ArticleClinical oral investigations2026
Effect of external cervical resorptive defects restored with two bioceramic materials, short glass fiber-reinforced composite and nanohybrid composite on fracture resistance of maxillary anterior teeth: an in-vitro study.
Article in Clinical oral investigations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate and compare the fracture resistance and structural reliability of maxillary anterior teeth with simulated external cervical resorption (ECR) defects restored using Biodentine (BD), TheraCal PT (TPT), short fiber-reinforced composite (SFRC), and nanohybrid composite resin (NHC). MATERIALS AND
methodsSixty-four extracted human maxillary anterior teeth were selected for the study. Sixty teeth were randomly allocated into six groups: positive control (PC, intact teeth), negative control (NC, defect unrestored), BD + NHC, BD + SFRC + NHC, TPT + NHC, and TPT + SFRC + NHC. Four teeth were randomly allocated to the four experimental groups for FESEM (field emission Scanning electron microscopy). Standardized cervical ECR defects (3 mm × 6 mm × 3 mm) were prepared on all teeth except the PC group. Restored specimens underwent thermocycling (10,000 cycles; 5-55 °C) prior to fracture testing. A compressive force was applied at 45° to the long axis of the tooth using a universal testing machine at a crosshead speed of 0.5 mm/min until fracture. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test (α = 0.05). Structural reliability was assessed using Weibull analysis to determine the Weibull modulus (m) and characteristic strength (σ₀).
resultsA statistically significant difference was observed among groups (F(5,54) = 5.92, p < 0.001; η² = 0.35). The PC group demonstrated the highest fracture resistance, whereas the NC group showed the lowest values. Among restorative groups, TPT + SFRC + NHC exhibited significantly higher fracture resistance than NC (p = 0.026), while no other restorative group differed significantly from NC. Weibull analysis demonstrated linear distribution of data on Weibull coordinates across all groups. The NC group exhibited the highest Weibull modulus (m = 5.73), whereas the PC group demonstrated the highest characteristic strength. Among restorative groups, fiber-reinforced combinations showed higher characteristic strength values, with TPT + SFRC + NHC demonstrating the highest σ₀ (801.67 N).
conclusionsRestoration of simulated ECR defects with TPT + SFRC + NHC significantly increased fracture resistance compared with unrestored defects. Both TPT and BD fiber-reinforced composite combinations enhanced load-bearing capacity; however, structural reliability varied among materials. CLINICAL RELEVANCE: When restoring ECR defects in maxillary anterior teeth, combining a bioceramic materials with SFRC and NHC provides pulp protection, enhances fracture resistance and improves esthetics. The biological properties of bioceramic materials must also be taken into consideration as these materials can differ in pulp and periodontal tissue response.
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