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Objective <p>This study aimed to evaluate and compare the fracture resistance of endodontically treated maxillary premolars restored with various direct and indirect restorative approaches, focusing on new self-cure composites and 3D-printed resin inlays.</p> Materials and methods <p>Sixty extracted human maxillary first premolars were divided into six groups (<i>n</i> = 10): (1) positive control (intact), (2) negative control (unrestored endodontically treated), (3) EverX Posterior + G-ænial Posterior (4) Stela Capsule (self-cure bulkfill composite), (5) Stela Automix (self-cure bulkfill composite), and (6) Saremco CrownTec (3D-printed inlays). All teeth, except Group 1, underwent root canal treatment and standardized MOD cavity preparation. Restored specimens were thermocycled (5000 cycles, 5–55&#xa0;°C) and subjected to oblique compressive loading at 30°. One-way ANOVA and post hoc tests assessed statistical significance (<i>p</i> &lt; 0.05).</p> Results <p>The intact group showed the highest fracture resistance. Among restorations, 3D-printed inlays and Stela Automix performed significantly better than EverX Posterior + G-ænial Posterior and Stela Capsule. The negative control had the lowest resistance. Differences among groups were statistically significant (<i>p</i> &lt; 0.001).</p> Conclusions <p>Both 3D-printed inlays and Stela Automix self-cure composite significantly improved fracture resistance in endodontically treated premolars, indicating their clinical potential as alternatives to conventional direct restorations.</p> Clinical relevance <p>These findings support the use of high-performance 3D-printed inlays and automix self-cure composites for reinforcing structurally compromised premolars, offering viable restorative options in cases of extensive MOD cavities.</p>

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Comparative evaluation of fracture resistance of endodontically treated premolars restored with additively manufactured inlays and self-cure bulk-fill composites

  • 期刊论文

  • 发表日期：

    2025年9月26日

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  • Esra Yildirim Manav,
  • Merve Ozdemi̇r,
  • Aysenur Oncu

摘要

Objective

This study aimed to evaluate and compare the fracture resistance of endodontically treated maxillary premolars restored with various direct and indirect restorative approaches, focusing on new self-cure composites and 3D-printed resin inlays.

Materials and methods

Sixty extracted human maxillary first premolars were divided into six groups (n = 10): (1) positive control (intact), (2) negative control (unrestored endodontically treated), (3) EverX Posterior + G-ænial Posterior (4) Stela Capsule (self-cure bulkfill composite), (5) Stela Automix (self-cure bulkfill composite), and (6) Saremco CrownTec (3D-printed inlays). All teeth, except Group 1, underwent root canal treatment and standardized MOD cavity preparation. Restored specimens were thermocycled (5000 cycles, 5–55 °C) and subjected to oblique compressive loading at 30°. One-way ANOVA and post hoc tests assessed statistical significance (p < 0.05).

Results

The intact group showed the highest fracture resistance. Among restorations, 3D-printed inlays and Stela Automix performed significantly better than EverX Posterior + G-ænial Posterior and Stela Capsule. The negative control had the lowest resistance. Differences among groups were statistically significant (p < 0.001).

Conclusions

Both 3D-printed inlays and Stela Automix self-cure composite significantly improved fracture resistance in endodontically treated premolars, indicating their clinical potential as alternatives to conventional direct restorations.

Clinical relevance

These findings support the use of high-performance 3D-printed inlays and automix self-cure composites for reinforcing structurally compromised premolars, offering viable restorative options in cases of extensive MOD cavities.