Citation Information :
Shafiei F, Jowkar Z, Hosseini N. Influence of Cavity Pretreatments on the Fracture Resistance of Premolars with Self-adhesive Cemented Composite Inlay. J Contemp Dent Pract 2019; 20 (7):828-833.
Aim: The aim of this study is to investigate whether different cavity pretreatment approaches affect the strength of premolars restored with self-adhesive (SA) resin cemented-composite resin inlays after mechanical and water aging.
Materials and methods: A total of 120 intact maxillary premolars were divided into 10 groups (n = 12). Mesio-occluso-distal (MOD) cavities were prepared in the teeth of nine groups, except group I in which the teeth remained intact. In group II, cavities were unrestored. Following fabrication of composite resin inlays for groups III–X, in group III, the inlays were cemented using the etch-and-rinse (E and R) adhesive/conventional resin cement. In other groups, cementation was performed using a SA cement with or without cavity pretreatments as follows: group IV: SA cement alone, group V: acid etching of enamel and dentin, group VI: acid etching of enamel, group VII: universal adhesive in the selective enamel-etching mode, group VIII: universal adhesive in the E and R mode, group IX: ethylenediaminetetraacetic acid (EDTA) conditioning, and group X: 20% polyacrylic acid conditioning. After aging processes, static fracture resistance was tested. Data were analyzed using one-way ANOVA and Dunn tests (α = 0.05).
Results: Fracture resistance of the 10 groups yielded a significant difference (p < 0.001). The median fracture resistances in Newton were the following: Gr I = 1025A, Gr II = 311BC, Gr III = 785A, Gr IV = 500B, Gr V = 435B, Gr VI = 775A, Gr VII = 805A, Gr VIII = 411BC, Gr IX = 397BC, and Gr X = 312C.
Conclusion: Unlike the conventional method, SA cementation could not restore the strength of inlay-cemented premolars. Selective enamel acid etching with or without universal adhesive significantly increased the fracture resistance.
Clinical significance: Selective enamel acid etching is recommended for increasing the fracture resistance of the SA cemented composite inlay to the level of intact teeth.
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