Citation Information :
Galyan G, Padda BK, Kaur TP, Sharma M, Kapur I, Kaur S. In vitro Study Comparing Fracture Resistance of Nanocomposites with and without Fiber Reinforcement with Different Cavity Designs Used for Obliquely Fractured Incisal Edge Restoration. J Contemp Dent Pract 2019; 20 (5):566-570.
Aim: The aim of the study is to evaluate fracture resistance of nanocomposites with and without fiber reinforcement with different cavity designs used for obliquely fractured incisal edge restoration.
Materials and methods: In the present study, 60 sound extracted maxillary central incisors were mounted on autopolymerizable acrylic resin up to the cementoenamel junction, out of which, 10 intact teeth were kept as control (group 1) and the remaining 50 samples were reduced incisally in an oblique manner up to 3 mm. All incisally reduced samples were divided into five groups (n = 10) based on the restoration techniques as follows: group 2 (conventional bevel), group 3 (single central palatal slot on the incisal edge), group 4 (single palatal slot with central 2 mm fiber), group 5 (two palatal slots on the incisal edge with a distance of 0.5 mm to 1 mm between them), and group 6 (two slots on the incisal edge with two 2 mm fibers). All samples were built incrementally with nanocomposites followed by finishing and polishing. All samples including control were then stored in distilled water before their fracture resistance was measured using a universal testing machine. Failure modes were visually examined and the results were subjected to statistical analysis.
Results: The mean fracture resistance among the experimental groups was observed, group 4 with single fiber in the central position had the highest (832.68 N) followed by group 3 (490.84 N), group 5 (446.175), and group 2 (270.1359), and the least in group 6 (223.443). The mean fracture resistance of group 4 is comparable to intact teeth, i.e., group 1 (1096.40). The mean of all samples was compared using the one-way Anova test, and it was found that there is statistically significant difference in fracture resistance among groups (p < 0.001**).
Conclusion: Fibers certainly have the reinforcing effect and the position of fibers determines their reinforcing effects. A single central slot with fiber (Ribbond) showed maximum fracture resistance almost equivalent to natural teeth. Modifying conventional beveled cavity design with an additional slot in the center also increases the fractural strength of restoration.
Clinical significance: Nanocomposites reinforced with single fiber in the central palatal slot used for restoring fractured incisors provide strength almost equivalent to natural teeth. In case when the fiber is not available for preparing a single palatal slot also, we can increase the fracture resistance.
Andreason JO, Andreason FM, et al. Textbook and color atlas of traumatic injuries to teeth; 2007; pp.217–243.
Thelen DS, Trovik TA, et al. Impact of traumatic dental injuries with unmet treatment need on the quality of daily life of adolescents, 16–19 years of age among adolescents—case control study. Dent Traumatol 2011;27:88–94.
Kovacs M, Pacurar M, et al. Fracture resistance of tooth fragments reattached with different techniques. An in vitro study. Rom J Oral Rehab 2012;4:36–41.
Demarco FF, Fay RM, et al. Fracture resistance of re-attached coronal fragments – influence of different adhesive materials and bevel preparation. Dent Traumatol 2004;20:157–163. DOI: 10.1111/j.1600-4469.2004.00221.x.
Sengun A, Ozer F, et al. Shear bond strength of tooth fragments reattatched or restored. J Oral Rehab 2003;30:82–86.
Black JB, Retief DH, et al. Effect of cavity design on retention of class IV composite resin restorations. J Am Dent Assoc 1981;103:42–46.
Mitra SB, Wu D, et al. An application of nanotechnology in advanced dental materials. J Am Dent Assoc 2003;134:1382–1390.
Coelho-de-Souza FH, Camacho GB, et al. Influence of Restorative Technique, Beveling, and Aging on Composite Bonding to Sectioned Incisal Edges. J Adhes Dent 2008;10:113–117.
Shashidhar J, Shashidhar C. Evaluation and comparison of the effect of enamel preparation designs on fracture resistance of micro-filled and nano-filled composite resin: an in vitro study. J Res Dent 2013;1:43–48.
Davidson DF, Jordan RE, et al. Esthetic conservative incisal restoration of anterior teeth – Part I. J Can Dent Assoc 1994;60:301–304.
Munksgaard EC, Hojtved L, et al. Enamel-dentin crown fractures bonded with various bonding agents. Endodont Dent Traumatol 1991;7:73–77.
Davari A, Sadeghi M. Influence of different bonding agents and composite resins on fracture resistance of reattached incisal tooth fragment. J Dent (Shiraz) 2014;15(1):6–14.
Andreasen FM, Flugge E, et al. Treatment of crown fractured incisors with laminate veneer restorations. An experimental study. Endod Dent Traumatol 1992;8:30–35.
Vallittu PK. Survival rates of resin-bonded, glass fiber-reinforced composite fixed partial dentures with a mean follow-up of 42 month: a pilot study. J Prosthet Dent 2004;91:241–246. DOI: 10.1016/S0022391304000034.
Vallittu PK. Prosthodontic treatment with a glass fiber-reinforced resin-bonded partial denture: a clinical report. J Prosthet Dent 1999;82:132–135.
Edwards KL. An overview of technology of fibre-reinforced plastics for design purposes. Mater Des 1998;19:1–10.
Arhun N, Arman A. Fibre reinforced technology in multidisciplinary chairside approaches. Indian J Dent Res 2008;19:272–277.
Smales JR, Gerke DC. Clinical evaluation of four anterior composite resins over five years. Dent Mater 1992;14:34–36.
Duke ES, Robbins JW, et al. The clinical performance of a new adhesive resin system in class V and IV restorations. Compendium 1994;15:852–856.
Lassila LVJ, Tezvergil A, et al. Effects of glass fiber layering on the flexural strength of microfill and hybrid composites. J Esthet Restor Dent 2009;21:171–181. DOI: 10.1111/j.1708-8240.2009.00259.x.
Sharafeddin F, Alavi A, et al. Flexural strength of glass and polyethylene fiber combined with three different composites. J Dent (Shiraz) 2013;14(1):13–19.
Tezvergil A, Lassila LVJ, et al. Strength of adhesive-bonded fiberreinforced composites to enamel and dentin substrates. J Adhes Dent 2003;5:301–311.
Ganesh M, Tandon S. Versatility of Ribbond in Contemporary Dental Practice. Trends Biomater Artif Organs 2006;20:53–58.
Garoushi SK, Ballo AM, et al. Fracture resistance of fragmented incisal edges restored with fiber-reinforced composite. J Adhes Dent 2006;8:91–95.
Sharafeddin F, Bahrani S. Load bearing capacity of fragmented incisal edges restored with two different positions of fiber reinforced composite restoration. Shiraz Univ Dent J 2011;11:23–28.
Eid H, White GE. Class IV preparations for fractured anterior teeth restored with composite resin restorations. J Clin Pediatr Dent 2003;27:201–211.
Farik B, Munksgaard EC, et al. Drying and rewetting anterior crown fragments prior to bonding. Endod Dent Traumatol 1999;15:113–116.