fracture strength with IDS) as well as discrepancies (e.g., variations in results depending on adhesive system or restorative material). This addition provides stronger context and situates our findings within the broader body of evidence. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 10 Sep 2025 Yosra Gassara , Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, 5000, Tunisia 10 Sep 2025 Author Response Reviewer Comment 1: The spelling of the Objective is a mistake. Please correct. Response: We thank the reviewer for pointing this out. The spelling error has been corrected from “objectif” ... Continue reading Reviewer Comment 1: The spelling of the Objective is a mistake. Please correct. Response: We thank the reviewer for pointing this out. The spelling error has been corrected from “objectif” to “objective” . The manuscript has also undergone a careful proofreading to ensure consistency in language and grammar throughout. Reviewer Comment 2: The Introduction presents the background and Method explains in detail. PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design) is also clear. Response: We are grateful for this positive feedback. We are pleased that the revised Introduction, Methods, and PICOS framework are now considered clear and appropriately detailed. Reviewer Comment 3: Does the IDS affect the bonding of the ceramic? Response: Thank you for raising this important point. We have expanded the Discussion section to address the effect of Immediate Dentin Sealing (IDS) on ceramic bonding. Evidence suggests that IDS improves adhesive infiltration and reduces the risk of contamination, thereby enhancing the bond strength between resin cement and ceramic restorations. This effect is particularly relevant for lithium disilicate ceramics, where improved adhesion contributes to increased fracture strength and long-term restoration stability. A paragraph discussing this relationship, supported by recent literature, has been added. Reviewer Comment 4: More discussion is needed. Discuss with similar previous studies. Response: We agree that the Discussion required further depth. We have now expanded it by comparing our findings with previous systematic reviews and experimental studies that investigated IDS protocols and their effect on indirect restorations. These comparisons highlight consistencies (e.g., improved fracture strength with IDS) as well as discrepancies (e.g., variations in results depending on adhesive system or restorative material). This addition provides stronger context and situates our findings within the broader body of evidence. Reviewer Comment 1: The spelling of the Objective is a mistake. Please correct. Response: We thank the reviewer for pointing this out. The spelling error has been corrected from “objectif” to “objective” . The manuscript has also undergone a careful proofreading to ensure consistency in language and grammar throughout. Reviewer Comment 2: The Introduction presents the background and Method explains in detail. PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design) is also clear. Response: We are grateful for this positive feedback. We are pleased that the revised Introduction, Methods, and PICOS framework are now considered clear and appropriately detailed. Reviewer Comment 3: Does the IDS affect the bonding of the ceramic? Response: Thank you for raising this important point. We have expanded the Discussion section to address the effect of Immediate Dentin Sealing (IDS) on ceramic bonding. Evidence suggests that IDS improves adhesive infiltration and reduces the risk of contamination, thereby enhancing the bond strength between resin cement and ceramic restorations. This effect is particularly relevant for lithium disilicate ceramics, where improved adhesion contributes to increased fracture strength and long-term restoration stability. A paragraph discussing this relationship, supported by recent literature, has been added. Reviewer Comment 4: More discussion is needed. Discuss with similar previous studies. Response: We agree that the Discussion required further depth. We have now expanded it by comparing our findings with previous systematic reviews and experimental studies that investigated IDS protocols and their effect on indirect restorations. These comparisons highlight consistencies (e.g., improved fracture strength with IDS) as well as discrepancies (e.g., variations in results depending on adhesive system or restorative material). This addition provides stronger context and situates our findings within the broader body of evidence. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 15 Oct 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 2 (revision) 29 Aug 25 read read Version 1 15 Oct 24 read read Dinesh Rokaya , Ajman University, Ajman, United Arab Emirates Sanpreet Singh Sachdev , Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Munbai, India Cherif Adel Mohsen , Minia University, Minya, Egypt Álvaro Ferrando Cascales , Universidad Católica de Murcia (UCAM), Murcia, Spain Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Cascales Á. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 07 Jan 2026 | for Version 2 Álvaro Ferrando Cascales , Universidad Católica de Murcia (UCAM), Murcia, Spain 0 Views copyright © 2026 Cascales Á. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This systematic review and meta-analysis protocol is well structured and addresses a clinically relevant question regarding the effect of immediate dentin sealing (IDS) on the fracture strength of indirect posterior restorations. The rationale and objectives are clearly defined, and the proposed methodology follows established guidelines (PRISMA-P and Cochrane standards). The study design is appropriate for the research question, and the planned search strategy, data extraction, and statistical analysis are generally well described. However, some methodological aspects could be further clarified to enhance reproducibility, particularly regarding the interpretation of fracture outcomes across different restoration types and testing protocols. A specific point that would benefit from clarification concerns the discussion of catastrophic failures, such as roots fractures. While IDS has been associated with increased fracture strength, some studies report a higher incidence of non-repairable failures. This phenomenon appears to be mainly related to endocrown restorations, where stress transmission to pulpal and pericervical dentin is maximized, rather than to restorations with peripheral support such as overlays or onlays. Explicitly distinguishing between fracture modes and restoration designs would improve the biomechanical interpretation of the findings and prevent overgeneralization. Overall, this protocol represents a valuable and timely contribution to the literature. Addressing the points above would further strengthen the clarity and clinical relevance of the final review. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Adhesive and restorative dentistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Cascales ÁF. Peer Review Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.187134.r444543) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1234/v2#referee-response-444543 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Mohsen C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 19 Sep 2025 | for Version 2 Cherif Adel Mohsen , Faculty of Dentistry, Minia University, Minya, Egypt 0 Views copyright © 2025 Mohsen C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Dear editorial board I accept this manuscript with only one comment which is reference number 1 is not fully cited. the topic entitled : effect of immediate dentin sealing on the fracture strength of indirect posterior restorations is nowadays. the manuscript is well written and answer many issues about the topic. Is the rationale for, and objectives of, the study clearly described? Yes Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Fixed Prosthodontics I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Mohsen CA. Peer Review Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.187134.r410704) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1234/v2#referee-response-410704 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Sachdev S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 11 Aug 2025 | for Version 1 Sanpreet Singh Sachdev , Oral Pathology and Microbiology,, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Munbai, India 0 Views copyright © 2025 Sachdev S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Data extraction needs to have details of the agent applied and the restorative material used. In meta-analysis, specify the effects model and define heterogeneity values for those models - random and fixed. Include a section of subgroup analysis if the authors are including different restorative materials and adhesive agents, as these may differently influence the bonding process entirely. Limitations of the protocol need to be acknowledged and wherever possible, addressed. There are several spelling mistakes and grammatical errors in the manuscript such as 'objectif' or in the sentence stating the aim of the study. Similar errors are present sporadically in the manuscript. The formatting of the manuscript is poor. The authors are suggested to write it in the form of paragraphs and use bullet points only when necessary for a neatly formatted protocol. The bullet points seem to be missing. The risk of bias tool mentioned may not be appropriate for in vitro studies. Since the authors are focusing on in vitro studies, they are suggested to use more suitable tools such as the QUIN tool. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Partly Are the datasets clearly presented in a useable and accessible format? Partly Competing Interests No competing interests were disclosed. Reviewer Expertise Dentistry, Systematic Reviews I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 10 Sep 2025 Yosra Gassara, Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, 5000, Tunisia Dear Reviewer, We would like to thank you sincerely for your constructive feedback on our manuscript. Your comments have greatly contributed to improving the clarity, methodological rigor, and overall quality of our work. Below, we provide a detailed response to each point, along with the corresponding revisions made in the manuscript. Comment 1: PICOS criteria needs to be properly defined. Include a table of PICOS framework with specific inclusion and exclusion criteria. The current PICOS is very vague. Response: We appreciate this suggestion. The eligibility criteria have been revised to provide a precise PICOS definition. A detailed PICOS framework table has been added (Table 1), specifying participants, interventions, comparisons, outcomes, and study designs, along with both inclusion and exclusion criteria. This improves methodological transparency. Comment 2: Data extraction needs to have details of the agent applied and the restorative material used. Response: We fully agree. The data extraction plan has been expanded to include details of: The adhesive/agent applied (etch-and-rinse, self-etch, universal, protective liners, etc.), The restorative material used (lithium disilicate, polymer-infiltrated ceramic, composite resin, glass-ceramic, etc.). Information on the provisional phase, impression method, and storage conditions has also been included. These modifications ensure a comprehensive capture of all relevant variables influencing fracture strength. Comment 3: In meta-analysis, specify the effects model and define heterogeneity values for those models – random and fixed. Response: Thank you for pointing this out. We clarified that a random-effects model will be the primary model due to the anticipated variability in IDS protocols and restorative materials. For sensitivity analyses, results under a fixed-effects model will also be reported. Heterogeneity thresholds are now explicitly defined as: I² 50% : substantial heterogeneity. Comment 4: Include a section of subgroup analysis if the authors are including different restorative materials and adhesive agents, as these may differently influence the bonding process entirely. Response: We agree. A subgroup analysis plan has been added to stratify studies by: Type of restorative material (ceramic, resin composite, polymer-infiltrated ceramic), Type of adhesive agent (etch-and-rinse, self-etch, universal adhesives, protective liners). This will allow us to evaluate whether IDS effectiveness differs across materials and bonding protocols. Comment 5: Limitations of the protocol need to be acknowledged and wherever possible, addressed. Response: A limitations section has been added in the Discussion. It acknowledges: Restriction to in vitro studies, limiting direct clinical applicability, Variability in test setups, IDS techniques, and restorative materials, Potential for publication bias, despite efforts to minimize it. We also suggest that future well-designed clinical studies address these gaps. Comment 6: There are several spelling mistakes and grammatical errors in the manuscript such as “objectif” or in the sentence stating the aim of the study. Similar errors are present sporadically in the manuscript. Response: We apologize for these errors. The manuscript has undergone thorough proofreading and English language editing. Spelling (e.g., “objectif” → “objective”, “anlysis” → “analysis”)) and grammar have been corrected throughout. Comment 7: The formatting of the manuscript is poor. The authors are suggested to write it in the form of paragraphs and use bullet points only when necessary for a neatly formatted protocol. The bullet points seem to be missing. Response: Thank you for this feedback. The manuscript has been reformatted to improve readability. Paragraph structure has been refined, and bullet points are now used only when appropriate (e.g., inclusion/exclusion criteria, data extraction items). Tables have been harmonized for consistency with PRISMA guidelines. Comment 8: The risk of bias tool mentioned may not be appropriate for in vitro studies. Since the authors are focusing on in vitro studies, they are suggested to use more suitable tools such as the QUIN tool. Response: We appreciate this valuable suggestion. The Cochrane risk of bias tool has been replaced with the QUIN tool (Quality Assessment Tool for In Vitro Studies) , which is specifically designed for laboratory studies. This improves the validity and reliability of our methodological assessment. We are grateful for the reviewer’s constructive insights, which have allowed us to substantially strengthen the manuscript. We believe the revised version now addresses all concerns and meets the methodological standards expected. Sincerely View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Sachdev SS. Peer Review Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.172252.r401655) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1234/v1#referee-response-401655 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Rokaya D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Jan 2025 | for Version 1 Dinesh Rokaya , Ajman University, Ajman, United Arab Emirates 0 Views copyright © 2025 Rokaya D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This is an interesting article done to evaluate the effect of IDS on the fracture strength of indirect posterior restorations. Abstract: The spelling of the Objective is a mistake. Please correct. The Introduction presents the background and Method explains in detail. PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design is also clear. Does the IDS affect the bonding of the ceramic? More discussion is needed. Discuss with similar previous studies. Is the rationale for, and objectives of, the study clearly described? Partly Is the study design appropriate for the research question? Yes Are sufficient details of the methods provided to allow replication by others? Yes Are the datasets clearly presented in a useable and accessible format? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Dental Biomaterials, Prosthetic Dentistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 10 Sep 2025 Yosra Gassara, Fixed prosthodontics, University of Monastir Faculty of Dental Medicine of Monastir, Monastir, 5000, Tunisia Reviewer Comment 1: The spelling of the Objective is a mistake. Please correct. Response: We thank the reviewer for pointing this out. The spelling error has been corrected from “objectif” to “objective” . The manuscript has also undergone a careful proofreading to ensure consistency in language and grammar throughout. Reviewer Comment 2: The Introduction presents the background and Method explains in detail. PICOS framework (Participants, Intervention, Comparison, Outcome, Study Design) is also clear. Response: We are grateful for this positive feedback. We are pleased that the revised Introduction, Methods, and PICOS framework are now considered clear and appropriately detailed. Reviewer Comment 3: Does the IDS affect the bonding of the ceramic? Response: Thank you for raising this important point. We have expanded the Discussion section to address the effect of Immediate Dentin Sealing (IDS) on ceramic bonding. Evidence suggests that IDS improves adhesive infiltration and reduces the risk of contamination, thereby enhancing the bond strength between resin cement and ceramic restorations. This effect is particularly relevant for lithium disilicate ceramics, where improved adhesion contributes to increased fracture strength and long-term restoration stability. A paragraph discussing this relationship, supported by recent literature, has been added. Reviewer Comment 4: More discussion is needed. Discuss with similar previous studies. Response: We agree that the Discussion required further depth. We have now expanded it by comparing our findings with previous systematic reviews and experimental studies that investigated IDS protocols and their effect on indirect restorations. These comparisons highlight consistencies (e.g., improved fracture strength with IDS) as well as discrepancies (e.g., variations in results depending on adhesive system or restorative material). This addition provides stronger context and situates our findings within the broader body of evidence. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Rokaya D. Peer Review Report For: Effect of immediate dentin sealing on the fracture strength of indirect posterior restorations:Systematic review and meta-analysis protocol. [version 2; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :1234 ( https://doi.org/10.5256/f1000research.172252.r344743) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1234/v1#referee-response-344743 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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