ABSTRACT
This study aimed to compare the effects of different combinations of adhesive bases and restorative materials on the fracture strength and mode of maxillary premolars with mesio-occlusodistal (MOD) cavities after mineral trioxide aggregate (MTA) pulpotomy. Ninety-six extracted human maxillary premolars were divided into 8 groups (n = 12). Group 1 (negative control) consisted of intact teeth. In the other teeth, MOD and endodontic access cavities were prepared, and a layer of MTA was placed. Group 2 was left unrestored as the positive control. Group 3 was restored with a glass ionomer cement (GIC) base and amalgam. The remaining groups were restored with a microhybrid composite after application of different bases: 4, resin-modified GIC (RMGIC); 5, zirconia-reinforced GIC (ZRGIC); 6, self-adhesive flowable composite (SAFC); 7, self-adhesive resin cement (SARC); and 8, short fiber-reinforced composite (SFRC). After fracture strength testing via continuous compressive axial loading, the fracture mode was classified as restorable or unrestorable. Data were analyzed using 1-way analysis of variance and post hoc Tamhane tests (P < 0.05). The fracture strength of the negative control group was significantly higher than that of all other groups (P < 0.001). The fracture strengths of groups 2 and 3 were not significantly different (P > 0.05) from each other but were significantly lower (P = 0.002) than those of all composite-restored groups. Group 8 showed a significantly greater fracture strength than group 4 (P < 0.001). Unlike GIC/amalgam, all of the base/composite restoration groups partly restored the strength of pulpotomized premolars. Although their fracture strengths were statistically similar, the fracture modes were more favorable in groups with SAFC or SARC bases than in groups with RMGIC or ZRGIC bases. The SFRC/composite specimens revealed advantages in both fracture strength and fracture mode compared to RMGIC/composite specimens.
