Fracture resistance of cuspal coverage of endodontically treated maxillary premolars with combined composite-amalgam compared to other techniques.

This in vitro study investigated the fracture resistance of teeth restored with combined composite-amalgam for cuspal coverage compared to direct coverage with composite (with or without an amalgam base) and composite onlay. Seventy-two intact maxillary premolars were randomly divided into six groups (n=12). The two control groups were G1, intact teeth (negative control), and G2, mesio-occlusodistal preparation only (positive control). Each of the four experimental groups used a different type of restoration for the prepared teeth: G3, direct composite cusp coverage; G4, composite onlay; G5, direct composite coverage with an amalgam base; and G6, combined composite-amalgam cuspal coverage. After thermocycling, fracture strength was tested. The data were analyzed with analysis of variance and the least significant differences post hoc tests (α=0.05). Mean fracture resistance in the six groups (in N) were G1, 1101 ±1 86; G2, 228 ± 38; G2, 699 ± 161; G4, 953 ± 185; G5, 859 ± 146; and G6, 772 ± 154. There were significant differences between G1 and all the other groups except for G4 and between G2 and all the other groups. Fracture strength in G3 also differed significantly compared to G4 and G5. The difference between G4 and G6 was statistically significant (p<0.05), but the difference between G3 and G6 was not (p>0.05).