Evaluation of fracture resistance of endodontically treated maxillary premolars, restored with ceromer or heat-pressed ceramic inlays and fixed with dual-resin cements

The aim of this study was to evaluate the fracture resistance of endodontically maxillary premolars restored with mesio-occlusal-distal (MOD) inlays made with ceramic (IPS-Empress 2) and ceromer (Targis) and luted with three different dual-cured resin cements (Enforce, Variolink II, Panavia F). Sixty maxillary premolars were randomly distributed into six groups, according to their mesio-distal and facio-lingual dimensions. The teeth were endodontically treated and MOD cavities prepared. After the restorations were cemented, the samples were thermocycled and submitted to an axial compressive load by the action of a rounded end steel cylinder contacting the incline planes of occlusal surfaces of the teeth. The mode of fracture was analysed with a microscope. The best results were found with the combinations (cement/restorative material) Enforce/Targis (107.57 kgf) and Enforce/Empress (90.21 kgf) followed by Variolink II/Targis (86.44 kgf)-Variolink II/Empress (84.07 kgf) and Panavia F/Targis (82.43 kgf)-Panavia F/Empress (76.73 kgf). Analysis of variance (P < 0.05) showed a significant difference between Enforce and Panavia cements regardless of the restorative material. Considering the same luting agent there was no statistically significant difference between the restorative materials. Fracture of lingual cusps occurred in 55 of the 60 teeth and most of them were of the cohesive type.