Fracture resistance of weakened premolars restored with sonically-activated composite, bulk-filled and incrementally-filled composites (A comparative in vitro study )

Abstract

This study was conducted to assess the effect of sonic activation and bulk placement of resin composite in comparison to horizontal incremental placement on the fracture resistance of weakened premolar teeth. Materials and method: Sixty sound human single-rooted maxillary premolars extracted for orthodontic purposes were used in this study. Teeth were divided into six groups of ten teeth each: Group 1 (sound unprepared teeth as a control group), Group 2 (teeth prepared with MOD cavity and left unrestored), Group 3 (restored with SonicFill™ composite), Group 4 (restored with Quixfil™ composite), Group 5 (restored with Tertic EvoCeram® Bulk Fill composite) and Group 6 (restored with Universal Tetric EvoCeram® composite using horizontal incremental layering technique). Standardized class II MOD cavity was prepared in all teeth except (group 1).After finishing the restorative procedure of each group according to the manufacturer's instructions, all teeth were stored in deionized distilled water in an incubator at 37°C for seven days.All specimens were subjected to compressive axial loading until fracturein a universal testingmachine.Specimens were examined by a stereomicroscope at a magnification of (20X) to evaluate the mode of fracture . Results: The results of this study revealed that the control group exhibited the highest fracture resistance compared to all prepared teeth groups (restored or unrestored) and the differences were statistically highly significant (P 0.05). Group 3and Group 5 showed mostly mixed mode of failure, while Group 4 showed mostly adhesive mode of failure. On the other hand Group 6 teeth showed different modes of failure. Conclusions: SonicFill™ composite can be considered as a viable treatment modality for the restoration of weakened maxillary premolar teeth. On the other hand, the time-consuming incremental layering technique can be substituted with bulk filling, using bulk fill materials (Quixfil™ and Tetric EvoCeram® Bulk Fill) for reinforcement ofweakened