Abstract
To reinforce extensively prepared cavities, different types of fiber reinforcement are utilized. Polyethylene and glass fibers are the most commonly used fibers in that purpose; each type has its own advantages over the other type. Therefore, the aim of this study is to review the literature to evaluate and compare the influence of different fiber reinforcement types on the performance of posterior large composite restorations. Two independent authors performed a comprehensive literature search using MEDLINE/PubMed, Google Scholar, and a manual search for cross references until July 2021. Authors selected only studies that contain comparisons between glass (continuous or short) and polyethylene (woven) fiber-reinforced composites (FRCs) in posterior cavities of human teeth, and that report the effect of fiber inclusion on fracture resistance, microleakage, and marginal adaptation of restorations. A number of 2711 potentially relevant articles were obtained from the electronic search. After extensive assessment, 2696 articles were ineligible to be included in the review, and only 15 articles met the inclusion criteria. Four out of nine studies, which tested the fracture resistance of FRC restorations, revealed similar performance of the glass and polyethylene fibers. The rest of the studies (n = 5) revealed statistically significant differences between the two types of fiber reinforcement, with the majority showed superior reinforcement of glass fiber. Moreover, the reviewed studies revealed that, using fibers within the composite restorations would reduce the microleakage and improve the marginal adaptation of the restoration regardless of the fiber type. FRCs tend to strengthen the restorations of structurally compromised teeth and improve their performance compared to plain composite restorations.
Highlights
Extensive cavity preparation is one of the major contributing factors of tooth fragility, which could result in the partial or complete fracture of cusps or roots of posterior teeth [1]
Eligibility Criteria Eligible studies for inclusion in this review are full-text studies that tested the fracture resistance, microleakage and marginal adaptation of composite restorations reinforced by both polyethylene and glass fiber-reinforced composites (FRCs)
Within the 15 included studies, nine published articles compared the fracture resistance of restorations reinforced by glass vs. polyethylene FRCs applied within extracted human teeth [4,8,26,27,28,29,30,31,32], and six articles compared the effect of the same FRCs on microleakage [9,10,11,33,34,35]
Summary
Extensive cavity preparation is one of the major contributing factors of tooth fragility, which could result in the partial or complete fracture of cusps or roots of posterior teeth [1]. Innovative treatment solutions based on new improved materials are continuously evolving to restore the function and preserve the remaining tooth structure, with resin composite being a prime example. Resin composite can bond to tooth structure, which means, theoretically, it has the ability to regain the lost fracture resistance, and to strengthen the tooth by providing an internal splint. The basic problems of the composite restorations are insufficient toughness and increased contraction, as well as polymerization shrinkage stress [3]. The polymerization shrinkage increases as the cavity depth increases, because of the greater cantilever effect and the greater volume of restorative materials, which is generally seen in big cavities and root-canal-treated teeth, as the pulpal floor is lost [5]. The increased shrinkage stress results in marginal breakage, microleakage, and secondary caries [5]
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