Fracture resistance of endodontically treated maxillary premolars using indirect and direct composite onlays: A comparative study

Abstract

ABSTRACT Aim: To evaluate and compare the fracture resistance of endodontically treated maxillary teeth using the same material as indirect and direct composite onlays and their modes of fracture. Materials and Methods: Ninety maxillary premolars were divided into six groups (n = 15) out of which 15 teeth were kept intact (negative control, Group 1). In the remaining 75 teeth, endodontic treatment was done and standardized mesio-occlusal-distal cavities were prepared. Fifteen teeth were kept unrestored (positive control, Group 2). The rest of the teeth were divided according to the type of restorations and the restorative material; Group 3: Ceram X sphereTEC™ one direct composite onlay, Group 4: Ceram X sphereTEC™ one indirect composite onlay, Group 5: Filtek Z 350 XT direct composite onlay, and Group 6: Filtek Z 350 XT indirect composite onlay. All the specimens were subjected to thermocycling and cyclic loading. The fracture resistance test was performed with the help of a universal testing machine and their modes of fracture were evaluated. Results: Mean fracture resistance values in the decreasing order are as: 1487.33N for Group 6, 1104.57N for Group 4, 933.87N for Group 1, 799.13N for Group 5, and 688.73N for Group 3, 265.23N for Group 2. Mean fracture resistance of Groups 6 and 4 was found to be significantly higher than Groups 1, 2, 3, and 5. Furthermore, there was a significant difference between Groups 1 and 3. Groups 1, 3, 4, 5, and 6 showed more number of favorable/restorable fractures, whereas Group 2 showed more unfavorable/unrestorable fracture. Conclusion: The indirect technique of fabrication of onlays improved the fracture resistance of endodontically treated maxillary premolars.