{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:15:42Z","timestamp":1782998142067,"version":"3.54.5"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Turku (UTU) including Turku University Central Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Odontology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to assess the fracture behavior of molar teeth restored with MOD inlays made of experimental short fiber-reinforced CAD\/CAM composite block (SFRC CAD) before and after cyclic fatigue aging. Standardized MOD cavities were prepared on 60 intact mandibular molars. Three groups of CAD\/CAM made inlay restorations (Cerasmart 270, Enamic, and SFRC CAD) were fabricated (<jats:italic>n<\/jats:italic>\u2009=\u200920\/group). All restorations were luted with self-adhesive dual-cure resin cement (G-Cem One). Half of restored teeth per each group (<jats:italic>n<\/jats:italic>\u2009=\u200910) were quasi-statically loaded until fracture without aging. The other half underwent cyclic fatigue aging for 500,000 cycles (<jats:italic>F<\/jats:italic><jats:sub>max<\/jats:sub>\u2009=\u2009150 N) before being loaded quasi-statically until fracture. Then, the fracture type was visually inspected. The microstructure and elemental content of CAD\/CAM materials were assessed using SEM and EDS. Two-way analysis of variance (ANOVA) was used to statistically examine the data, and it was followed by the Tukey HSD test (<jats:italic>\u03b1<\/jats:italic>\u2009=\u20090.05). ANOVA demonstrated that both material type and aging had a significant effect (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) on the load-bearing capacity values of the restorations. Teeth restored with SFRC CAD showed significantly the highest (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) load-bearing capacity (2535\u2009\u00b1\u2009830 N) after fatigue aging among all groups. SEM images showed the ability of short fibers in SFRC CAD composite to redirect and hinder crack propagation. With regard to fracture mode, Enamic group revealed 85% of catastrophic failure (vs. 45% and 10% for Cerasmart 270 and SFRC CAD, respectively). Large MOD cavities on molar teeth were most favorably restored with SFRC CAD inlays, yielding the highest load-bearing capacity and more restorable failures.<\/jats:p>","DOI":"10.1007\/s10266-023-00815-y","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T10:03:11Z","timestamp":1682416991000},"page":"138-147","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fracture behavior of short fiber-reinforced CAD\/CAM inlay restorations after cyclic fatigue aging"],"prefix":"10.1007","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9457-2314","authenticated-orcid":false,"given":"S.","family":"Garoushi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Barlas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. K.","family":"Vallittu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. B.","family":"Uctasli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Lassila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"815_CR1","doi-asserted-by":"publisher","first-page":"182","DOI":"10.11607\/ijp.5616","volume":"32","author":"CC Mello","year":"2019","unstructured":"Mello CC, Lemos CAA, de Luna Gomes JM, Verri FR, Pellizzer EP. CAD\/CAM vs conventional technique for fabrication of implant-supported frameworks: a systematic review and meta-analysis of in vitro studies. Int J Prosthodont. 2019;32:182\u201392.","journal-title":"Int J Prosthodont"},{"key":"815_CR2","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1111\/jerd.12384","volume":"30","author":"J Abduo","year":"2018","unstructured":"Abduo J, Sambrook RJ. Longevity of ceramic onlays: a systematic review. J Esthet Restor Dent. 2018;30:193\u2013215.","journal-title":"J Esthet Restor Dent"},{"key":"815_CR3","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.prosdent.2005.08.004","volume":"94","author":"C Hannig","year":"2005","unstructured":"Hannig C, Westphal C, Becker K, Attin T. Fracture resistance of endodontically treated maxillary premolars restored with CAD\/CAM ceramic inlays. J Prosthet Dent. 2005;94:342\u20139.","journal-title":"J Prosthet Dent"},{"key":"815_CR4","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.joen.2011.11.017","volume":"38","author":"DG Seo","year":"2012","unstructured":"Seo DG, Yi YA, Shin SJ, Park JW. Analysis of factors associated with cracked teeth. J Endod. 2012;38:288\u201392.","journal-title":"J Endod"},{"key":"815_CR5","first-page":"25","volume":"41","author":"JA Hood","year":"1991","unstructured":"Hood JA. Biomechanics of the intact, prepared and restored tooth: some clinical implications. Int Dent J. 1991;41:25\u201332.","journal-title":"Int Dent J"},{"key":"815_CR6","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-023-04934-2","author":"A Volom","year":"2023","unstructured":"Volom A, Vincze-Bandi E, S\u00e1ry T, Alleman D, Forster A, Jakab A, Braunitzer G, Garoushi S, Fr\u00e1ter M. Fatigue performance of endodontically treated molars reinforced with different fiber systems. Clin Oral Investig. 2023. https:\/\/doi.org\/10.1007\/s00784-023-04934-2.","journal-title":"Clin Oral Investig"},{"key":"815_CR7","doi-asserted-by":"publisher","first-page":"3501","DOI":"10.1007\/s00784-021-04319-3","volume":"26","author":"M Fr\u00e1ter","year":"2022","unstructured":"Fr\u00e1ter M, S\u00e1ry T, Moln\u00e1r J, Braunitzer G, Lassila L, Vallittu PK, Garoushi S. Fatigue performance of endodontically treated premolars restored with direct and indirect cuspal coverage restorations utilizing fiber-reinforced cores. Clin Oral Investig. 2022;26:3501\u201313.","journal-title":"Clin Oral Investig"},{"key":"815_CR8","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.prosdent.2017.03.001","volume":"119","author":"A Goujat","year":"2018","unstructured":"Goujat A, Abouelleil H, Colon P, Jeannin C, Pradelle N, Seux D, Grosgogeat B. Mechanical properties and internal fit of 4 CAD-CAM block materials. J Prosthet Dent. 2018;119:384\u20139.","journal-title":"J Prosthet Dent"},{"key":"815_CR9","doi-asserted-by":"publisher","DOI":"10.11607\/ijp.7207","author":"S Garoushi","year":"2021","unstructured":"Garoushi S, S\u00e4ilynoja E, Vallittu PK, Lassila L. Fracture-behavior of CAD\/CAM ceramic crowns before and after cyclic fatigue aging. Int J Prosthodont. 2021. https:\/\/doi.org\/10.11607\/ijp.7207.","journal-title":"Int J Prosthodont"},{"key":"815_CR10","doi-asserted-by":"publisher","first-page":"318.e1","DOI":"10.1016\/j.prosdent.2018.05.011","volume":"120","author":"FS Ludovichetti","year":"2018","unstructured":"Ludovichetti FS, Trindade FZ, Werner A, Kleverlaan CJ, Fonseca RG. Wear resistance and abrasiveness of CAD-CAM monolithic materials. J Prosthet Dent. 2018;120:318.e1-318.e8.","journal-title":"J Prosthet Dent"},{"key":"815_CR11","doi-asserted-by":"publisher","first-page":"E160","DOI":"10.2341\/13-092-L","volume":"39","author":"A Costa","year":"2014","unstructured":"Costa A, Xavier T, Noritomi P, Saavedra G, Borges A. The influence of elastic modulus of inlay materials on stress distribution and fracture of premolars. Oper Dent. 2014;39:E160\u201370.","journal-title":"Oper Dent"},{"key":"815_CR12","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1177\/0022034514553976","volume":"93","author":"ND Ruse","year":"2014","unstructured":"Ruse ND, Sadoun MJ. Resin-composite blocks for dental CAD\/CAM applications. J Dent Res. 2014;93:1232\u20134.","journal-title":"J Dent Res"},{"key":"815_CR13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.4012\/dmj.28.44","volume":"28","author":"T Miyazaki","year":"2009","unstructured":"Miyazaki T, Hotta Y, Kunii J, Kuriyama S, Tamaki Y. A review of dental CAD\/CAM: current status and future perspectives from 20 years of experience. Dent Mater J. 2009;28:44\u201356.","journal-title":"Dent Mater J"},{"key":"815_CR14","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.dental.2016.10.009","volume":"33","author":"R Belli","year":"2017","unstructured":"Belli R, Wendler M, de Ligny D, Cicconi MR, Petschelt A, Peterlik H, Lohbauer U. Chairside CAD\/CAM materials. Part 1: Measurement of elastic constants and microstructural characterization. Dent Mater. 2017;33:84\u201398.","journal-title":"Dent Mater"},{"key":"815_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2019.103444","volume":"101","author":"L Lassila","year":"2020","unstructured":"Lassila L, S\u00e4ilynoja E, Prinssi R, Vallittu PK, Garoushi S. Fracture behavior of Bi-structure fiber-reinforced composite restorations. J Mech Behav Biomed Mater. 2020;101: 103444.","journal-title":"J Mech Behav Biomed Mater"},{"key":"815_CR16","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1016\/j.dental.2018.01.002","volume":"34","author":"L Lassila","year":"2018","unstructured":"Lassila L, Keulemans F, S\u00e4ilynoja E, Vallittu PK, Garoushi S. Mechanical properties and fracture behavior of flowable fiber-reinforced composite restorations. Dent Mater. 2018;34:598\u2013606.","journal-title":"Dent Mater"},{"key":"815_CR17","doi-asserted-by":"publisher","DOI":"10.1111\/eos.12815","volume":"129","author":"E Mangoush","year":"2021","unstructured":"Mangoush E, Lassila L, Vallittu PK, Garoushi S. Shear-bond strength and optical properties of short fiber-reinforced CAD\/CAM composite blocks. Eur J Oral Sci. 2021;129: e12815.","journal-title":"Eur J Oral Sci"},{"key":"815_CR18","first-page":"189","volume":"28","author":"E Mangoush","year":"2020","unstructured":"Mangoush E, Garoushi S, Vallittu PK, Lassila L. Influence of short fiber-reinforced composites on fracture resistance of single-structure restorations. Eur J Prosthodont Restor Dent. 2020;28:189\u201398.","journal-title":"Eur J Prosthodont Restor Dent"},{"issue":"3","key":"815_CR19","first-page":"166","volume":"29","author":"E Mangoush","year":"2021","unstructured":"Mangoush E, Lassila L, Vallittu PK, Garoushi S. Microstructure and surface characteristics of short-fiber reinforced CAD\/CAM composite blocks. Eur J Prosthodont Restor Dent. 2021;29(3):166\u201374.","journal-title":"Eur J Prosthodont Restor Dent"},{"issue":"2","key":"815_CR20","doi-asserted-by":"publisher","first-page":"271","DOI":"10.2186\/jpr.JPR_D_22_00050","volume":"67","author":"L Lassila","year":"2022","unstructured":"Lassila L, Mangoush E, Vallittu PK, Garoushi S. Fracture behavior of discontinuous fiber-reinforced composite inlay-retained fixed partial denture before and after fatigue aging. J Prosthodont Res. 2022;67(2):271\u20137.","journal-title":"J Prosthodont Res"},{"key":"815_CR21","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/j.cden.2022.05.007","volume":"66","author":"A Bacchi","year":"2022","unstructured":"Bacchi A, Cesar PF. Advances in ceramics for dental applications. Dent Clin North Am. 2022;66:591\u2013602.","journal-title":"Dent Clin North Am"},{"key":"815_CR22","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1080\/23337931.2016.1224670","volume":"2","author":"K Nagata","year":"2016","unstructured":"Nagata K, Garoushi SK, Vallittu PK, Wakabayashi N, Takahashi H, Lassila LVJ. Fracture behavior of single-structure fiber-reinforced composite restorations. Acta Biomater Odontol Scand. 2016;2:118\u201324.","journal-title":"Acta Biomater Odontol Scand"},{"key":"815_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2019.103537","volume":"103","author":"J Tiu","year":"2020","unstructured":"Tiu J, Belli R, Lohbauer U. Rising R-curves in particulate\/fiber-reinforced resin composite layered systems. J Mech Behav Biomed Mater. 2020;103: 103537.","journal-title":"J Mech Behav Biomed Mater"},{"key":"815_CR24","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1016\/j.dental.2013.04.016","volume":"29","author":"S Garoushi","year":"2013","unstructured":"Garoushi S, Sailynoja E, Vallittu PK, Lassila L. Physical properties and depth of cure of a new short fiber-reinforced composite. Dent Mater. 2013;29:835\u201341.","journal-title":"Dent Mater"},{"key":"815_CR25","doi-asserted-by":"publisher","first-page":"580","DOI":"10.4012\/dmj.2021-321","volume":"41","author":"J Bijelic-Donova","year":"2022","unstructured":"Bijelic-Donova J, Garoushi S, Lassila LV, Rocca GT, Vallittu PK. Crack propagation and toughening mechanism of bilayered short-fiber reinforced resin composite structure-evaluation up to six months storage in water. Dent Mater J. 2022;41:580\u20138.","journal-title":"Dent Mater J"},{"key":"815_CR26","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.jmbbm.2016.01.036","volume":"60","author":"L Lassila","year":"2016","unstructured":"Lassila L, Garoushi S, Vallittu PK, S\u00e4ilynoja E. Mechanical properties of fiber reinforced restorative composite with two distinguished fiber length distribution. J Mech Behav Biomed Mater. 2016;60:331\u20138.","journal-title":"J Mech Behav Biomed Mater"},{"key":"815_CR27","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.dental.2020.12.002","volume":"37","author":"J Tiu","year":"2021","unstructured":"Tiu J, Belli R, Lohbauer U. Thickness influence of veneering composites on fiber-reinforced systems. Dent Mater. 2021;37:477\u201385.","journal-title":"Dent Mater"},{"key":"815_CR28","doi-asserted-by":"publisher","first-page":"e308","DOI":"10.1016\/j.dental.2022.11.012","volume":"38","author":"L Ling","year":"2022","unstructured":"Ling L, Lai T, Malyala R. Fracture toughness and brittleness of novel CAD\/CAM resin composite block. Dent Mater. 2022;38:e308\u201317.","journal-title":"Dent Mater"},{"key":"815_CR29","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1093\/ejo\/cjq097","volume":"33","author":"S Varga","year":"2011","unstructured":"Varga S, Spalj S, Lapter Varga M, Anic Milosevic S, Mestrovic S, Slaj M. Maximum voluntary molar bite force in subjects with normal occlusion. Eur J Orthod. 2011;33:427\u201333.","journal-title":"Eur J Orthod"},{"key":"815_CR30","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1016\/j.dental.2006.06.031","volume":"23","author":"F Takeshige","year":"2007","unstructured":"Takeshige F, Kawakami Y, Hayashi M, Ebisu S. Fatigue behavior of resin composites in aqueous environments. Dent Mater. 2007;23:893\u20139.","journal-title":"Dent Mater"},{"key":"815_CR31","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1016\/j.dental.2021.04.002","volume":"37","author":"M Wendler","year":"2021","unstructured":"Wendler M, Stenger A, Ripper J, Priewich E, Belli R, Lohbauer U. Mechanical degradation of contemporary CAD\/CAM resin composite materials after water ageing. Dent Mater. 2021;37:1156\u201367.","journal-title":"Dent Mater"},{"key":"815_CR32","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1177\/0022034513490734","volume":"92","author":"U Lohbauer","year":"2013","unstructured":"Lohbauer U, Belli R, Ferracane JL. Factors involved in mechanical fatigue degradation of dental resin composites. J Dent Res. 2013;92:584\u201391.","journal-title":"J Dent Res"},{"key":"815_CR33","doi-asserted-by":"publisher","first-page":"2769","DOI":"10.3390\/ma14112769","volume":"14","author":"J Oja","year":"2021","unstructured":"Oja J, Lassila L, Vallittu PK, Garoushi S. Effect of accelerated aging on some mechanical properties and wear of different commercial dental resin composites. Materials (Basel). 2021;14:2769.","journal-title":"Materials (Basel)"},{"key":"815_CR34","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1016\/j.dental.2017.08.190","volume":"33","author":"Z Xu","year":"2017","unstructured":"Xu Z, Yu P, Arola DD, Min J, Gao S. A comparative study on the wear behavior of a polymer infiltrated ceramic network (PICN) material and tooth enamel. Dent Mater. 2017;33:1351\u201361.","journal-title":"Dent Mater"},{"key":"815_CR35","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1016\/j.dental.2008.01.002","volume":"24","author":"SS Scherrer","year":"2008","unstructured":"Scherrer SS, Quinn GD, Quinn JB. Fractographic failure analysis of a Procera All Ceram crown using stereo and scanning electron microscopy. Dent Mater. 2008;24:1107\u201313.","journal-title":"Dent Mater"},{"key":"815_CR36","first-page":"179","volume":"34","author":"Y Iketani","year":"2021","unstructured":"Iketani Y, Kobayashi M, Niizuma Y, Sugai R, Manabe A. Effect of various resin cements and immediate dentin sealing on tooth fracture resistance of zirconia inlay restorations. Am J Dent. 2021;34:179\u201385.","journal-title":"Am J Dent"},{"key":"815_CR37","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.3390\/polym13071130","volume":"13","author":"S Uctasli","year":"2021","unstructured":"Uctasli S, Boz Y, Sungur S, Vallittu PK, Garoushi S, Lassila L. Influence of post-core and crown type on the fracture resistance of incisors submitted to quasistatic loading. Polymers (Basel). 2021;13:1130.","journal-title":"Polymers (Basel)"}],"container-title":["Odontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10266-023-00815-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10266-023-00815-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10266-023-00815-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T22:03:12Z","timestamp":1704837792000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10266-023-00815-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,25]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["815"],"URL":"https:\/\/doi.org\/10.1007\/s10266-023-00815-y","relation":{},"ISSN":["1618-1247","1618-1255"],"issn-type":[{"value":"1618-1247","type":"print"},{"value":"1618-1255","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,25]]},"assertion":[{"value":"19 January 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Author Garoushi S declares that he has no conflict of interest. Author Barlas D declares that she has no conflict of interest. Author Uctasli MB declares that she has no conflict of interest. Author Vallittu PK declares that he consults Stick Tech\u2014Member of GC in training and RD. Author Lassila L declares that he has no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}