Back molar cavity
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Understanding Back Molar Cavities: Fracture Resistance and Restoration Techniques
Impact of MOD Cavity Preparation on Molar Teeth
MOD Cavity Weakening
Molar teeth with MOD (mesial-occlusal-distal) cavity preparations experience a significant reduction in cuspal stiffness, weakening by up to 63% and often leading to cuspal fractures1. This weakening necessitates effective restoration techniques to restore the structural integrity of the tooth.
Restoration Techniques for MOD Cavities
Direct Composite Restorations
Research indicates that molar teeth with MOD cavities of 3 mm or shallower can be restored to their physiological fracture strength using direct composite restorations. However, for cavities deeper than 5 mm, direct composite restorations fail to restore the teeth to their original fracture strength1. This suggests that while direct composite restorations are effective for shallower cavities, alternative methods may be required for deeper cavities.
Glass Fibre Reinforcement
Another study evaluated the use of unidirectional and woven glass fibre tapes in MOD cavity preparations of root-filled molar teeth. The results showed that the inclusion of glass fibres did not significantly enhance fracture resistance compared to composite resin restorations alone2. Both unidirectional and woven fibres showed a tendency for fractures to occur at the pulp chamber floor, compromising tooth integrity2.
Comparative Analysis of Restoration Methods
Effectiveness of Composite Restorations
For MOD cavities up to 3 mm deep, direct composite restorations are effective in restoring fracture resistance to levels comparable to intact natural teeth1. This makes them a viable option for less extensive cavities.
Limitations of Fibre Reinforcement
The addition of glass fibres, whether unidirectional or woven, does not provide a significant advantage over composite resin alone in terms of fracture resistance2. This indicates that while fibre reinforcement might be considered, it does not offer a substantial benefit and may lead to fractures that compromise the tooth's structural integrity.
Conclusion
In summary, for back molar cavities, particularly those with MOD preparations, direct composite restorations are effective for cavities up to 3 mm deep. For deeper cavities, alternative restoration methods need to be explored as direct composite restorations and fibre reinforcements do not restore the teeth to their original fracture strength. Understanding these limitations is crucial for dental practitioners in choosing the most appropriate restoration technique to ensure the longevity and integrity of molar teeth.
Sources and full results
Most relevant research papers on this topic
In Vitro Fracture Resistance of Adhesively Restored Molar Teeth with Different MOD Cavity Dimensions
Direct composite restorations can restore 3 mm or shallower MOD cavities to physiological fracture strength, while deeper cavities cannot, and cusp thickness does not significantly influence fracture strength.
Fracture resistance of root filled molar teeth restored with glass fibre bundles.
Glass fibers inserted into MOD cavity preparations and restoring with composite resin do not significantly impact fracture resistance of root filled molar teeth.
RCTCost-effectiveness of managing cavitated primary molar caries lesions: A randomized trial in Germany.
The Hall Technique is more cost-effective than Non-Restorative Cavity Control and conventional carious tissue removal and restoration for managing cavitated caries lesions in primary molars, yielding better dental health outcomes at lower costs.
RCTEffect of Caries Experience in Primary Molars on Cavity Formation in the Adjacent Permanent First Molar
Cavity formation in permanent first molars is influenced by the status of adjacent primary molars, with the second deciduous molar having the most pronounced effect.
Management of Retained Primary Teeth in Adult Patient: Case Report
Pulpectomy and gutta percha restoration effectively treated a retained primary tooth in an adult patient with apical periodontitis.
Case ReportThe radix entomolaris in mandibular first molars: an endodontic challenge.
Mandibular first molars with an additional distolingual root (radix entomolaris) are more common in Caucasian patients, requiring modified access and special endodontic techniques.
Highly CitedThe Effects of Endodontic Access Cavity Preparation Design on the Fracture Strength of Endodontically Treated Teeth: Traditional Versus Conservative Preparation
Traditional endodontic cavity preparation (TEC) and conservative endodontic cavity (CEC) methods both improve fracture strength of endodontically treated teeth, with SDR bulk-fill composite being more effective than EverX Posterior.
RCTHighly Cited