The purpose of this study was to compare the fracture resistance of four posterior restorations involving an entire cusp replacement. Four groups were established, each containing eight caries-free mandibular molars, similar in size and anatomic form. A mesio-occlusal preparation including the lingual cusp was prepared on all teeth. Group A were restored with a pin-retained amalgam. Group B were restored with amalgam and a meta adhesive. Group C were restored with a composite resin with a beta-glass quartz insert. Group D were restored with composite resin and a HEMA adhesive. All specimens were mounted in acrylic and stored in artificial saliva for 30 days. Each specimen was loaded in compression at a 90° angle in an Instron testing machine with a crosshead speed of 0.5 cm/min. Results demonstrated the mean (SD) failure loads in kilograms for each group to be: A, 1155 (388); B, 1232 (436); C, 1345 (375); D, 1595 (373). Analysis of variance indicated no significant difference among groups at P < 0.05. Although the values for the composite resin restoration with the adhesive were higher than the other restorative techniques.
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