Evidence map›Paper›PMID 41021045›Full record

ArticleClinical oral investigations2025

Effect of combined use of reinforcement materials on the fracture resistance of MOD cavity restorations in endodontically treated teeth.

Lena Bal, Cangül Keskin, Aybüke Karaca Sakallı, Bilge Özcan, İsen Güleç Koçyiğit

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Article in Clinical oral investigations, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Lena BalDepartment of Restorative Dentistry, Faculty of Dentistry, Ankara Medipol University, Eti, Celal Bayar Blvd, no: 88/1, Çankaya, 06570, Ankara, Turkey. lena.almasifar@ankaramedipol.edu.tr.ORCID http://orcid.org/0000-0003-3493-0137
Cangül KeskinDepartment of Endodontics, Faculty of Dentistry, 19 Mayıs University, Körfez. No. 45, Atakum, Samsun, 55270, Turkey.ORCID http://orcid.org/0000-0001-8990-4847
Aybüke Karaca SakallıDepartment of Endodontics, Faculty of Dentistry, Ankara Medipol University, Eti, Celal Bayar Blvd, no: 88/1, Çankaya, 06570, Ankara, Turkey.ORCID http://orcid.org/0000-0001-5472-0781
Bilge ÖzcanBilge Özcan. DDS, MSc, Endodontics, DentTarz Academy Dental Clinic, 2666 St. No:5B, Altay, 06820, Ankara, Turkey.ORCID http://orcid.org/0000-0003-0527-5620
İsen Güleç KoçyiğitDepartment of Endodontics, Faculty of Dentistry, Ankara Medipol University, Eti, Celal Bayar Blvd, no: 88/1, Çankaya, 06570, Ankara, Turkey.ORCID http://orcid.org/0000-0002-6649-3413

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveBucco-lingual/palatinal vertical fractures are among the most common fractures found in mesio-occluso-distal (MOD) cavity restorations of endodontically treated teeth. This study aimed to compare the effects of different new-generation reinforcement materials applied to two cervical and coronal segments of the teeth on the fracture resistance of endodontically treated teeth in their coronal restorations. MATERIALS AND

methodsA total of 84 freshly extracted, intact human mandibular molars were selected and treated endodontically according to standardized protocols. Standard MOD cavities were prepared, and the specimens were then randomly divided into seven groups (n = 12) based on the combinations of reinforcement materials applied to the cervical or coronal segments, and a control group. The control group had intact teeth. The experimental groups included combinations of flowable composite (Flow), posterior composite (PC), EverX flow (Xflow), EverX posterior (XP), PC, and Ribbond (RIB). After thermocycling, fracture resistance was evaluated using a universal testing machine, and failure patterns were examined under a stereomicroscope. Data were analyzed using the Kruskal-Wallis H test, following a Shapiro-Wilk test that indicated the data did not follow a normal distribution (p < .05).

resultsA statistically significant difference was observed between the groups (p < .05). Group 5, which had RIB flow and XP restoration structure, exhibited the highest fracture resistance (1827.90 N), while Group 1, which had Flow and PC restoration structure, demonstrated the lowest fracture resistance (1121.98 N). Fiber-reinforced structures demonstrate superior fracture resistance compared to the other groups (p < .05). There was no significant difference between conventional restoration and Ribbond in the coronal segment (p > .05).

conclusionUsing fiber-reinforced restoration in the cervical segment increases fracture resistance more than in the coronal segment. Fiber-reinforced composites are easily packable and demonstrate higher fracture resistance than Ribbond. CLINICAL RELEVANCE: Resin-reinforced composite combinations used in cervical and coronal applications improve fracture resistance and can be safely applied for MOD cavity restoration of endodontically treated teeth.

Indexed as

Composite ResinsDental Cavity PreparationDental MaterialsDental Restoration, PermanentTooth FracturesTooth, NonvitalDental Restoration FailureDental Stress AnalysisHumansIn Vitro TechniquesMaterials TestingMolarPolyethylenesComposite ResinsDental MaterialsEverX PosteriorPolyethylenesRIBBONDEndodonticsFiber-reinforced compositeFracture resistanceInjectable compositeRestorative dentistryRibbond

Identifiers

PMID41021045

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.