Fracture Resistance Of Maxillary Premolar With Class II MOD Cavities Filled With Novel Composites Namely Nanohybrid Composite, Nanoceramic Composite, Short Fiber Enforced Composite And Nanohybrid With Fiber Splint Reinforced Composite
Keywords:
Composite, Composite, fracture, fracture, resistance, resistanceAbstract
Aim: The aim of this study is to evaluate the fracture resistance of maxillary premolar with class II MOD cavities filled with novel composites namely nanohybrid composite, nanoceramic composite, short fiber enforced composite and nanohybrid with fiber splint reinforced composite.
Materials and methods: This in-vitro study utilized 100 freshly extracted non-carious maxillary premolars, sourced from patients aged 20–45 years for orthodontic purposes at New Horizon Dental College and affiliated camps. The selected teeth met strict inclusion criteria, ensuring absence of cracks, caries, or anatomical anomalies. Teeth were stored in 10% formalin at room temperature until use, then mounted in acrylic blocks for testing.Teeth were randomly divided into five groups of 20 each. The positive control group consisted of intact, unrestored teeth, while the negative control group had MOD cavities left unrestored. The remaining groups had standardized MOD cavities prepared using diamond burs under air-water cooling. Cavity dimensions were maintained with precision using a digital caliper. The teeth were restored with one of the following: nanohybrid composite (Tetric N-Ceram), nanoceramic composite (Magma NT), short fiber reinforced composite (GC everX Posterior) with a nanohybrid surface layer, and nanohybrid composite reinforced with a fiber splint (Angelus Interlig).
Results: Statistical analysis was first made by Kruskal Wallis Test, which showed significant difference of fracture resistance between the groups as a whole (H=88.44, p value<0.0001). Further it was analyzed by Mann Whitney U Test for 2- group comparison, the test showed highly significant statistical differences between all the study groups except between Group -II and Group –IV
Conclusion: Within the limitations of this study, it can be concluded that the preparation of MOD cavities reduced the fracture resistance of maxillary premolars. Among the restorative materials tested under compressive loads, nanoceramic composites demonstrated the lowest fracture resistance, while nanohybrid and fibre-reinforced composite resins exhibited higher and comparable fracture resistance. Notably, the fibre-reinforced composite group showed superior reinforcing ability, as indicated by the favorable fracture patterns observed.
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Joshi, Chintan, et al. "Comparative analysis of fracture resistance of maxillary premolars with class II MOD cavities restored with novel nanocomposites including fibre reinforced composite restorative system: a step ahead in composite dentistry." Advances in Human Biology 4.2 (2014): 14-21.
Braga, Marcia Rachel & Messias, Danielle Cristine & Macedo, LucianaMartins & Silva-Sousa, Yara Correa & Gabriel, Aline Evangelista. (2015). Rehabilitation of weakened premolars with a new polyfiber post and adhesive materials. Indian Journal of Dental Research. 26. 400. 10.4103/0970-9290.167643.
Ata, Mostafa S. Mohamed. "Fracture resistance of premolars teeth restored by silorane, nanohybrid and two types of fiber-reinforced composite: an: in-vitro: study." Tanta Dental Journal 14.4 (2017): 216-219.
Taher, Hebatallah M., and Mohamed Haridy. "Fracture resistance of maxillary premolars restored with different fiber-reinforced composites: An in vitro study." Egyptian Dental Journal 65.2-April (Fixed Prosthodontics, Dental Materials, Conservative Dentistry & Endodontics) (2019): 1833-1843.
Khaleel, Passant Mohammad, Ahmed Safwat Elkady, and Maha Adly Abd El Motie. "Fracture resistance of maxillary premolars with complex class ii cavities restored with recent types of posterior composites and biaxial flexural strength assessment." alexandria dental journal 47.2 (2022): 162-172.
Yoshihiro Yamada, Yuji Tsubota, and Shunji Fukushima. "Effect of restoration method on fracture resistance of endodontically treated maxillary premolars," International Journal of Prosthodontics in the January-February 2004 issue (Volume 17, Issue 1, Pages 94-98)
Guilherme Brião Camacho, Mariane Gonçalves, Tomio Nonaka, and Ângela Brys Osorio. "Fracture strength of restored premolars," the American Journal of Dentistry in 2007 (Volume 20, Issue 2, Pages 121-124).
Taha DG, Abdel-Samad AA, Mahmoud SH. Fracture resistance of maxillary premolars with class II MOD cavities restored with Ormocer, Nanofilled, and Nanoceramic composite restorative systems. Quintessence Int. 2011 Jul-Aug;42(7):579-87. PMID: 21716986
Costa, S., Silva-Sousa, Y., Curylofo, F., Steier, L., Sousa-Neto, M., & Souza-Gabriel, A. (2014). Fracture resistance of endodontically treated premolars restored with different methods. Journal of Dentistry, 42(3), 275–280.
Atiyah, A. H., & Baban, L. M. (2014). Fracture resistance of endodontically treated premolars with extensive MOD cavities restored with different composite restorations: An in vitro study. Journal of Baghdad College of Dentistry, 26(1), 7–15.
Jawad, Z. S., & Al-Azzawi, A. K. J. (2015). The influence of cavity design for cusp coverage on fracture strength of weakened maxillary first premolars using two esthetic restorative systems (CAD/CAM hybrid ceramic and nanohybrid composite): An in vitro study. Journal of Baghdad College of Dentistry, 27(1), 1–10.
Mincik, J., Urban, D., Timkova, S., & Urban, R. (2016). Fracture resistance of endodontically treated maxillary premolars restored by various direct filling materials: An in vitro study. International Journal of Biomaterials, 2016, Article ID 9138945.
Sud N, Gupta AK, Sharma V, Minocha A. Comparative evaluation of the fracture resistance of maxillary premolars with Mesio-occluso distal cavities restored with Zirconomer, Amalgam, Composite and GIC: An in vitro study. Int J Res Health Allied Sci. 2019;5(1):79-82.
Gunwal MK, Shenoi PR, Paranjape T, Dhote S, Tongya R, Kumar M, Rastogi S. Evaluation of fracture resistance and mode of failure of premolars restored with nanohybrid composite, ORMOCER, and ceramic inlays. J Oral Biol Craniofac Res. 2018 May-Aug;8(2):134-139.
Naik, Sadanand & Ataide, Ida & Fernandes, Marina. (2023). Fracture Resistance of Endodontically Treated Premolars Using Nanohybrid Composite, Fiber-Reinforced Composite, Horizontal Glass Fiber Posts, and Ceramic Inlays: An In Vitro Study. Journal of Endodontics. 49. 10.1016/j.joen.2023.08.004.
Moosavi H, Zeynali M, Pour HZ. Fracture resistance of premolars restored by various types and placement techniques of resin composites. Int J Dent. 2012;2012:973641.
Wu Y, Cathro P, Marino V. Fracture resistance and pattern of the upper premolars with obturated canals and restored endodontic occlusal access cavities. J Biomed Res. 2010;24(6):474-78.
Minick J, Urban D, Timkova S, Urban R. Fracture resistance of endodontically treated maxillary premolars restored by various direct filling materials: An in vitro study. Int J Biomater. 2016;2016:9138945.
Vaid DS, Shah NC, Bilgi PS. One year comparative clinical evaluation of EQUIA with resin-modified glass ionomer and a nanohybrid composite in noncarious cervical lesions. J Conserv Dent. 2015;18(6):449-52.
Balkaya H, Arslan S, Pala K. A randomised, prospective clinical study evaluating effectiveness of a bulk-fill composite resin, a conventional composite resin and a reinforced glass ionomer in Class II cavities: One-year results. J Appl Oral Sci. 2019;27:e20180678.
Rezvani MB, Mohammadi Basir M, Mollaverdi F, Moradi Z, Sobout A. Comparison of the effects of micro filled and hybrid composite resin restorations on the fracture resistance of extensively weakened teeth. (JIDAI) Winter. 2013;25(1):51-56.
Sideridou ID, Karabela MM, Vouvoudi EC. Physical properties of current dental nanohybrid and nanofiller light-cured resin composites. Dent Mater. 2011;27(6):598- 07.
Sorrentino R. Effect of post retained composite restorations of mesial occlusal-distal cavities on the fracture resistance of endodontically treated teeth. J Adhes Dent 2007;9(1):49–56.
Garlapati TG, Krithikadatta J, Natanasabapathy V. Fracture resistance of endodontically treated teeth restored with short fiber composite used as a core material—an in vitro study. J Prosthodont Res 2017;61(4):464–470. DOI: 10.1016/j.jpor.2017.02.001
Bremer BD, Geurtsen W. Molar fracture resistance after adhesive restoration with ceramic inlays or resin-based composites. Am J Dent 2001;14(4):216–220.
De Freitas CR, Miranda MI , de Andrade MF, Flores VH, Vaz LG, Guimaraes C. Resistance to maxillary premolar fractures after restoration of Class II preparations with resin composite or ceromer. Quintessence Int 2002; 33(8):589 94.
Burke FJ, Wilson NH, Watts DC. The effect of cavity wall taper on fracture resistance of teeth restored with resin composite inlays. Oper Dent 1993;18(6):230–6.
Yap AU, Wang HB, Siow KS, Gan LM. Polymerization shrinkage of visible-light-cured composites. Oper Dent 2000; 25(2):98–103.
Versluis A, Tantbirojn D. Theoretical considerations of contraction stress. Compend Contin Educ Dent Suppl 1999; 25:24–32.
Ausiello P, Apicella A, Davidson CL, Rengo S. 3D-finite element analyses of cusp movements in a human upper premolar, restored with adhesive resin-based composites. J Biomech 2001; 34(10):1269–77.
Dupasquier F, Gritsch K, Farlay D, Zydowicz N, Grosgogeat B. Mechanical properties and polymerization shrinkage of dental nanohybrid composites. Eur Cell Mater 2007; 13(1):21.
Koplin C, Jaeger R, Hahn P. A material model for internal stress of dental composites caused by the curing process. Dent Mater 2009; 25(3):331–8
Kolbeck C, Rosentritt M, Lang R, Handel G. In vitro study of fracture strength and marginal adaptation of polyethylene-fibre-reinforced-composite versus glass-fibrereinforced-composite fixed partial dentures. J Oral Rehabil 2002; 29:668–674.
Soares S, Queiroz E, Araújo T, Campos R, Araújo C, Soares C. Fracture resistance and stress distribution in endodontically treated maxillary premolars restored with composite resin. J Prosthodont 2008; 17:114–119.
Ata MSM. Fracture resistance of premolars teeth restored by silorane, nanohybrid, and two types of fiber-reinforced composite: an in-vitro study. Ain Shams Dent J. 2017;10(2):216-219
an Dijken J, Sunnegårdh-Grönberg K. Fiber-reinforced packable resin composites in Class II cavities. J Dent 2006; 34:763–769.
Schmidt M, Kirkevang LL, Hørsted-Bindslev P, Poulsen S. Marginal adaptation of a low-shrinkage silorane-based composite: 1-year randomized clinical trial. Clin Oral Investig 2011; 15:291–295.
Hegde MN, Hegde P, Bhandary S, Deepika K. An evaluation of compressive strength of newer nanocomposite: an in vitro study. J Conserve Dent 2011; 14:36–39.
Ausiello P, Apicella A, Davidson CL. Effect of adhesive layer properties on stress distribution in composite restorations: a 3D finite element analysis. Dent Mater 2002; 18:295–303.
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