{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:30:37Z","timestamp":1779917437069,"version":"3.53.1"},"reference-count":31,"publisher":"Operative Dentistry","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n        <jats:sec>\n          <jats:title>Objective:<\/jats:title>\n          <jats:p>To evaluate the effect of polyethylene fiber-reinforcement on the fracture resistance and fracture mode of extensive resin-based composite (RBC) restorations in structurally compromised maxillary premolars.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Methods and Materials:<\/jats:title>\n          <jats:p>Maxillary premolars (54) with specific dimensions and extracted for orthodontic reasons were used. Following mesio-occluso-distal (MOD) cavity preparation and endodontic access, teeth were randomly assigned to one of three restorative protocols (n=18): RBC applied incrementally (I) or reinforced with woven polyethylene fibers (Ribbond) placed horizontally (H) or U-shaped (U). Restored teeth were stored for 45 days in distilled water at 37\u00b0C and then loaded monotonically until fracture. Half of the specimens in each group received axial loading (A) and the other half was loaded paraxially (PA). Fracture load data was assessed using two-way analysis of variance and Tukey's post hoc test for multiple comparisons (\u03b1=0.05). The fracture initiation and propagation path were analyzed using stereomicroscopy and scanning-electron microscopy.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results:<\/jats:title>\n          <jats:p>No significant differences were observed for the fracture strength among loading configurations, except for groups IA (825 N) and HA (553 N). Fracture initiated and propagated mainly at and through the RBC restoration in the I group, whereas a shift to the interface was observed in both polyethylene fiber-reinforced groups. Blocking and bridging of cracks were identified around the fibers, especially in specimens of group U.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusions:<\/jats:title>\n          <jats:p>Incorporation of woven polyethylene fibers to reinforce extensive MOD resin-based composite restorations on endodontically treated premolars reduced the occurrence of cohesive fractures in the restorative material but was unable to increase the fracture resistance of the affected teeth.<\/jats:p>\n        <\/jats:sec>","DOI":"10.2341\/23-138-l","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T01:41:21Z","timestamp":1720489281000},"page":"455-464","source":"Crossref","is-referenced-by-count":8,"title":["Fracture Resistance and Failure Mode of Polyethylene Fiber-reinforced Resin-based Restorations in Structurally Compromised Premolars: an in Vitro Study"],"prefix":"10.2341","volume":"49","author":[{"given":"LF","family":"Canobra","sequence":"first","affiliation":[{"name":"Luis Felipe Canobra, DDS, Facultad de Odontolog\u00eda, Universidad San Sebasti\u00e1n, Sede de la Patagonia, Puerto Montt, Chile, and Master's Program in Dental Sciences, Faculty of Dentistry, Universidad de Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Parra-Gatica","sequence":"additional","affiliation":[{"name":"Elizabeth Parra-Gatica, DDS, Master's Program in Dental Sciences, Faculty of Dentistry, Universidad de Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Sanhueza","sequence":"additional","affiliation":[{"name":"Vilma Sanhueza, PhD, Instituto de Geolog\u00eda Econ\u00f3mica Aplicada (GEA), Universidad de Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Medina","sequence":"additional","affiliation":[{"name":"Carlos Medina, PhD, Department of Mechanical Engineering (DIM), Faculty of Engineering (FI), Universidad de Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Wendler","sequence":"additional","affiliation":[{"name":"*Michael Wendler, DDS, PhD, Department of Restorative Dentistry, Faculty of Dentistry, Universidad de Concepci\u00f3n, Chile, and Master's Program in Dental Sciences, Faculty of Dentistry, Universidad de Concepci\u00f3n, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1188","reference":[{"issue":"2","key":"b1","series-title":"Quintessence International","first-page":"117","article-title":"Biomechanical considerations for the restoration of endodontically treated teeth: A systematic review of the literature, Part II (Evaluation of fatigue behavior, interfaces, and in vivo studies)","volume":"39","author":"Dietschi\n              D","year":"2008","unstructured":"Dietschi\n              D\n            , DucO, KrejciI, & SadanA (2008) Biomechanical considerations for the restoration of endodontically treated teeth: A systematic review of the literature, Part II (Evaluation of fatigue behavior, interfaces, and in vivo studies)Quintessence International39(2) 117\u2013129."},{"issue":"4","key":"b2","series-title":"International Journal of Periodontics and Restorative Dentistry","first-page":"361","article-title":"CT scan-based finite element analysis of premolar cuspal deflection following operative procedures","volume":"29","author":"Magne\n              P","year":"2009","unstructured":"Magne\n              P\n            \n           & OganesyanT (2009) CT scan-based finite element analysis of premolar cuspal deflection following operative proceduresInternational Journal of Periodontics and Restorative Dentistry29(4) 361\u2013369."},{"issue":"1","key":"b3","series-title":"Biomedical Engineering Online","first-page":"3","article-title":"Influence of the indirect restoration design on the fracture resistance: A finite element study","volume":"15","author":"Mei\n              ML","year":"2016","unstructured":"Mei\n              ML\n            , ChenYM, LiH, & ChuCH (2016) Influence of the indirect restoration design on the fracture resistance: A finite element studyBiomedical Engineering Online15(1) 3. http:\/\/dx.doi.org\/10.1186\/s12938-015-0115-4"},{"issue":"7","key":"b4","series-title":"Dental Materials","first-page":"854","article-title":"A comparison of mvM stress of inlays, onlays and endocrowns made from various materials and their bonding with molars in a computer simulation of mastication - FEA","volume":"36","author":"Dejak\n              B","year":"2020","unstructured":"Dejak\n              B\n            \n           & M\u0142otkowskiA (2020) A comparison of mvM stress of inlays, onlays and endocrowns made from various materials and their bonding with molars in a computer simulation of mastication - FEADental Materials36(7) 854\u2013864. http:\/\/dx.doi.org\/10.1016\/j.dental.2020.04.007"},{"issue":"3","key":"b5","series-title":"Journal of Adhesive Dentistry","first-page":"183","article-title":"Direct and indirect restorations for endodontically treated teeth: A systematic review and meta-analysis, IAAD 2017 Consensus Conference paper","volume":"20","author":"Shu\n              X","year":"2018","unstructured":"Shu\n              X\n            , MaiQQ, BlatzM, PriceR, WangXD, & ZhaoK (2018) Direct and indirect restorations for endodontically treated teeth: A systematic review and meta-analysis, IAAD 2017 Consensus Conference paperJournal of Adhesive Dentistry20(3) 183\u2013194. http:\/\/dx.doi.org\/10.3290\/j.jad.a40762"},{"issue":"Supplement 7","key":"b6","series-title":"Operative Dentistry","first-page":"S27","article-title":"From \u2018direct versus indirect\u2019 toward an integrated restorative concept in the posterior dentition","volume":"41","author":"Opdam\n              N","year":"2016","unstructured":"Opdam\n              N\n            , FrankenbergerR, & MagneP (2016) From \u2018direct versus indirect\u2019 toward an integrated restorative concept in the posterior dentitionOperative Dentistry41(Supplement 7) S27\u2013S34. http:\/\/dx.doi.org\/10.2341\/15-126-lit"},{"issue":"5","key":"b7","series-title":"Journal of Adhesive Dentistry","first-page":"407","article-title":"Clinical effectiveness of direct class II restorations - a meta-analysis","volume":"14","author":"Heintze\n              SD","year":"2012","unstructured":"Heintze\n              SD\n            \n           & RoussonV (2012) Clinical effectiveness of direct class II restorations - a meta-analysisJournal of Adhesive Dentistry14(5) 407\u2013431. http:\/\/dx.doi.org\/10.3290\/j.jad.a28390"},{"issue":"5","key":"b8","series-title":"Operative Dentistry","first-page":"481","article-title":"Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition","volume":"29","author":"Manhart\n              J","year":"2004","unstructured":"Manhart\n              J\n            , ChenH, HammG, & HickelR (2004) Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentitionOperative Dentistry29(5) 481\u2013508."},{"issue":"10","key":"b9","series-title":"Journal of Dental Research","first-page":"943","article-title":"Longevity of posterior composite restorations: A systematic review and meta-analysis","volume":"93","author":"Opdam\n              NJ","year":"2014","unstructured":"Opdam\n              NJ\n            , van de SandeFH, BronkhorstE, CenciMS, BottenbergP, PallesenU, GaenglerP, LindbergA, HuysmansMCDNJM, & van DijkenJW (2014) Longevity of posterior composite restorations: A systematic review and meta-analysisJournal of Dental Research93(10) 943\u2013949. http:\/\/dx.doi.org\/10.1177\/0022034514544217"},{"key":"b10","series-title":"Journal of the Mechanical Behavior of Biomedical Materials","first-page":"268","article-title":"Polymerization shrinkage stress of resin-based dental materials: A systematic review and meta-analyses of composition strategies","volume":"82","author":"Meereis\n              CTW","year":"2018","unstructured":"Meereis\n              CTW\n            , M\u00fcnchowEA, de Oliveira da RosaWL, da SilvaAF, & PivaE (2018) Polymerization shrinkage stress of resin-based dental materials: A systematic review and meta-analyses of composition strategiesJournal of the Mechanical Behavior of Biomedical Materials82268\u2013281. http:\/\/dx.doi.org\/10.1016\/j.jmbbm.2018.03.019"},{"issue":"1","key":"b11","series-title":"Journal of Dental Research","first-page":"36","article-title":"Randomized control trial of composite cuspal restorations: Five-year results","volume":"93","author":"Fennis\n              WM","year":"2014","unstructured":"Fennis\n              WM\n            , KuijsRH, RoetersFJ, CreugersN, & KreulenCM (2014) Randomized control trial of composite cuspal restorations: Five-year resultsJournal of Dental Research93(1) 36\u201341. http:\/\/dx.doi.org\/10.1177\/0022034513510946"},{"issue":"1","key":"b12","series-title":"Dental Materials","first-page":"1","article-title":"High-aspect ratio fillers: Fiber-reinforced composites and their anisotropic properties","volume":"31","author":"Vallittu\n              PK","year":"2015","unstructured":"Vallittu\n              PK\n            \n           (2015) High-aspect ratio fillers: Fiber-reinforced composites and their anisotropic propertiesDental Materials31(1) 1\u20137. http:\/\/dx.doi.org\/10.1016\/j.dental.2014.07.009"},{"key":"b13","series-title":"Engineering Fracture Mechanics","first-page":"146","article-title":"Resistance curves of short-fiber reinforced methacrylate-based biomedical composites","volume":"190","author":"Wendler\n              M","year":"2018","unstructured":"Wendler\n              M\n            , BelliR, SchachtnerM, AmbergerG, PetscheltA, FeyT, & LohbauerG. (2018) Resistance curves of short-fiber reinforced methacrylate-based biomedical compositesEngineering Fracture Mechanics190146\u2013158. http:\/\/dx.doi.org\/10.1016\/j.engfracmech.2017.12.008"},{"key":"b14","series-title":"Journal of the Mechanical Behavior of Biomedical Materials","first-page":"103674","article-title":"R-curve behavior of a short-fiber reinforced resin composite after water storage","volume":"104","author":"Tiu\n              J","year":"2020","unstructured":"Tiu\n              J\n            , BelliR, & LohbauerU (2020) R-curve behavior of a short-fiber reinforced resin composite after water storageJournal of the Mechanical Behavior of Biomedical Materials104103674. http:\/\/dx.doi.org\/https:\/\/doi.org\/10.1016\/j.jmbbm.2020.103674"},{"issue":"5","key":"b15","series-title":"Dental Materials Journal","first-page":"618","article-title":"Effect of novel restoration techniques on the fracture resistance of teeth treated endodontically: An in vitro study","volume":"34","author":"Kemaloglu\n              H","year":"2015","unstructured":"Kemaloglu\n              H\n            , KavalEM, TurkunM, & KurtSM (2015) Effect of novel restoration techniques on the fracture resistance of teeth treated endodontically: An in vitro studyDental Materials Journal34(5) 618\u2013622. http:\/\/dx.doi.org\/10.4012\/dmj.2014-326"},{"issue":"12","key":"b16","series-title":"Journal of Clinical Experimental Dentistry","first-page":"e1408","article-title":"Comparative evaluation between glass and polyethylene fiber reinforced composites: A review of the current literature","volume":"9","author":"Mangoush\n              E","year":"2017","unstructured":"Mangoush\n              E\n            , S\u00e4ilynojaE, PrinssiR, LassilaL, VallittuPK, & GaroushiS (2017) Comparative evaluation between glass and polyethylene fiber reinforced composites: A review of the current literatureJournal of Clinical Experimental Dentistry9(12) e1408\u2013e1417. http:\/\/dx.doi.org\/10.4317\/jced.54205"},{"key":"b17","series-title":"Fiber Posts and Endodontically Treated Teeth: A Compendium of Scientific and Clinical Perspectives","article-title":"Biomechanical properties and clinical use of a polyethylene fiber post-core material","author":"Belli\n              S","year":"2008","unstructured":"Belli\n              S\n            \n           & EskitasciogluG (2008) Biomechanical properties and clinical use of a polyethylene fiber post-core material In: FerrariM (ed) Fiber Posts and Endodontically Treated Teeth: A Compendium of Scientific and Clinical PerspectivesModern Dentistry Media, Wendywood, South Africa."},{"issue":"1","key":"b18","series-title":"Journal of Biomedical Materials Research Part B, Applied Biomaterials","first-page":"35","article-title":"The effect of fiber insertion on fracture resistance of endodontically treated molars with MOD cavity and reattached fractured lingual cusps","volume":"79","author":"Belli\n              S","year":"2006","unstructured":"Belli\n              S\n            , CobankaraFK, EraslanO, EskitasciogluG, & KarbhariV (2006) The effect of fiber insertion on fracture resistance of endodontically treated molars with MOD cavity and reattached fractured lingual cuspsJournal of Biomedical Materials Research Part B, Applied Biomaterials79(1) 35\u201341. http:\/\/dx.doi.org\/10.1002\/jbm.b.30508"},{"issue":"4","key":"b19","series-title":"Journal of Prosthodontic Research","first-page":"464","article-title":"Fracture resistance of endodontically treated teeth restored with short fiber composite used as a core material-an in vitro study","volume":"61","author":"Garlapati\n              TG","year":"2017","unstructured":"Garlapati\n              TG\n            , KrithikadattaJ, & NatanasabapathyV (2017) Fracture resistance of endodontically treated teeth restored with short fiber composite used as a core material-an in vitro studyJournal of Prosthodontic Research61(4) 464\u2013470. http:\/\/dx.doi.org\/10.1016\/j.jpor.2017.02.001"},{"key":"b20","series-title":"International Journal of Dentistry","first-page":"6159338","article-title":"Fracture resistance of endodontically treated maxillary premolar teeth restored with wallpapering technique: A comparative in vitro study","volume":"2023","author":"Abdulamir\n              SW","year":"2023","unstructured":"Abdulamir\n              SW\n            \n           & MajeedMA (2023) Fracture resistance of endodontically treated maxillary premolar teeth restored with wallpapering technique: A comparative in vitro studyInternational Journal of Dentistry20236159338. http:\/\/dx.doi.org\/10.1155\/2023\/6159338"},{"key":"b21","series-title":"Journal of the Mechanical Behavior of Biomedical Materials","first-page":"103537","article-title":"Rising R-curves in particulate\/fiber-reinforced resin composite layered systems","volume":"103","author":"Tiu\n              J","year":"2020","unstructured":"Tiu\n              J\n            , BelliR, & LohbauerU (2020) Rising R-curves in particulate\/fiber-reinforced resin composite layered systemsJournal of the Mechanical Behavior of Biomedical Materials103103537. http:\/\/dx.doi.org\/https:\/\/doi.org\/10.1016\/j.jmbbm.2019.103537"},{"issue":"3","key":"b22","series-title":"Odontology","first-page":"342","article-title":"Characterization of a new fiber-reinforced flowable composite","volume":"107","author":"Lassila\n              L","year":"2019","unstructured":"Lassila\n              L\n            , S\u00e4ilynojaE, PrinssiR, VallittuP, & GaroushiS (2019) Characterization of a new fiber-reinforced flowable compositeOdontology107(3) 342\u2013352. http:\/\/dx.doi.org\/10.1007\/s10266-018-0405-y"},{"issue":"1","key":"b23","series-title":"Clinical Oral Investigations","first-page":"265","article-title":"Fracture resistance and marginal gap formation of post-core restorations: influence of different fiber-reinforced composites","volume":"24","author":"Fr\u00e1ter\n              M","year":"2020","unstructured":"Fr\u00e1ter\n              M\n            , LassilaL, BraunitzerG, VallittuPK, & GaroushiS (2020) Fracture resistance and marginal gap formation of post-core restorations: influence of different fiber-reinforced compositesClinical Oral Investigations24(1) 265\u2013276. http:\/\/dx.doi.org\/10.1007\/s00784-019-02902-3"},{"issue":"2","key":"b24","series-title":"International Endodontic Journal","first-page":"73","article-title":"The effect of fibre insertion on fracture resistance of root filled molar teeth with MOD preparations restored with composite","volume":"38","author":"Belli\n              S","year":"2005","unstructured":"Belli\n              S\n            , ErdemirA, OzcopurM, & EskitasciogluG (2005) The effect of fibre insertion on fracture resistance of root filled molar teeth with MOD preparations restored with compositeInternational Endodontic Journal38(2) 73\u201380. http:\/\/dx.doi.org\/10.1111\/j.1365-2591.2004.00892.x"},{"issue":"2","key":"b25","series-title":"Operative Dentistry","first-page":"162","article-title":"Influence of different restoration techniques on fracture resistance of root-filled teeth: In vitro investigation","volume":"43","author":"Hshad\n              ME","year":"2018","unstructured":"Hshad\n              ME\n            , Dalk\u0131l\u0131\u00e7EE, OzturkGC, DogruerI, & KorayF (2018) Influence of different restoration techniques on fracture resistance of root-filled teeth: In vitro investigationOperative Dentistry43(2) 162\u2013169. http:\/\/dx.doi.org\/10.2341\/17-040-l"},{"issue":"5","key":"b26","series-title":"Operative Dentistry","first-page":"526","article-title":"The effect of different restoration techniques on the fracture resistance of endodontically-treated molars","volume":"33","author":"Cobankara\n              FK","year":"2008","unstructured":"Cobankara\n              FK\n            , UnluN, CetinAR, & OzkanHB (2008) The effect of different restoration techniques on the fracture resistance of endodontically-treated molarsOperative Dentistry33(5) 526\u2013533. http:\/\/dx.doi.org\/10.2341\/07-132"},{"issue":"2","key":"b27","series-title":"International Endodontic Journal","first-page":"136","article-title":"Reinforcement effect of polyethylene fibre in root-filled teeth: Comparison of two restoration techniques","volume":"39","author":"Belli\n              S","year":"2006","unstructured":"Belli\n              S\n            , ErdemirA, & YildirimC (2006) Reinforcement effect of polyethylene fibre in root-filled teeth: Comparison of two restoration techniquesInternational Endodontic Journal39(2) 136\u2013142. http:\/\/dx.doi.org\/10.1111\/j.1365-2591.2006.01057.x"},{"issue":"3","key":"b28","series-title":"Australian Endodontic Journal","first-page":"458","article-title":"Stress distribution and fracture resistance of repairing cracked tooth with fiber-reinforced composites and onlay","volume":"48","author":"Shi\n              R","year":"2022","unstructured":"Shi\n              R\n            , MengX, FengR, HongS, HuC, YangM, & JiangY (2022) Stress distribution and fracture resistance of repairing cracked tooth with fiber-reinforced composites and onlayAustralian Endodontic Journal48(3) 458\u2013464. http:\/\/dx.doi.org\/10.1111\/aej.12578"},{"issue":"3","key":"b29","series-title":"International Journal of Prosthodontics","first-page":"313","article-title":"Fatigue resistance of teeth restored with cuspal-coverage composite restorations","volume":"17","author":"Fennis\n              WMM","year":"2004","unstructured":"Fennis\n              WMM\n            , KuijsRH, KreulenCM, VerdonschotN, & CreugersNHJ (2004) Fatigue resistance of teeth restored with cuspal-coverage composite restorationsInternational Journal of Prosthodontics17(3) 313\u2013317."},{"issue":"6","key":"b30","series-title":"Dental Materials","first-page":"565","article-title":"In vitro fracture resistance of fiber reinforced cusp-replacing composite restorations","volume":"21","author":"Fennis\n              WM","year":"2005","unstructured":"Fennis\n              WM\n            , TezvergilA, KuijsRH, LassilaLVJ, KreulenCM, CreugersNHJ, & VallittuPK (2005) In vitro fracture resistance of fiber reinforced cusp-replacing composite restorationsDental Materials21(6) 565\u2013572. http:\/\/dx.doi.org\/10.1016\/j.dental.2004.07.019"},{"issue":"6","key":"b31","series-title":"Clinical Oral Investigations","first-page":"3211","article-title":"Fatigue performance of endodontically treated molars reinforced with different fiber systems","volume":"27","author":"Volom\n              A","year":"2023","unstructured":"Volom\n              A\n            , Vincze-BandiE, S\u00e1ryT, AllemanD, ForsterA, JakabA, BraunitzerG, GaroushiS, & Fr\u00e1terM (2023) Fatigue performance of endodontically treated molars reinforced with different fiber systemsClinical Oral Investigations27(6) 3211\u20133220. http:\/\/dx.doi.org\/10.1007\/s00784-023-04934-2"}],"container-title":["Operative 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