Comparative evaluation of fracture resistance of endodontically treated premolars restored with additively manufactured inlays and self-cure bulk-fill composites.
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Abstract
Objective: This study aimed to evaluate and compare the fracture resistance of endodontically treated maxillary premolars restored with various direct and indirect restorative approaches, focusing on new self-cure composites and 3D-printed resin inlays.
Materials and methods: Sixty extracted human maxillary first premolars were divided into six groups (n = 10): (1) positive control (intact), (2) negative control (unrestored endodontically treated), (3) EverX Posterior + G-ænial Posterior (4) Stela Capsule (self-cure bulkfill composite), (5) Stela Automix (self-cure bulkfill composite), and (6) Saremco CrownTec (3D-printed inlays). All teeth, except Group 1, underwent root canal treatment and standardized MOD cavity preparation. Restored specimens were thermocycled (5000 cycles, 5-55 °C) and subjected to oblique compressive loading at 30°. One-way ANOVA and post hoc tests assessed statistical significance (p < 0.05).
Results: The intact group showed the highest fracture resistance. Among restorations, 3D-printed inlays and Stela Automix performed significantly better than EverX Posterior + G-ænial Posterior and Stela Capsule. The negative control had the lowest resistance. Differences among groups were statistically significant (p < 0.001).
Conclusions: Both 3D-printed inlays and Stela Automix self-cure composite significantly improved fracture resistance in endodontically treated premolars, indicating their clinical potential as alternatives to conventional direct restorations.
Clinical relevance: These findings support the use of high-performance 3D-printed inlays and automix self-cure composites for reinforcing structurally compromised premolars, offering viable restorative options in cases of extensive MOD cavities.
期刊介绍：
The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.
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