Performance of direct and indirect onlay restorations for structurally compromised teeth

Abstract

Research is lacking on the restoration of structurally compromised posterior teeth using direct composite resin or indirect restorations. The purpose of this in vitro study was to measure the fracture resistance and microleakage of different onlay restorations fabricated by using conventional and digital computer-aided design and computer-aided manufacturing (CAD-CAM) to restore structurally compromised teeth. Mandibular molars (n=54) were prepared for onlay restorations. Teeth were allocated to 3 groups (n=18) according to the type of restoration materials, nanohybrid composite resin (Grandio blocs), resin hybrid ceramic (SHOFU Block HC), and fiber-reinforced composite resin (everX Posterior). Onlays were bonded using a dual-polymerized adhesive resin cement. All specimens were thermocycled, followed by cyclic loading. Based on the type of investigation conducted, fracture resistance, and microleakage test, each group was then divided into 2 equal subgroups (n=9). The collected data were statistically analyzed with the chi-square of the Fischer exact test (α=.05). Fracture resistance testing revealed a statistically significant difference between groups (P<.001). The fiber-reinforced composite resin demonstrated the highest fracture resistance, with statistically significantly less microleakage compared with the other groups (P=.013). Direct fiber-reinforced composite resin could be considered a suitable alternative to CAD-CAM composite resin for the restoration of structurally compromised teeth.