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Materials and Methods: Fifty sound human maxillary premolar teeth were used in this in vitro study. Teeth were divided randomly into one control group and four experimental groups of ten teeth each; Group A: Restored with direct composite veneer (Filtek Z250 XT), Group B: Restored with indirect composite veneers (Filtek Z250 XT), Group C: Restored with lithium disilicate ceramic CAD/CAM blocks (IPS e. max CAD) and Group D: Restored with resin nano ceramic CAD/CAM blocks (Lava Ultimate Restorative). Standard preparations were done using Ceramic Veneer Set (Komet). Indirect laminate veneers were cemented with the Relyx Veneer Cement (3M ESPE) and all specimens were stored in distilled water at 37Â°C for 2 weeks. The load was applied on the occlusal part of the veneer at 45Ëš to long axis of the tooth using universal testing machine. Results were analyzed with one-way ANOVA and LSD tests. Specimens were examined by stereomicroscope at a magnification of 20x to evaluate the mode of failure.
Results: Control group showed higher mean of fracture strength with highly significant difference in comparison to the experimental groups (P<0.01). (Group A) showed higher mean of fracture strength with statistically significant difference in comparison to (Group B and Group D). On the other hand the difference between (Group A and Group C) was statistically highly significant. Statistically non-significant difference was found among the three indirectly restored groups.
Conclusions: All veneers used in this study can be considered as acceptable treatment in the premolars region for patients with normal biting force. Direct composite veneer is the most favorable technique in term of fracture strength, while IPS e. max CAD laminate veneers were least likely to fracture and most likely to completely debond.
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