Cuspal deformation and fracture resistance of teeth with dentin adhesives and composites

This study investigated the effect of polymerization shrinkage of posterior composite (Herculite) on the dimensions and fracture strength of human maxillary premolars with a phosphonate-ester DBA (Bondlite) and a second DBA comprised of 4-META with MMA/TBB (Superbond). The individual role of etched enamel and nonetched dentin bonding was also studied with high-copper amalgam used as a control. Two sizes of preparation isthmus were designated for evaluation of the effect of the polymerization contraction on weakened teeth. The following conclusions were drawn. 1. Narrow intracoronal tooth preparations were significantly stronger than wider, expansive preparations. There was no difference among the narrow isthmus preparations restored with amalgam or acid etching and composite. 2. There was a significant expansion in tooth dimension when MOD cavities were restored with amalgam. 3. Teeth with narrow isthmus preparations using composite bonded with Bondlite adhesive to etched enamel demonstrated a significant contraction compared with Superbond DBA. 4. Composite restorations using Superbond DBA in wide MOD cavities significantly improved the fracture strength of maxillary premolars. 5. Superbond DBA with composite restorations benefited the tooth in dimensional change and fracture strength. 6. There was a positive correlation between the fracture strength and tooth dimension.