Fracture Resistance of Cuspal Coverage of Endodontically Treated Maxillary Premolars with Combined Composite-Amalgam Compared to Other Techniques

Abstract

Combined composite-amalgam for cuspal coverage of endodontically treated premolars was similar to direct composite coverage in strengthening restored teeth; however, composite onlay had the highest fracture resistance. SUMMARYThis in vitro study investigated the fracture resistance of teeth restored with combined composite-amalgam for cuspal coverage compared to direct coverage with composite (with or without an amalgam base) and composite onlay. Seventy-two intact maxillary premolars were randomly divided into six groups (n¼12). The two control groups were G1, intact teeth (negative control), and G2, mesio-occlusodistal preparation only (positive control). Each of the four experimental groups used a different type of restoration for the prepared teeth: G3, direct composite cusp coverage; G4, composite onlay; G5, direct composite coverage with an amalgam base; and G6, combined compositeamalgam cuspal coverage. After thermocycling, fracture strength was tested. The data were analyzed with analysis of variance and the least significant differences post hoc tests (a¼0.05). Mean fracture resistance in the six

Influence of restorative procedures on endodontically treated premolars: Finite element analysis of a CT-scan based three-dimensional model

“…The values were markedly lower in MODP and MODPB models, regardles of the use of a FRC post. These findings are in accordance with the results of certain studies 8,13,23,24) . In a FEA study, Lin et al 13) recommend a cusp reduction of at least 1.5 mm in order to increase the fracture resistance of premolars.…”

“…Kantardžić et al 23) found using the FEA method that the reduction of the palatal cusp reduces stresses in the enamel significantly. Certain in vitro studies showed that endodontically treated premolars restored using partial ceramic 24) or full composite onlays 8) had a higher fracture resistance as compared to other techniques used, while another group of authors 6) found that cusp capping does not influence fracture resistance significantly. In the present study MODP and MODP+P showed the lowest values of maximum von Mises stresses in the enamel, which could indicate that bucal premolar cusp reduction is not necessary.…”

“…Owing to technological progress and the introduction of dental resin composite materials and adhesive systems of improved characteristics 5) , nowadays composite resin fillings are often the restoration of choice in such cases 6,7) . Furthermore, it requires less chair time and is much more affordable than the indirect restorations 8) . Despite the adequate aesthetic and mechanical properties, and affordable price, it was shown that the direct resin composite fillings alone might not be sufficient to ensure the longevity of an endodontically treated tooth with an MOD cavity 8) .…”

“…Furthermore, it requires less chair time and is much more affordable than the indirect restorations 8) . Despite the adequate aesthetic and mechanical properties, and affordable price, it was shown that the direct resin composite fillings alone might not be sufficient to ensure the longevity of an endodontically treated tooth with an MOD cavity 8) . Therefore, additional procedures, such as the palatal and buccal cusp reduction (MODP, MODPB), and/or fiber-reinforced composite (FRC) posts [9][10][11][12][13] , were suggested.…”

Direct Restoration of Endodontically Treated Teeth: a Brief Summary of Materials and Techniques

“…Compressive loading during the fracture resistance test may be distributed throughout the restored tooth by different materials. Thus, Shafiei et al (2014) [80] suggested covering the cusps with an amalgam and composite resin combination and found no difference between the group receiving direct composite coverage and the one undergoing amalgam-based composite restoration. Nevertheless, direct cusp coverage with composite restoration appears to be a reliable method in extensive cavities [44,73].…”