Fracture strength and fracture patterns of root-filled teeth restored with direct resin composite restorations under static and fatigue loading

Abstract

Aim: To assess fracture strength and fracture patterns of root-filled teeth with direct resin composite restorations under static and fatigue loading. Methodology: MOD cavities plus endodontic access were prepared in 48 premolars. Teeth were root filled and divided into three restorative groups, as follows 1) resin composite; 2) glass ionomer cement (GIC) core and resin composite; and 3) open laminate technique with GIC and resin composite. Teeth were loaded in a servohydraulic material test system. Eight samples in each group were subjected to stepped fatigue loading: a preconditioning load of 100 N (5000 cycles) followed by 30,000 cycles each at 200 N and higher loads in 50-N increments until fracture. Noncycled teeth were subjected to a ramped load. Fracture load, number of cycles, and fracture patterns were recorded. Data were analyzed using two-way analysis of variance and Bonferroni tests. Results: Fatigue cycling reduced fracture strength significantly (p<0.001). Teeth restored with a GIC core and a laminate technique were significantly weaker than the composite group (379±56 N, 352±67 N vs 490±78 N, p=0.001). Initial debonding occurred before the tooth underwent fracture. All failures were predominantly adhesive, with subcrestal fracture of the buccal cusp.