To compare and evaluate the effects of different indirect composite onlay and/or core buildup materials on the fracture resistance and fracture mode of restored endodontically treated premolars. Methods: Two conventional handmade indirect composite resins (SR Nexco (NC) and Ceramage (CM)) and two core buildup materials, dual-cure composite resin (MultiCore Flow (MC)), and short fiber-reinforced composite resin (EverX Posterior (EXP)), were selected. Sixty maxillary premolars were randomly divided into six groups (n=10). Group 1 included intact teeth (INT; negative control). Mesio-occluso-distal cavity preparation and endodontic treatment was performed on the remaining premolars. Group 2 was restored with polymer-reinforced zinc oxide eugenol intermediate restorative material (IRM; positive control), whereas the experimental groups (groups 3-6) were restored with core buildup material and indirect composite onlay (MC_NC, MC_CM, EXP_NC, and EXP_CM). The specimens received compressive loading using a universal testing machine, at 45° to the long axis with a crosshead speed of 0.5 mm/min until fracture. Fracture modes were visually analyzed. Fracture resistance was measured and statistically analyzed using two-way and one-way ANOVA (α=0.05). Results: Only the type of indirect composite onlay affected the fracture resistance of the experimental groups (P=0.009). The MC_CM group showed the highest fracture resistance, which was significantly higher than that of the MC_NC group (P=0.031). No statistically significant differences were found between the INT group and other experimental groups(P>0.05). All groups had a greater incidence of restorable than unrestorable failures.
Conclusion:The type of indirect composite onlay affected the fracture resistance of restored endodontically treated maxillary premolars.
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