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Fatigue resistance and crack propensity of large MOD composite resin restorations: direct versus CAD/CAM inlays.
Dent Mater. 2013 Mar; 29(3):324-31.DM

Abstract

OBJECTIVES

To assess the influence of material/technique selection (direct vs. CAD/CAM inlays) for large MOD composite adhesive restorations and its effect on the crack propensity and in vitro accelerated fatigue resistance.

METHODS

A standardized MOD slot-type tooth preparation was applied to 32 extracted maxillary molars (5mm depth and 5mm bucco-palatal width) including immediately sealed dentin for the inlay group. Fifteen teeth were restored with direct composite resin restoration (Miris2) and 17 teeth received milled inlays using Paradigm MZ100 block in the CEREC machine. All inlays were adhesively luted with a light curing composite resin (Filtek Z100). Enamel shrinkage-induced cracks were tracked with photography and transillumination. Cyclic isometric chewing (5 Hz) was simulated, starting with a load of 200 N (5000 cycles), followed by stages of 400, 600, 800, 1000, 1200 and 1400 N at a maximum of 30,000 cycles each. Samples were loaded until fracture or to a maximum of 185,000 cycles.

RESULTS

Teeth restored with the direct technique fractured at an average load of 1213 N and two of them withstood all loading cycles (survival=13%); with inlays, the survival rate was 100%. Most failures with Miris2 occurred above the CEJ and were re-restorable (67%), but generated more shrinkage-induced cracks (47% of the specimen vs. 7% for inlays).

SIGNIFICANCE

CAD/CAM MZ100 inlays increased the accelerated fatigue resistance and decreased the crack propensity of large MOD restorations when compared to direct restorations. While both restorative techniques yielded excellent fatigue results at physiological masticatory loads, CAD/CAM inlays seem more indicated for high-load patients.

Authors+Show Affiliations

Department of Operative Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23287406

Citation

Batalha-Silva, Silvana, et al. "Fatigue Resistance and Crack Propensity of Large MOD Composite Resin Restorations: Direct Versus CAD/CAM Inlays." Dental Materials : Official Publication of the Academy of Dental Materials, vol. 29, no. 3, 2013, pp. 324-31.
Batalha-Silva S, de Andrada MA, Maia HP, et al. Fatigue resistance and crack propensity of large MOD composite resin restorations: direct versus CAD/CAM inlays. Dent Mater. 2013;29(3):324-31.
Batalha-Silva, S., de Andrada, M. A., Maia, H. P., & Magne, P. (2013). Fatigue resistance and crack propensity of large MOD composite resin restorations: direct versus CAD/CAM inlays. Dental Materials : Official Publication of the Academy of Dental Materials, 29(3), 324-31. https://doi.org/10.1016/j.dental.2012.11.013
Batalha-Silva S, et al. Fatigue Resistance and Crack Propensity of Large MOD Composite Resin Restorations: Direct Versus CAD/CAM Inlays. Dent Mater. 2013;29(3):324-31. PubMed PMID: 23287406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fatigue resistance and crack propensity of large MOD composite resin restorations: direct versus CAD/CAM inlays. AU - Batalha-Silva,Silvana, AU - de Andrada,Mauro Amaral Caldeira, AU - Maia,Hamilton Pires, AU - Magne,Pascal, Y1 - 2013/01/01/ PY - 2012/02/23/received PY - 2012/07/01/revised PY - 2012/11/15/accepted PY - 2013/1/5/entrez PY - 2013/1/5/pubmed PY - 2013/12/29/medline SP - 324 EP - 31 JF - Dental materials : official publication of the Academy of Dental Materials JO - Dent Mater VL - 29 IS - 3 N2 - OBJECTIVES: To assess the influence of material/technique selection (direct vs. CAD/CAM inlays) for large MOD composite adhesive restorations and its effect on the crack propensity and in vitro accelerated fatigue resistance. METHODS: A standardized MOD slot-type tooth preparation was applied to 32 extracted maxillary molars (5mm depth and 5mm bucco-palatal width) including immediately sealed dentin for the inlay group. Fifteen teeth were restored with direct composite resin restoration (Miris2) and 17 teeth received milled inlays using Paradigm MZ100 block in the CEREC machine. All inlays were adhesively luted with a light curing composite resin (Filtek Z100). Enamel shrinkage-induced cracks were tracked with photography and transillumination. Cyclic isometric chewing (5 Hz) was simulated, starting with a load of 200 N (5000 cycles), followed by stages of 400, 600, 800, 1000, 1200 and 1400 N at a maximum of 30,000 cycles each. Samples were loaded until fracture or to a maximum of 185,000 cycles. RESULTS: Teeth restored with the direct technique fractured at an average load of 1213 N and two of them withstood all loading cycles (survival=13%); with inlays, the survival rate was 100%. Most failures with Miris2 occurred above the CEJ and were re-restorable (67%), but generated more shrinkage-induced cracks (47% of the specimen vs. 7% for inlays). SIGNIFICANCE: CAD/CAM MZ100 inlays increased the accelerated fatigue resistance and decreased the crack propensity of large MOD restorations when compared to direct restorations. While both restorative techniques yielded excellent fatigue results at physiological masticatory loads, CAD/CAM inlays seem more indicated for high-load patients. SN - 1879-0097 UR - https://www.unboundmedicine.com/medline/citation/23287406/Fatigue_resistance_and_crack_propensity_of_large_MOD_composite_resin_restorations:_direct_versus_CAD/CAM_inlays_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0109-5641(12)00470-8 DB - PRIME DP - Unbound Medicine ER -