Fracture behaviour of MOD restorations reinforced by various fibre-reinforced techniques - An in vitro study

Purpose: The aim was to evaluate the fracture resistance of various direct restorative techniques utilizing different fibre-reinforced materials for restoring deep class II. MOD cavities in molar teeth. Material and methods: Two hundred forty intact mandibular third molars were randomly divided into twelve groups (n = 20). Except for the control group (G12), deep mesio-occluso-distal (MOD) cavities were prepared all other groups. After adhesive treatment and rebuilding the missing interproximal walls with composite, the specimen were restored with different fibres and a final occlusal layer of composite as follows: composite only (G1), short fibre-reinforced composite (SFRC) (G2), glass fibre net (GFN) on the base of the cavity bucco-lingually (BL) and SFRC (G3), SFRC and GFN on top of it BL (G4), SFRC and occlusal splinting with GFN (G5), GFN circumferentially and SFRC (G6), polyethylene fibres (PF) on the base of the cavity BL and composite (G7), composite and PF on top of it BL (G8), composite and occlusal splinting with PF (G9), PF circumferentially and composite (G10), transcoronal splinting with PF (G11). Fracture-resistance for the restored teeth were tested using universal-testing machine. Fracture thresholds and fracture patterns were measured and evaluated. Results: The transcoronal splinting (G11) yielded the highest fracture resistance among the restored groups. Groups 1, 3 and 4 showed significantly lower fracture resistance values compared to intact teeth. Conclusion: Incorporating polyethylene or a combination of short and bidirectional glass fibres in certain positions in direct restorations seems to be able to restore the fracture resistance of sound molar teeth.