Influence of viscosity and fiber reinforcement of resin composite on fracture strength and failure mode of restored molars.

Objective: To evaluate the fracture behavior of human molars with extensive MOD restorations using short-fiber-reinforced resin composite of varying viscosities.
Materials and Methods: Human molars were randomly divided into seven groups (n = 12): intact teeth (control); restoration using conventional high-viscosity resin composite without (Filtek Z350XT, 3M) or with fibers (everX Posterior, GC); conventional low-viscosity resin composite without (Filtek Supreme Flowable, 3M) or with fibers (everX Flow Dentin Shade, GC); bulk-fill low-viscosity resin composite (Filtek Bulk Fill Flow, 3M) or with fibers (everX Flow Bulk Shade, GC). Restorations were performed on extensive MOD preparations, following the manufacturers' recommendations for each material. Specimens underwent fracture strength testing (N) and fracture pattern (%) categorized as repairable, possibly repairable, or non-repairable. Results were analyzed using a generalized linear model (N) and Fisher's exact test (%), with α = 0.05.
Results: Restorations performed with high-viscosity materials showed fracture strength values similar to the control and higher than those of restorations using low-viscosity resin composites (p < 0.0001), except for the bulk-fill low-viscosity resin composite with fibers (p > 0.05). Teeth restored using low-viscosity resin composite with fibers showed a higher % of repairable and possibly repairable fractures than the control (p = 0.0091).
Conclusions: The viscosity of materials mediated the fracture strength, with restorations using high-viscosity resin composites promoting values similar to the intact tooth; however, the presence of fibers influenced the fracture pattern.
Clinical Significance: Teeth with MOD cavities restored with high-viscosity resin composites showed similar fracture strength to intact teeth. Fiber-reinforced low-viscosity resin composite for the base of restoration resulted in a more repairable/possibly repairable fracture pattern.
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