Background: Large mesio-occluso-distal (MOD) cavities significantly weaken posterior teeth, increasing the risk of deformation and fracture. Fibre reinforcement techniques have been proposed to improve the biomechanical behaviour of composite restorations. Aim: To evaluate and compare the stress distribution and deformation patterns of MOD-restored premolars using direct composite alone, horizontal fibre post, fibre-reinforced direct composite, and a combined reinforcement technique. Materials and methods: Four three-dimensional (3D) finite element models of a maxillary premolar were generated and restored with different reinforcement strategies. Static occlusal load of 300 N was applied, and Von Mises stresses, deformation values, and stress localisation were analysed. Stress patterns were compared across enamel, dentin, periodontal ligament, restorative materials, and reinforcement fibres. Results: Direct composite exhibited unfavourable stress concentration at the buccal and palatal cusp inclines and cervical region. Horizontal fibre posts effectively splinted cusps and redirected stresses away from marginal ridges. Ribbond fibre resulted in more uniform stress distribution with reduced cusp stress. The combined technique produced the lowest deformation (3.721 µm) and most favourable stress distribution, with minimal stress at cusp tips, cervical regions, and internal line angles. Conclusion: Fibre reinforcement improved stress distribution in MOD restorations, with the combined technique providing the most favourable biomechanical outcome. Incorporating Ribbond and horizontal posts may enhance restoration longevity and reduce fracture risk in structurally compromised premolars. Clinical significance: Fibre-reinforced techniques offer a viable option for restoring extensive MOD cavities, improving cuspal stability, and reducing stress-induced failure.
Arora et al. (Mon,) studied this question.
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