Performance of bulk-fill versus conventional nanocomposite resin restorations supporting the occlusal rests of removable partial dentures: An in vitro investigation

Abstract

Statement of problem: Placing removable partial denture (RPD) rests on composite resin restorations has long been a debatable issue. Despite developments in composite resins such as nanotechnology and bulk-filling techniques, studies investigating the performance of composite resin restorations when used to support occlusal rests remain scarce.

Purpose: The purpose of this in vitro study was to investigate the performance of bulk-fill versus incremental (conventional) nanocomposite resin restorations when they are used to support RPD rests under functional loading.

Material and methods: Thirty-five caries-free intact maxillary molars of similar coronal size were collected and divided into 5 equal groups (n=7): Enamel (Control) group: rest seats prepared entirely in enamel; Class I Incremental group: Class I cavities restored with incrementally placed nanohybrid resin composite resin (Tetric N-Ceram); Class II Incremental group: Mesio-occlusal (MO) Class II cavities restored with Tetric N-Ceram; Class I Bulk-fill group: Class I cavities restored with high-viscosity bulk-fill hybrid resin composite (Tetric N-Ceram Bulk-Fill); and Class II Bulk-fill group: MO Class II cavities restored with Tetric N-Ceram Bulk-Fill. Occlusal rest seats were prepared mesially in all groups, and clasp assemblies were fabricated and cast in cobalt chromium alloy. Specimens with their clasp assemblies were subjected to thermomechanical cycling using a mechanical cycling machine (250000 masticatory cycles) and 5000 thermal cycles (5 °C to 50 °C). Surface roughness (Ra) was measured with a contact profilometer before and after cycling. Fracture analysis was done using stereomicroscopy, and margin analysis was done with a scanning electron microscope (SEM) before and after cycling. Statistical analysis of Ra was conducted using ANOVA followed by the Scheffé test for between-group comparison and paired t test for within-group comparison. The Fisher exact probability test was used for fracture analysis. The Mann-Whitney test was used for between-group comparison and Wilcoxon signed rank test for within-group comparison for the SEM images (α=.05).

Results: Mean Ra increased significantly after cycling in all groups. Significant differences in Ra were found between enamel and all 4 resin groups (P<.001), with no significant differences between incremental and bulk-fill resin groups for both Class I and II specimens (P>.05). No significant differences were found between the 2 resin groups with regard to fracture and margin analysis (P>.05).

Conclusions: The surface roughness of enamel was significantly lower than that of both incremental and bulk-fill nanocomposite resins before and after functional loading. Incremental and bulk-fill nanocomposite resins showed comparable performance in terms of surface roughness, fracture behavior, and marginal adaptation.