Performance of direct and indirect onlay restorations for structurally compromised teeth.

STATEMENT OF PROBLEM: Research is lacking on the restoration of structurally compromised posterior teeth using direct composite resin or indirect restorations.

PURPOSE: The purpose of this in vitro study was to measure the fracture resistance and microleakage of different onlay restorations fabricated by using conventional and digital computer-aided design and computer-aided manufacturing (CAD-CAM) to restore structurally compromised teeth.

MATERIAL AND METHODS: Mandibular molars (n=54) were prepared for onlay restorations. Teeth were allocated to 3 groups (n=18) according to the type of restoration materials, nanohybrid composite resin (Grandio blocs), resin hybrid ceramic (SHOFU Block HC), and fiber-reinforced composite resin (everX Posterior). Onlays were bonded using a dual-polymerized adhesive resin cement. All specimens were thermocycled, followed by cyclic loading. Based on the type of investigation conducted, fracture resistance, and microleakage test, each group was then divided into 2 equal subgroups (n=9). The collected data were statistically analyzed with the chi-square of the Fischer exact test (α=.05).

RESULTS: Fracture resistance testing revealed a statistically significant difference between groups (P<.001). The fiber-reinforced composite resin demonstrated the highest fracture resistance, with statistically significantly less microleakage compared with the other groups (P=.013).

CONCLUSIONS: Direct fiber-reinforced composite resin could be considered a suitable alternative to CAD-CAM composite resin for the restoration of structurally compromised teeth.