Fracture resistance of premolars restored with inlay and onlay ceramic restorations and luted with two different agents

Abstract

Purpose: The purpose of this study was to evaluate the fracture resistance of human maxillary premolars restored with 2 ceramic systems (Vitadur Alpha and In Ceram) comparing 3 preparation designs and 2 luting agents.

Methods: Seventy sound teeth were prepared to receive ceramic restorations (Vitadur Alpha; n=14) as follows: (1) control, sound premolars, with no preparation, (2) inlays, (3) partial onlays (palatal cuspid coverage), (4) total onlays (both cuspids coverage), and (5) total onlays with an In Ceram core. The ceramic restorations were cemented using Enforce or RelyX ARC (half restorations with each cement), placed into the cavity and held under pressure, except for the control group. The teeth were subjected to compressive axial loading at 0.5 mm min⁻¹ using a 9 mm steel ball until fracture. Data were analyzed by 3-way ANOVA and post hoc Tukey's test (α=.05).

Results: There was a significant difference between cements and among preparation designs (P<.05). All restorations cemented with Enforce exhibited significantly higher fracture resistance (P<.05). Inlay restorations showed similar fracture resistance when compared to control group (P>.05). Partial and total onlays did not statistically differ and showed the weakest performance. The use of an In Ceram core did not produce higher fracture resistance.

Conclusions: Within the limitations of this study, the cements tested had different mechanical properties, while cuspid coverage did not result in improved fracture resistance of the restored teeth.