Fracture resistance of composite resin restorations and porcelain veneers in relation to residual tooth structure in fractured incisors

Abstract

The aim of the present study was to investigate whether there is a direct correlation between the amount of residual tooth structure in a fractured maxillary incisor and the fracture resistance of composite resin restorations or porcelain veneers after cyclic loading. Sixty human-extracted maxillary central and lateral incisors were mounted in an acrylic block with the coronal aspect of the tooth protruding from the block surface. The teeth were assigned to two groups: 2-mm incisal fracture and 4-mm incisal fracture. Then, the teeth were further divided into two different restoration subgroups, porcelain laminate veneer and composite resin restoration, therefore obtaining four groups for the study (n=15). The specimens were subjected to 1000 cycles of thermocycling and were mechanically tested with a custom-designed cyclic loading apparatus for 2×106 cycles or until they failed. The specimens that survived the cyclic loading were loaded on the incisal edge along the long axis of the tooth with a flat stainless steel applicator until they fractured using a universal testing machine to measure the failure load. Two-way anova was used to assess the significance of restoration, amount of fracture, and interaction effect (α=0.05). During the cyclic loading, for the composite resin group, two specimens with 2-mm fracture and three specimens with 4-mm fracture failed. For the porcelain veneer group, two specimens with 2-mm fracture and one specimen with 4-mm fracture failed. The 2-way anova did not show statistical significance for restoration (P=0.584), amount of fracture (P=0.357), or interaction effect (P=0.212). A composite resin restoration and a porcelain veneer could perform similarly for replacing a fractured incisor edge up to 4mm. Other factors such as esthetic and/or cost would be considerations to indicate one treatment over the other.