Evaluation of fracture behavior in short fiber–reinforced direct and indirect overlay restorations


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Garoushi S., Akbaşak-Sungur A., Erkut S., Vallittu P., ÜÇTAŞLI S., Lassila L.

Clinical Oral Investigations, cilt.27, sa.9, ss.5449-5458, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 27 Sayı: 9
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1007/s00784-023-05164-2
  • Dergi Adı: Clinical Oral Investigations
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.5449-5458
  • Anahtar Kelimeler: Bilayered restoration, CAD/CAM, Fracture resistance, MOD, Overlays, Short-fiber composite
  • Ankara Üniversitesi Adresli: Evet

Özet

Objectives: The aim was to assess how incorporating a short-fiber composite (SFC) core would affect the fracture behavior of direct and indirect overlays. Furthermore, to examine the relationship between the thickness ratio of SFC core to particulate-filled composite (PFC) veneering and the fracture-behavior of bilayered-structured restorations. Materials and methods: A total of 120 molars were used to create MOD cavities, with palatal cusps removed. Four different groups of direct overlays were then made (n = 15/group), all of which featured a SFC core (everX Flow) with varying thicknesses (0, 1, 4, and 5 mm), as well as a surface layer of PFC (G-aenial Posterior), with the overall thickness of the bilayered-structured restoration set at 5 mm. Additionally, four groups of CAD/CAM restorations were created (Cerasmart 270 and Initial LiSi Block), with or without 2 mm of SFC core reinforcement. Following the fabrication of these restorations, cyclic fatigue aging was carried out for a total of 500,000 cycles, with an applied maximum load (F max) of 150 N. Subsequently, each restoration underwent quasi-static loading until fracture. The fracture mode was subsequently evaluated using optical microscopy and SEM. Results: There were no statistically significant differences (p > 0.05) observed in the fracture resistance of indirect overlays reinforced with a 2-mm SFC core compared to those made solely from restorative materials. Direct overlays constructed using plain SFC or with a 4-mm layer thickness of SFC core exhibited significantly higher fracture resistance values (2674 ± 465 and 2537 ± 561 N) (p < 0.05) when compared to all other groups tested, according to the statistical analysis ANOVA. Conclusions: The most effective method for restoring large MOD cavities was found to be direct restoration using SFC either alone or as a bulk core in combination with PFC composite. Clinical relevance: The use of SFC as bulk reinforcing base will significantly improve the loading performance of directly layered restorations.