Marginal adaptation, retention and fracture resistance of adhesive composite restorations on devital teeth with and...

This in vitro study generated data on the quality of marginal adaptation, fracture resistance and retention of several indirect adhesive composite configurations on root-treated premolars before and after a long-term fatigue test and compared these results to a control group of adhesive onlays on "vital" teeth. Six root-treated extracted human premolars per group, with four different restorative configurations with and without adhesive fiber posts, were evaluated. Another group of six premolars, "revitalized" by using diluted horse serum to simulate pulpal fluid and restored with adhesive composite onlays, served as the control. Marginal adaptation before and after long-term occlusal loading (1,200,000 occlusal loading cycles at max 49 N) was assessed by using the replica technique and quantitative evaluation in SEM at 200x magnification. The number of lost restorations was recorded after loading. Fracture resistance and fracture patterns were evaluated by using a universal-testing machine on the fatigued samples. No significant differences (p > 0.05) between groups were detected before and after loading for the percentage of "continuous margin" at the total marginal length. Loading had a significant (p < 0.05) effect on the percentage of "continuous margin" for the total marginal length of two groups only. No significant difference (p > 0.05) for fracture resistance was detected and no lost restorations were observed. The results suggest that for both the less decayed and the more significantly decayed devital teeth, the minimally invasive adhesive restorative approach is promising.