Unveiling the mechanical performance of partially replaced coronal restorations in root canal-treated teeth: an in-vitro study

To compare the mechanical performance of partially replaced (repaired) intra-coronal restorations to totally replaced ones in root canal-treated teeth.

Thirty maxillary second premolars were selected according to strict criteria, mounted on moulds, and had mesio-occluso-distal (MOD) cavities prepared. Resin composite restorative material was used to perform the initial restoration, followed by aging procedures using thermo-mechanical cycling fatigue to replicate six months of intraoral aging. The specimens were then randomly divided into two groups: a totally replaced restoration (TR) group (n = 15), which involved the preparation of a traditional endodontic access cavity after the complete removal of the pre-existing coronal filling; and a partially replaced restoration (PR) group (n = 15), which involved accessing the tooth through the pre-existing restoration without completely removing it. Root canal preparation and filling procedures were conducted, and the access cavity was sealed with a new resin composite restoration, followed by a new thermo-mechanical cycling aging procedure. Finally, the specimens were submitted to a static fracture test to measure specimen fracture strength and determine the failure mode pattern (repairable fracture or irreparable fracture). Chi-square and t-tests were used for statistical analysis.

Significant differences between the groups regarding their mechanical resistance were found. The average failure load of the TR group was 1115.13 N and 1330.23 N in the PR group (p = 0.002). Regarding the failure modes, the TR group exhibited eight irreparable fractures, while the PR group had four (p = 0.136).

Partially replaced restorations presented higher fracture strength and led to fewer irreparable fractures when compared to totally replaced restorations in root canal-treated teeth.