The effect of three composite fiber insertion techniques on fracture resistance of root-filled teeth.

The aim of this study was to evaluate the effect of three methods of fiber insertion on fracture resistance of endodontically treated maxillary premolars in vitro. Sixty extracted human maxillary premolars received endodontic treatment followed by mesioocclusodistal (MOD) cavities with 2.5 +/- 0.2 mm thicknesses of buccal and lingual cusps at height of contour. The gingival cavosurface margin was 1.5 mm coronal to the cementoenamel junction (CEJ). Subsequently, the teeth were randomly divided into four groups. In the no-fiber group, the cavities were restored with composite, and in other groups, composite impregnated glass fibers were placed in the gingival, middle, and occlusal third surfaces of the cavities, respectively, and were restored similar to the no-fiber group. Subsequent to thermocycling and exertion of compressive forces, statistical analysis showed that the fracture resistance in the occlusal fiber group was significantly higher than that in other groups (p < 0.0005). In addition, the highest favorable fracture and the lowest cusp detachment rates were observed in the occlusal fiber group.