The effect of box preparation on the strength of glass fiber-reinforced composite inlay-retained fixed partial dentures

STATEMENT OF PROBLEM: Nonstandardized box dimensions for inlay-retained fixed partial dentures (FPDs) may result in uneven distribution of the forces on the connector region of such restorations. PURPOSE: The objective of this in vitro study was to evaluate the effect of box dimensions on the initial and final failure strength of inlay-retained fiber-reinforced composite (FRC) FPDs. MATERIAL AND METHODS: Twenty-one inlay-retained FPDs were prepared using FRC (everStick) frameworks with unidirectional fiber reinforcement between mandibular first premolars and first molars. Boxes were prepared using conventional inlay burs (Cerinlay), and small and large ultrasonic tips (SONICSYS approx). Box dimensions were measured after preparation with a digital micrometer. All restorations were subjected to thermal cycling (6000 cycles, 5 degrees C-55 degrees C). Fracture testing was performed in a universal testing machine (1 mm/min). Acoustic emission signals were monitored during loading of the specimens. Initial and final fracture strength values (2-way ANOVA, Bonferroni post hoc tests, alpha =.05) and failure types (Fisher exact test) were statistically compared for each group. RESULTS: Significant differences (P =.0146 and P =.0086) were observed between the groups in the dimensions of the boxes prepared using conventional burs buccolingually (2.8-3.0 mm in molars, 3.1-4.3 mm in premolars) and the small size (2.5-2.9, 2.9-3.8 mm) or large size (2.6-3.8, 3.2-4.9 mm) ultrasonic tips for the premolars and the molars, respectively. No significant differences were found at the initial and final failures between the conventionally prepared group (842 +/- 267 N, 1161 +/- 428 N) and those prepared with either small (1088 +/- 381 N, 1320 +/- 380 N) or large ultrasonic tips (1070 +/- 280 N, 1557 +/- 321 N), respectively. The failure analysis demonstrated no significant difference in failure types but predominant delamination of the veneering resin (85%) in all experimental groups. According to acoustic emission tests, a higher energy level was required for final failure of the FRC FPDs with boxes finished using small ultrasonic tips. CONCLUSION: Standardized box dimensions showed no significant effect on fracture strength at either initial or final failure of the fiber-reinforced FPDs. The FRC FPDs with boxes refined with small ultrasonic burs required a greater energy level before failure. The type of failure observed after the fracture tests was primarily delamination of the veneering resin.