Background: Class II MOD cavity in maxillary premolar creates a specific challenge for the restoration material in terms of longevity and fracture resistance due to the anatomical shape of premolars that render them susceptible to fracture and the microleakage issue of composite restoration at the gingival margin of the proximal boxes. Bulk-fill composite was introduced to provide more strength and resistance and also to provide less polymerization shrinkage and better cure depth. With the advances in dental material science and technology, several attempts have also been made to increase the advantage of bulk-fill composite: by modifying the monomers, utilizing special restoration placement instrument, and adding fiber reinforcement to its composition, which have not been compared adequately. Hence, this study was undertaken to evaluate the effect of different bulk-fill composites in class II MOD cavities on upper premolars in terms of fracture resistance.
Materials and methods: A total of 30 sound upper premolars were divided into three groups of 10 each. Teeth were prepared in the form of class II MOD cavity and restored accordingly: group I restored with Filtek bulk-fill (3M), group II with Sonicfill bulk-fill (Kerr), and group III with EverX bulk-fill (GC). Afterward, samples were thermocycled at 5°C and 55°C for 500 cycles. Fracture resistance test was done using Torsee's Electronic System Universal Testing Machine. Data obtained were analyzed with one-way ANOVA and post hoc least significant difference (LSD) test to determine the difference between groups.
Results: ANOVA statistical test showed no significant differences (p > 0.05) in all groups. However, resin composite EverX bulk-fill (GC) has a higher fracture resistance (882.94 ± 64.41 N) compared to other groups, Sonicfill bulk-fill (Kerr) (856.48 ± 101.35 N), and Filtek bulk-fill (3M) (812.15 ± 66.89 N).
Conclusion: The use of different bulk-fill resin composites did not yield significant effects in terms of fracture resistance in the restoration of class II MOD cavity on upper premolars (p > 0.05). However, bulk-fill resin composite did offer advantages in clinical applications due to the simplified restoration process and reduced working time.
Vahid NA, Mahjunath MK. Comparation of fracture resistance of maxillary first premolars with class II mesio-occluso-distal (MOD) cavities restored with newer resin based composites-an ex vivo study. Int J Curr Res 2016;8(4):29814–29820.
Frater M, Foster A, et al. In Vitro fracture resistance of molar teeth restored with a short fibre-reinforced composit material. J Dent 2014; 1143–1150. DOI: 10.1016/j.jdent.2014.05.004.
Valian A, Moravej S, et al. Effect of extension and type of composite-restored class II cavities on biomehanical properties of teeth: a three dimensional finite element analysis. J Dent 2015;12(2):140–149.
Moosavi H, Zeynali M, et al. Fracture resistance of premolars restored by various types and placement techniques of resin composites. Int J Dent 2012;3(1):1–5. DOI: 10.1155/2012/973641.
Patel P, Shah M, et al. Comparative evaluation of microleakage of class II cavities restored with different bulk fill composite restorative system: an in vitro study. J Res Adv Dent 2016;5(2):52–62.
Irfan A. A new technique for composite restorations. Cosmetic Dentistry 2013; 12–18.
Abouelleil H, Pradelle N, et al. Comparison of mechanical properties of a new fiber reinforced composite and bulk filling composite. Rest Dent Endo 2015;1:1–8. DOI: 10.5395/rde.2015.40.4.262.
Fahad F, Majeed MAR. Fracture resistance of weakened premolars restored with sonically-activated composite, bulk-filed and incerementally-filled composite: a comparative in vitro study. J Baghdad College Dent 2014;26:22–27. DOI: 10.12816/0015250.
Kapoor N, Bahuguna N, et al. Influence of composite insertion technique on gap formation. J Conserv Dent 2016;19(1):77–81. DOI: 10.4103/0972-0707.173205.
Garoushi SK, Hatem M, et al. The effect of short fiber composite base in microleakage and load-bearing capacity of posterior restorations. Acta Biomater Odontol Scand 2015;1(1):6–12. DOI: 10.3109/23337931.2015.1017576.
Ibarra ET, Lien W, et al. Physical properties of a new sonically placed composit resin restorative material. Dent Mater 2015;6:51–56.
Farahanny W, Dennis, et al. Fracture resistance of various bulk fill composite resin in endodontically treated class I premolar (an in vitro study). J Evol Med Dent 2017;1–4.
Woelfel JB, Scheid RC. Dental anatomy its relevance to Dentistry. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2002. pp. 81–82.
Pereira JR, McDonald A, et al. Effect of cavity design on tooth surface strain. J Prosthet Dent 2013;110:369–375. DOI: 10.1016/j.prosdent.2013.08.004.
Noronha FD, Scelza MF, et al. Evaluation of compressive strength in the first premolars between young and elderly people: ex vivo study. Gerodontology 2012;29:e898–e901. DOI: 10.1111/j.1741-2358.2011.00583.x.
Franca FMG, Worschech CC, et al. Fracture Resistance of Premolar Teeth Restored With Different Filling Techniques. J Contemp Dent Pract 2005;6:1–7.
Makramani A, Razak A. Effect of restorative techniques on fracture resistance of endodontically treated premolars. J Stomatol 2013;3:379–385. DOI: 10.4236/ojst.2013.37064.