Effect of using different materials and restorative techniques on cuspal deflection and microleakage in endodontically treated teeth.

Abstract

Background: This study aimed to evaluate the effects of different restorative techniques and materials on cuspal deflection and microleakage in MOD restorations. Eight groups were tested using incremental and bulk-fill techniques, with or without fiber reinforcement. The restorative materials included Filtek Z250 and Filtek Bulk-fill Posterior, while reinforcement materials such as Interlig glass fiber, EverX Posterior, and Surefill SDR were incorporated to assess their impact.

Methods: In total, 96 freshly extracted, sound human maxillary first premolars were selected and stored in 0.1% thymol solution at 37 °C. The teeth were randomly assigned into eight groups (n = 12). Standardized MOD cavities were prepared, followed by endodontic treatment and sealing with glass ionomer cement. The groups were as follows: Group 1-Filtek Z250 applied incrementally in 2-mm layers; Group 2-U-shaped Interlig glass fiber followed by incremental Filtek Z250; Group 3-Filtek Bulk-fill Posterior using the bulk technique; Group 4-U-shaped Interlig glass fiber followed by Filtek Bulk-fill Posterior; Group 5-EverX Posterior followed by incremental Filtek Z250; Group 6-EverX Posterior followed by Filtek Bulk-fill Posterior; Group 7-Surefill SDR followed by incremental Filtek Z250; and Group 8-Surefill SDR followed by Filtek Bulk-fill Posterior. Cuspal deflection was measured using a digital micrometer with 0.05 μm precision. Microleakage was assessed using a 0.5% basic fuchsin dye solution at 37 °C for 24 h, followed by sectioning and examination under magnification.

Results: The lowest mean cuspal deflection was observed in Group 2 (15.8 μm), while the highest was in Group 5 (27.2 μm). Statistically significant differences were observed in cuspal deflection across the groups and over time (p < 0.05). Significant differences in microleakage scores were also found among the groups, indicating the impact of restorative materials and techniques on these outcomes (p < 0.05).

Conclusion: This study demonstrated that Filtek Z250 and Filtek Bulk-fill Posterior showed different effects on cuspal deflection and microleakage. The use of glass fiber and EverX Posterior improved restoration performance by reducing polymerization effects. Surefill SDR also reduced cuspal deflection due to its low polymerization shrinkage. Clinically, selecting the appropriate restorative materials and techniques based on the extent of tooth structure loss can improve long-term outcomes.