Document Type

Article

Publication Date

2025

Abstract

Abstract

Objectives: This study aimed to evaluate the fracture resistance of premolar teeth with standardized mesio-

occluso-distal (MOD) cavities, restored using various techniques (layering techniques and composite-resin

restorations)

Materials and Methods: Seventy intact maxillary premolars with standardized MOD cavities were randomly

divided into seven groups (n=10): G1 control intact teeth; G2: MOD cavities left unrestored; G3: restored using an

incremental technique with nanohybrid resin composite (Neo Spectra TM ST, Dentsply Sirona); G4: restored in

bulk using a flowable composite (SDR Flow+, Dentsply Sirona); G5: bulk-filled with a multihybrid composite

(Tetric N Ceram, Ivoclar); G6: restored using an incremental technique with SDR Flow+ & Tetric N Ceram; and

G7: restored incrementally with SDR Flow+ & Neo Spectra TM ST. After 24 hours of storage at 37°C, the

specimens were tested for fracture resistance using a universal testing machine, applying force through a 4 mm

diameter steel sphere at a crosshead speed of 5 mm/min until fracture occurred. Statistical analysis was performed

using the D'Agostino-Pearson test, Kruskal–Wallis test, and Mann–Whitney U tests at a 5% significance level to

identify differences among groups.

Results: A significant variation in mean fracture resistance was observed among the tested groups. Groups G1,

G6, and G7 demonstrated the highest mean fracture resistance, followed by groups G3 and G5, which showed no

significant difference from each other. The lowest mean fracture resistance was recorded in groups G2 and G4.

Conclusions: Using a bulk-fill flowable composite as a lining beneath resin composite layering enhances fracture

resistance. Additionally, bulk-fill flowable resin composites should be overlaid with a methacrylate-based resin

composite.

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