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Moussa C, Savard G, Rochefort G, Renaud M, Denis F, Daou MH. Fracture Resistance of Direct versus Indirect Restorations on Posterior Teeth: A Systematic Review and Meta-Analysis. Bioengineering (Basel) 2024; 11:536. [PMID: 38927772 PMCID: PMC11201167 DOI: 10.3390/bioengineering11060536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
The aim of this systematic review and meta-analysis was to compare static compression forces between direct composite resin restorations and indirect restorations for posterior teeth. All studies comparing mechanical properties of direct versus indirect restorations of posterior teeth were included from 2007 up to February 2024. A meta-analysis was conducted for static compression fracture resistance. Medline, Central, and Embase databases were screened. Twenty-four articles were included in the qualitative synthesis, and sixteen studies were finally included in the quantitative synthesis. There was no difference in terms of fracture resistance between direct and indirect restorations for posterior teeth (p = 0.16 for direct and indirect composite resin restorations and p = 0.87 for direct composite resin restorations and indirect ceramic restorations). Also, sub-group analysis with or without cusp coverage in each group revealed no discernable difference. Based on this study, it can be concluded that the choice between direct and indirect restoration approaches may not significantly impact fracture resistance outcomes. There was no statically significant difference between direct and indirect restorations for posterior teeth in all cases of restorations with or without cusp coverage and no matter the used materials. However, to better evaluate these materials, further studies are warranted.
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Affiliation(s)
- Carol Moussa
- Faculty of Dentistry, University of Tours, 37032 Tours, France; (G.S.); (G.R.); (M.R.); (F.D.); (M.H.D.)
- Department of Restorative Dentistry, Faculty of Dental Medicine, Saint-Joseph University, Beirut 1107 2180, Lebanon
- Division of Education, Ethics, Health, Faculty of Medicine, University of Tours, 37044 Tours, France
| | - Guillaume Savard
- Faculty of Dentistry, University of Tours, 37032 Tours, France; (G.S.); (G.R.); (M.R.); (F.D.); (M.H.D.)
- Division of Education, Ethics, Health, Faculty of Medicine, University of Tours, 37044 Tours, France
- Department of Medicine and Bucco-Dental Surgery, Tours University Hospital, 37044 Tours, France
| | - Gael Rochefort
- Faculty of Dentistry, University of Tours, 37032 Tours, France; (G.S.); (G.R.); (M.R.); (F.D.); (M.H.D.)
- INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, 37032 Tours, France
| | - Matthieu Renaud
- Faculty of Dentistry, University of Tours, 37032 Tours, France; (G.S.); (G.R.); (M.R.); (F.D.); (M.H.D.)
- Department of Medicine and Bucco-Dental Surgery, Tours University Hospital, 37044 Tours, France
- N2C Laboratory, UMR INSERM U 1069, University of Tours, 37032 Tours, France
| | - Frédéric Denis
- Faculty of Dentistry, University of Tours, 37032 Tours, France; (G.S.); (G.R.); (M.R.); (F.D.); (M.H.D.)
- Division of Education, Ethics, Health, Faculty of Medicine, University of Tours, 37044 Tours, France
- Department of Medicine and Bucco-Dental Surgery, Tours University Hospital, 37044 Tours, France
| | - Maha H. Daou
- Faculty of Dentistry, University of Tours, 37032 Tours, France; (G.S.); (G.R.); (M.R.); (F.D.); (M.H.D.)
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Saint Joseph University, Beirut 1107 2180, Lebanon
- Division of Biomaterials, Craniofacial Research Laboratory, Saint Joseph University, Beirut 1107 2180, Lebanon
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Nezir M, Dinçtürk BA, Sarı C, Alp CK, Altınışık H. Effect of fiber-reinforced direct restorative materials on the fracture resistance of endodontically treated mandibular molars restored with a conservative endodontic cavity design. Clin Oral Investig 2024; 28:316. [PMID: 38750289 PMCID: PMC11096213 DOI: 10.1007/s00784-024-05720-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE This study aimed to evaluate the fracture strength of teeth restored using fiber-reinforced direct restorative materials after endodontic treatment with a conservative mesio-occlusal access cavity design. MATERIALS AND METHODS A total of 100 extracted intact mandibular first molars were selected and distributed into a positive control group where teeth left intact and the following four test groups comprised of teeth with conservative mesio-occlusal access cavities that had undergone root canal treatment (n = 20/group): access cavity without restoration (negative control), bulk-fill resin composite with horizontal glass fiber post reinforcement, fiber-reinforced composite with bulk-fill resin and bulk-fill resin composite. Following thermocycling (10,000 cycles), fracture resistance was measured using a universal testing machine. Statistical analyses (one-way analysis of variance and the Tamhane test) were performed, and statistical significance was set at p < 0.05. RESULTS Groups with minimally invasive access cavities had lower fracture strength than intact teeth, regardless of the restoration material (p < 0.05). Fiber-reinforced composite groups demonstrated higher fracture strength than bulk-fill resin composite alone (p < 0.05). Fracture types varied among groups, with restorable fractures predominant in the fiber-reinforced composite groups. CONCLUSION This study suggests that using fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, can effectively enhance the fracture strength of endodontically treated teeth with conservative access cavities. However, using only bulk-fill resin composite is not recommended based on the fracture strength results. CLINICAL SIGNIFICANCE When teeth that undergo endodontic treatment are restored using a conservative access cavity design and fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, the fracture strength of the teeth can be effectively increased.
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Affiliation(s)
- Merve Nezir
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Emek, Ankara, 06510, Turkey
| | - Beyza Arslandaş Dinçtürk
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Emek, Ankara, 06510, Turkey
| | - Ceyda Sarı
- Department of Restorative Dentistry, Faculty of Dentistry, İstanbul Medipol University, İstanbul, Turkey
| | - Cemile Kedici Alp
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Emek, Ankara, 06510, Turkey
| | - Hanife Altınışık
- Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Emek, Ankara, 06510, Turkey.
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The Restored Premolars Biomechanical Behavior: FEM and Experimental Moiré Analyses. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136768] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study applied the finite element method (FEM) and the moiré strip projection method to evaluate the biomechanical behavior of healthy and endodontic-treated premolar teeth. The finite element method and the moiré strip projection method were applied to evaluate the influence of restored materials in association with cervical lesions and were considered as strain estimates for a tooth sample with 21 units, under loads of 25, 50, 75, and 100 N, frontal and oblique applied. The focused cases were: tooth H healthy; tooth A-MOD amalgam; tooth AL-MOD amalgam + lesion; tooth ALR-MOD amalgam + injury restored; tooth R-MOD resin; tooth RL-MOD resin + lesion; tooth RLR-MOD resin + injury restored. The results obtained by FEM simulation can be considered perfectly validated by the results presented by the experimental moiré projection analysis, demonstrating that the FEM numerical analysis can be used to evaluate the biomechanical behavior of healthy and endodontically treated teeth. Developing an alternative protocol to generate FEM three-dimensional models will lead to a ready and inexpensive tool since there is no need for costly equipment for tooth extraction prognosis.
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