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Structural Integrity Evaluation of Large MOD Restorations Fabricated With a Bulk-Fill and a CAD/CAM Resin Composite
Composite CAD/CAM inlays significantly enhance fracture resistance in teeth with large MOD cavities compared to direct bulk-fill composites. Both restorative techniques showed repairable fracture modes, but CAD/CAM offered superior strength.
Area of Science:
- Dental Materials Science
- Restorative Dentistry
- Biomaterials Engineering
Background:
- Extended mesio-occlusal-distal (MOD) cavities compromise tooth structure.
- Evaluating restorative materials for large cavity preparations is crucial for long-term tooth survival.
- Direct bulk-fill and indirect CAD/CAM composite restorations are common treatment options.
Purpose of the Study:
- To compare the fracture resistance of direct bulk-fill versus indirect CAD/CAM composite restorations.
- To analyze the mode of fracture in extended MOD preparations restored with these techniques.
- To assess the clinical relevance of fracture resistance and modes for tooth longevity.
Main Methods:
- Fifty-one human mandibular third molars with extended MOD cavities were divided into three groups: bulk-fill composite, CAD/CAM composite inlay, and intact control.
- Specimens underwent thermocycling followed by fracture resistance testing using a universal testing machine.
- Fracture modes were classified, and statistical analyses (ANOVA, Duncan test, chi-square) were performed.
Main Results:
- Teeth restored with CAD/CAM composite inlays (1869.8±529.4 N) showed significantly higher fracture resistance than those restored with bulk-fill composite (1285.3±655.0 N).
- No significant difference was observed in the distribution of fracture modes between the two restorative groups.
- All tested restorations failed at loads exceeding typical oral cavity forces.
Conclusions:
- Indirect CAD/CAM composite inlays provide superior fracture resistance for extended MOD cavities compared to direct bulk-fill composite restorations.
- Both restorative techniques resulted in predominantly intraorally repairable fracture types.
- CAD/CAM restorations may offer a more durable solution for extensively damaged posterior teeth.
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