Cuspal Flexure of Teeth with Composite Restorations Subjected to Occlusal Loading

Purpose: To measure in vitro the cuspal deflection produced by polymerization shrinkage and occlusal loading in mesio-occlusal (MO) and mesio-occlusal-distal (MOD) bonded composite restorations. Materials and Methods: Twenty first premolars were studied, attaching a small crystal ball to each cusp vertex as a reference point for intercuspal distance measurements. MO cavities were made in ten premolars and MOD cavities in the other ten. Cavities were then restored with Syntac Single adhesive and Tetric Ceram composite in two increments. A precision micrometer was used to measure intercuspal distances in unaltered teeth (baseline distance), unaltered teeth under 150 N load, restored teeth at 5 min after restoration completion, and restored teeth under 150 N load. Results: In the two study groups, both polymerization shrinkage and application of 150 N load produced a statistically significant change in intercuspal distance compared with baseline measurement. The cuspal deflection produced by 150 N load was statistically similar between unaltered and restored teeth, although polymerization shrinkage acted as a preload in the latter case (starting point was not baseline condition). The cuspal deflection produced by polymerization shrinkage and occlusal load was significantly greater in MOD than in MO restorations. Conclusion: The cuspal deflection produced by composite polymerization shrinkage and occlusal loading is significantly greater in MOD vs MO composite restorations. Keywords: occlusal loading, cuspal flexure, cuspal deflection, cusp movement, polymerization shrinkage.