ArticleBMC oral health2026
Mechanical behavior of endodontically treated molars restored using two restorative approaches and two CAD/CAM materials: an in-vitro study.
Article in BMC oral health, 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
backgroundRestoration of endodontically treated teeth (ETT) with significant coronal loss poses a challenge in clinical dentistry. Advances in CAD/CAM technology and biomimetic materials have introduced minimally invasive approaches, such as endocrowns and overlays, which can replace traditional post-core and crown approach.
aimThe aim of this in-vitro study was to comparatively assess the mechanical behaviour of two restorative designs (endocrowns and overlays) fabricated from two CAD/CAM materials in endodontically treated mandibular molars. MATERIALS AND
methodsThirty-six endodontically treated lower molars (n = 36) were split into two main groups based on restoration type (n = 18): endocrowns and overlays. Each group was further subdivided into two subgroups based on the CAD/CAM material (n = 9): lithium disilicate (Tessera) and indirect composite (Crios). Restorations were fabricated and bonded to their respective specimens following a strict bonding protocol with an adhesive resin cement (Bisco self-adhesive). Thermo-mechanical aging (Chewing Simulator CS-4, SD Mechatronic) was conducted to simulate oral conditions, followed by a universal testing machine's evaluation of fracture resistance. The test was stopped after fracture. Fractured parts were analysed to determine mode of failure. Data were analyzed using two-way ANOVA followed by Tukey's honestly significant difference (HSD) test for pairwise comparisons (α = 0.05).
resultsAll specimens survived the 5,000 chewing cycles, simulating early intraoral service. Fracture resistance test showed significantly higher fracture resistance for overlays (2048.46 ± 664.63 N) than endocrowns (1234.54 ± 338.50 N) (p = 0.002). Crios overlays exhibited the highest fracture resistance (2384.60 ± 631.10 N), significantly outperforming Tessera overlays (1712.33 ± 559.59 N) (p = 0.043) and endocrowns (1354.20 ± 346.88 N) (p = 0.004). No substantial material change was seen in endocrown restorations (p = 0.445).
conclusionOverlay restorations and indirect composite material (Crios) provide superior resistance to fracture compared to lithium disilicate overlays and endocrowns and may represent a reliable restorative option for endodontically treated molars.
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