Basic Research—Technology
Effect of Fiber Post and Cusp Coverage on Fracture
Resistance of Endodontically Treated Maxillary Premolars
Directly Restored with Composite Resin
Narmin Mohammadi, DDS, MSD,* Mehdi Abed Kahnamoii, DDS, MSD,*
Parnian Karimi Yeganeh, DDS, MSD,† and Elmira Jafari Navimipour, DDS, MSD*
Abstract
Introduction: There are different reinforcement
methods in restoring root-filled teeth. The aim of this
in vitro study was to evaluate the effect of fiber post
and cusp coverage on fracture resistance of endodonti-
cally treated maxillary premolars directly restored with
composite resin. Methods: Seventy-five maxillary
premolars were divided into 5 groups (n = 15). Except
for the control group (intact teeth), in other groups me-
sio-occlusodistal (MOD) cavities were prepared after
endodontic treatment. In the groups with cusp
coverage, both buccal and lingual cusps were reduced
up to 2 mm. Then specimens in the experimental groups
were prepared as follows: composite resin restoration
without post and cusp capping, composite resin restora-
tion without post but with cusp capping, composite
resin restoration with post but without cusp capping,
and composite resin restoration with post and cusp
capping. After finishing and polishing, the specimens
were stored in distilled water at 37 C for a week. Subse-
quent to thermocycling and exertion of compressive
forces parallel to the long axes of the teeth at a strain
rate of 2 mm/min, data were analyzed by using one-
way analysis of variance and c2 test. Results: There
were no significant differences in fracture resistance
between the groups (P = .057). However, c2 test
showed statistically significant differences between
the groups in failure mode (P < .001). The highest
number of favorable fractures was observed in the
control group (intact teeth). Conclusions: Root-filled
maxillary premolars, restored with direct resin composite
with or without fiber post and cusp capping, had similar
fracture resistance under static loading. (J Endod
2009;35:1428–1432)
Key Words
Composite resin, cusp coverage, endodontically treated
maxillary premolars, fiber-reinforced post, fracture resis-
tance
From the *Department of Operative Dentistry, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran; and †Department of Operative Dentistry, School
of Dentistry, Ghazvin University of Medical Sciences, Ghazvin, Iran.
Address requests for reprints to Dr Elmira Jafari Navimipour, Tabriz University of Medical Sciences, Department of Operative Dentistry, Tabriz, Iran. E-mail address:
elmiranavimi@yahoo.com.
0099-2399/$0 - see front matter
Copyright ª 2009 American Association of Endodontists.
doi:10.1016/j.joen.2009.07.010
1428 Mohammadi et al.
R estoring nonvital teeth is a major challenge for dental practitioners because it
requires profound knowledge in endodontics, periodontics, and operative
dentistry. Among these factors, restorative treatment for endodontically treated teeth
might be the most important. A good-quality coronal restoration significantly increases
the success rate of an endodontic treatment that is carried out well (1, 2).
Traditionally, custom-cast post and cores, covered by metal or porcelain fused to
metal crowns, were the restorations of choice. In the early 1970s prefabricated metal
posts used in combination with direct composite cores became available and enabled
the clinicians to use them without the necessity of removing tooth structure for elimi-
nation of undercuts in the pulp chamber (3). Recently there has been a clearly observ-
able transition toward the use of fiber-reinforced resin-based composite posts, used
with composite resin buildups, especially with the teeth in esthetic zone such as maxil-
lary premolars (3–5).
Generally, placement of a post is indicated whenever the coronal tooth structure is
insufficient in quality and quantity to support a core buildup. Although posts and cores
used to restore pulpless teeth should be strong in the face of mechanical stress, it is
preferred that the post, regardless of its construction material, should fail instead of
tooth tissue. Tooth-colored fiber posts are useful because they provide esthetic means
of building up a post and core at chairside. There is also the advantage of compatibility
between the flexibility of the tooth and post structure (5). Some investigators claim fiber
posts increase resistance of endodontically treated teeth, whereas others believe that
fiber posts do not strengthen the teeth; they can only reduce the incidence of cata-
strophic fracture modes (5, 6–8).
Sometimes in direct composite resin fillings for endodontically treated teeth, there
are residual compromised cusps, which are theoretically indicated for reduction and
coverage with restorative materials (9). However, with recent advances in adhesive
restorations, a concept of minimal intervention dentistry has been introduced to
preserve the tooth structure as much as possible (10, 11). It has been advocated in
some studies that with direct and indirect adhesive techniques, the internal strength
of teeth can be reinforced without occlusal capping (2, 11).
Fracture of endodontically treated premolars is a common problem in clinical
settings, and numerous reports have documented a high incidence of fracture for
endodontically treated maxillary premolars (11–13). As a result, different reinforce-
ment methods for these teeth have been studied, such as use of horizontal pins with
composite restorations and splinting cusps with composite fibers (14, 15). Because
the majority of dental practitioners routinely restore root-filled maxillary premolars
with fiber posts and cusp coverage in the clinic and there is controversy in this regard,
JOE — Volume 35, Number 10, October 2009
 Basic Research—Technology
TABLE 1. Fracture Resistance of the Groups in Newtons
Group Characteristics No. Mean ± SD Minimum Maximum
1 Post (–), cusp capping (–) 15 802.87  227.84 525 1339
2 Post (–), cusp capping (+) 15 1115.47  340.12 593 1710
3 Post (+), cusp capping (–) 15 935.00  279.94 534 1623
4 Post (+), cusp capping (+) 15 999.07  200.17 728 1478
5 Intact teeth 15 1001.80  345.22 360 1511
F4,70 = 2.41, P = .057.

the present in vitro study was designed to evaluate the effect of the
factors mentioned on fracture resistance of these teeth. The null hypoth-
esis postulated that fiber post and/or cusp coverage cannot affect frac-
ture resistance of endodontically treated maxillary premolars directly
restored with composite resin.
Materials and Methods
Seventy-five noncarious single-rooted maxillary premolars with
mature apices, extracted for orthodontic reasons, were selected. The
inclusion criteria indicated that the teeth should have nearly similar
crown and root sizes and no cracks under transillumination. A hand
scaling instrument was used for surface debridement of the teeth, fol-
lowed by cleaning with a rubber cup and slurry of pumice. The speci-
mens were stored in 0.5% chloramine-T trihydrate for infection control
and prevention of dehydration. Then the teeth were randomly divided
into 5 groups, each containing 15 teeth.
Endodontic treatment was carried out in all the groups except for
the control group (intact teeth). Therefore, standard access cavities
were prepared, followed by preparation of the canals up to 1 mm
from the radiographic apex. The root canal of each tooth was instru-
mented by using passive step-back technique to K-file #35 (MANI
Inc, Tochigi, Japan) at the apical constriction and obturated by lateral
condensation of gutta-percha (Ariadent, Tehran, Iran) and sealer (AH
26; Dentsply DeTrey, GmbH, Konstanz, Germany).
Class II mesio-occlusodistal (MOD) cavities were prepared with
the gingival cavosurface margin located 1.5 mm coronal to the cemen-
toenamel junction (CEJ). The buccolingual dimension of mesial and
distal boxes was 4 mm. Thus, residual thickness of buccal and lingual
cusps at height of contour was 2.5  0.2 mm. The cavosurface angle in
all the walls was 90 degrees. In the groups with cusp capping, both
buccal and lingual cusps were reduced up to 2 mm.
In the first group (post [–], cusp capping [–]), the whole
prepared teeth were etched with 35% phosphoric acid (Scotch Bond
Etchant; 3 M ESPE, St Paul, MN) for 15 seconds. After rinsing the teeth
for 2–5 seconds and removing the excess water, bonding agent was
applied according to manufacturer’s instructions (Adper Single
Bond; 3 M ESPE) and cured for 10 seconds by using a light-curing
unit (Astralis 7; Ivoclar Vivadent AG, FL-9494, Schaan, Liechtenstein).
After fixation of matrix band with a retainer, A2-shaded hybrid resin
diameter of 1 mm and double-tapered design, by using Peeso reamers
#1 and #2 (Dentsply Maillefer, Ballaigues, Switzerland) for removing
gutta-percha and special drills suggested by manufacturer for canal
shaping up to 8 mm apical to CEJ. Therefore, the remaining apical
gutta-percha was 3–5 mm. To bond the post, each canal was etched
with 35% phosphoric acid for 15 seconds, rinsed with water spray
for 10 seconds, and dried with paper points. Subsequently, bonding
agent (Adper Single Bond) was applied in the canal according to manu-
facturer’s instructions. For post preparation, the same bonding agent
was applied on the post surface. Adhesive resin cement (Rely X ARC;
3 M ESPE) was mixed and placed in the canal by using a lentulo spiral
(Dentsply Maillefer). Then additional resin cement was applied to the
total post surface. Subsequently, the post was seated in place by using
finger pressure for 10 seconds, and excess cement was removed with
a brush. The cement was light-cured for 20 seconds from the occlusal
direction via the post.
In the fourth group (post [+], cusp capping [+]), the teeth
received a post in a similar manner as in the third group and were filled
in a manner described for the second group.
In the fifth group, intact teeth without any preparation were used as
controls.
All the restored specimens were finished, polished, and then
stored in distilled water at 37 C for a week. Then the specimens
were subjected to thermocycling at 5 C  2 C to 55 C  2 C with
30 seconds dwell time and 5 seconds for transfer for 500 cycles. After
that, all the specimens were embedded in cold-cured acrylic resin up to
1.5 mm apical to the CEJ. Fracture resistance was evaluated in
a universal testing machine (H5 K-S model; Hounsfield Test Equipment,
Ltd., Surrey, England). The compressive force was applied to the long
axes of the teeth toward the central fossae of the crowns by using
a 2-mm-diameter round tip load cell at a strain rate of 2 mm/min until
fracture occurred. After fracture all the specimens were evaluated for
15 15
14
13
Failure Modes
12 12
Favorable
Unfavorable
9 9
Count

composite (Filtek Z 250; 3 M ESPE) was placed by using an oblique

layering technique. The thickness of each layer was 1.5–2 mm and 6 6

was light-cured for 40 seconds. After removal of matrix band and

retainer, post-curing was carried out on buccal and lingual aspects 3 3
of the boxes for 40 seconds on each side. 2
1
In the second group (post [–], cusp capping [+]), a similar
0
procedure was used as in the first group. However, the reduced
P(-) P(-) P(+) P(+) Intact teeth
cusps were covered by 2-mm thicknesses of composite resin on CC(-) CC (+) CC(-) CC (+)
each cusp. Group
In the third group (post [+], cusp capping [–]) before the resto-
ration procedure, the root canal was prepared to receive a quartz fiber– Figure 1. Favorable and unfavorable fracture modes regarding the number of
reinforced post (DT light post #2; RTD, St Egreve, France) with a head fractures are shown at the top of each bar (P, post; CC, cusp capping).

JOE — Volume 35, Number 10, October 2009 Fracture Resistance of Endodontically Treated Maxillary Premolars 1429
Basic Research—Technology
Figure 2. Photographs of 2 types of fracture patterns in the groups: (A) favorable fracture; (B) unfavorable fracture.
failure mode. Favorable failures were defined as fractures above CEJ or
1 mm or less apical to CEJ. Unfavorable failures were defined as frac-
tures more than 1 mm apical to CEJ.
Data were expressed as mean  standard deviation (SD) and
frequency (%). Kolmogorov-Smirnov statistical test was used for testing
normality of continuous variables. Data were analyzed with one-way
analysis of variance to compare the fracture resistance, and c2 test
was used to compare the failure modes of the specimens. A P value
less than .05 was considered statistically significant.
Results
The means of fracture resistance of all the groups are listed in
Table 1. According to the results, there were no statistically significant
differences between the mean fracture resistance of the groups (F4,70 =
2.41, p = .057). Therefore the null hypothesis was accepted.
As to the patterns of fracture, c2 test showed that the differences
between the groups were statistically significant (c2 = 40.27, df = 4,
p < .001). The highest number of favorable fractures (80%) was
observed in group 5 (intact teeth). In group 3 with post but without
cusp capping, the favorable and unfavorable modes were approximately
equal, and in other groups most of the fractures were unfavorable (Figs.
1 and 2).
Discussion
Endodontically treated teeth demonstrate a lower fracture resis-
tance in the face of a myriad of intraoral forces because of coronal
destruction from dental caries, fractures, and previous restorations
or endodontic techniques (16). Restorative procedures must recon-
struct these teeth, compensate the reduced fracture resistance, and
provide an effective seal between the canal system and mouth (17).
There are different treatment plans for restoring endodontically treated
teeth. In the present study, the effect of fiber post and cusp coverage on
fracture resistance of endodontically treated maxillary premolars
restored with direct composite resin was evaluated.
In the current study we used adhesive luting agent (Rely X ARC) for
cementation of quartz fiber posts (DT light post), placed into post space
by using lentulo spiral. The cement was applied onto the non-silanized
post surface before post placement as well. According to the results of
previous studies, adhesive post cementation is much more reliable to
withstand simulated functional forces compared with nonadhesive
approaches, and silanization of DT light post surface has no significant
1430 Mohammadi et al.
effect on bond strength of the fiber post to dentin (18, 19). On the other
hand, it has been stated that using lentulo spiral or applying the cement
onto the post surface or injecting the material with a syringe cannot
significantly affect the bond strength of fiber post to the apical part of
post space (20).
The results of our study did not demonstrate any significant differ-
ences in fracture resistance among the groups regarding fiber post
placement and/or cusp coverage (p = .057). The finding that restored
root-filled maxillary premolars without a fiber post showed similar frac-
ture resistance to those with a post is consistent with a number of other
studies (2, 3, 7), which might be attributed to the fact that because more
tooth structure is removed during post placement, the resistance to
occlusal forces is diminished, and the possibility of fracture increases
(16). In addition, endodontic treatment and preparing the root canal
to receive a post might lead to cracks and defects that can concentrate
stresses and increase the possibility of tooth fracture (21). On the other
hand, it has been claimed that adhesive restorations transmit and
distribute functional stresses across the bonding interface to the tooth
more properly, with the potential to reinforce weakened tooth structure
(22). Therefore, it seems that even without fiber post placement, it is
possible to dissipate occlusal forces in a wide surface area as a result
of micromechanical adhesion, rendering the tooth more resistant
against forces. However, in contrast to our results, it has been reported
that fiber posts provide significantly higher fracture resistance in inci-
sors with indirect all-ceramic crowns or veneers (23, 24). In another
study, Soares et al (6) showed that glass fiber posts do not restore the
lost fracture resistance in endodontically treated mandibular premolars
with major tooth structure loss and actually reduce fracture resistance
in cases of moderate structure loss when the tooth is restored with
direct composite resin. These inconsistencies might be attributed to
the type of crown restorative material, the type of teeth, and the direction
of the load applied, which are different in these studies.
In our study, coverage of the cusps with composite led to higher
fracture resistance in MOD preparations of root-filled maxillary premo-
lars; however, this increase was not statistically significant (p = .057).
In this regard, our results are consistent with the results of some other
studies (2, 11, 25). The reason for the tendency of onlay composite
restoration to receive higher load might be attributed to dispersion of
compressive stresses in onlays, whereas it tends to concentrate in the
case of inlays. On the other hand, composite has a low modulus of elas-
ticity and transmits less of the applied load to the underlying tooth struc-
ture (26). However, it seems that in our study, considering the splinting
JOE — Volume 35, Number 10, October 2009

of cusps by composite restoration, the possibility of cuspal fracture
caused by cuspal deflection was decreased even without cusp coverage.
These results justify the observations of Mannocci et al (25). They re-
ported that the clinical success rates of endodontically treated premo-
lars with limited loss of tooth structure, restored with fiber posts and
direct composite restorations without cuspal overlay, were equivalent
to a similar treatment of full coverage with metal-ceramic crowns after
3 years of clinical service. In contrast, in the study of Soares et al (6),
reduction of cusps and coverage by composite resin reduced fracture
resistances in mandibular premolars. However, the amount of reduc-
tion in that study was greater than in our study.
Regarding failure mode, the differences between the groups were
significant (p < .001). The highest percentage of favorable fracture
mode (80%) was observed in group 5 (intact teeth). This might be
related to the fact that in intact teeth the structural continuity has
been maintained, so the forces applied do not concentrate in any partic-
ular area and are uniformly distributed in dentin (27). On the other
hand, the reason for the greater number of unfavorable fractures in
other groups might be the concentration of unfavorable stress gradients
on the base of scraped cusps, where most of the forces meet (28). In
addition, in teeth restored with composite, the stresses from polymer-
ization shrinkage of composite can affect failure mode, compared with
intact teeth (29). In group 3 (post [+], cusp capping [–]), 40% of frac-
tures were favorable, which is higher than those in other experimental
groups. This means that although using fiber post might not increase
fracture resistance, it might create a higher incidence of more favorable
and re-restorable failure modes. This finding is consistent with the
results of some other studies (6, 30, 31). In a study Salameh et al
(32) suggested that in root-filled upper premolars covered with all-
ceramic crowns, placement of fiber posts is necessary to improve
fracture resistance and fracture pattern of teeth from unrestorable to
restorable patterns. However, they reported that even without fiber
post, all crown designs resisted vertically applied forces beyond those
that might be encountered in the mouth. On the other hand, some
studies might not show any improvement in failure mode of maxillary
premolars after fiber post placement (3).
In the present study, the means of fracture resistance in all the
groups were higher than normal bite forces exerted on maxillary
premolars, which is in the range of 100–300 N (33). Because static
laboratory tests such as measuring fracture resistance in the manner
carried out by our study do not always simulate dynamic oral conditions
in which the forces are constantly changing their rate, magnitude, and
direction and because of the variety of cavity designs in the clinical situ-
ations, it must be pointed out that long-term clinical evaluation of this
correlation should be carried out (34, 35).
Summary
Within the limits of this laboratory investigation, root-filled maxil-
lary premolars with MOD preparations restored with direct resin
composite, with or without fiber post and cusp capping, had similar
fracture resistance under static loading. However, clinical studies are
required to confirm these findings.
Acknowledgments
This project was carried out by the financial support from the
Deputy Dean of Research at Tabriz University of Medical Sciences.
The authors thank Dr Morteza Ghojazadeh for statistical analysis of
the data and Dr Majid Abdolrahimi, who edited the English manu-
script of this article.
JOE — Volume 35, Number 10, October 2009
Basic Research—Technology
References
1. Wagnild G, Muller K. Restoration of endodontically treated teeth. In: Cohen S,
Hargreaves KM, eds. Pathways of the pulp. 9th ed. St Louis: Mosby Co, 2006:
786–821.
2. Krejci I, Duc O, Dietschi D, de Campos E. Marginal adaptation, retention and frac-
ture resistance of adhesive composite restorations on devital teeth with and without
posts. Oper Dent 2003;28:127–35.
3. Fokkinga WA, Le Bell AM, Kreulen CM, Lassila LV, Vallittu PK, Creugers NH. Ex vivo
fracture resistance of direct resin composite complete crowns with and without
posts on maxillary premolars. Int Endod J 2005;38:230–7.
4. Christensen GJ. Post concepts are changing. J Am Dent Assoc 2004;135:1308–10.
5. Qualtrough AJE, Mannocci F. Tooth-colored post systems: a review. Oper Dent
2003;28:86–91.
6. Soares CJ, Soares PV, de Freitas Santos-Filho PC, Castro CG, Magalhaes D, Versluis A.
The influence of cavity design and glass fiber posts on biomechanical behavior of
endodontically treated premolars. J Endod 2008;34:1015–9.
7. Siso SH, Hürmüzlü F, Turgut M, Altundas xar E, Serper A, Er K. Fracture resistance of
the buccal cusps of root filled maxillary premolar teeth restored with various tech-
niques. Int Endod J 2007;40:161–8.
8. Stockton L, Lavelle CLB, Suzuki M. Are posts mandatory for the restoration of
endodontically treated teeth? Endod Dent Traumatol 1998;14:59–63.
9. Roberson TM. Fundamentals in tooth preparation. In: Roberson TM, Heymann HO,
Swift EJ Jr., eds. Sturdevant’s art and science of operative dentistry. 5th ed. St Louis:
Mosby Co, 2006:281–321.
10. Mount GJ, Ngo H. Minimal intervention: a new concept for operative dentistry. Quin-
tessence Int 2000;31:527–33.
11. Yamada Y, Tsubota Y, Fukushima S. Effect of restoration method on fracture resis-
tance of endodontically treated maxillary premolars. Int J Prosthodont 2004;17:
94–8.
12. Testori T, Badino M, Castagnola M. Vertical root fractures in endodontically treated
teeth: a clinical survey of 36 cases. J Endod 1993;19:87–90.
13. Tamse A, Fuss Z, Lustig J, Kaplavi J. An evaliuation of endodontically treated vertically
fractured teeth. J Endod 1999;7:506–8.
14. Oskoee SS, Oskoee PA, Navimipour EJ, Shahi S. In vitro fracture resistance of
endodontically-treated maxillary premolars. Oper Dent 2007;32:510–4.
15. Oskoee PA, Ajami AA, Navimipour EJ, Oskoee SS, Sadjadi J. The effect of three
composite fiber insertion techniques on fracture resistance of root-filled teeth. J En-
dod 2009;35:413–6.
16. Assif D, Gorfil C. Biomechanical considerations in restoring endodontically treated
teeth. J Prosthet Dent 1994;71:565–7.
17. Belli S, Erdemir A, Ozcopur M, Eskitascioglu G. The effect of fiber insertion on frac-
ture resistance of root filled molar teeth with MOD preparations restored with
composite. Int Endod J 2005;38:73–80.
18. Naumann M, Sterzenbach G, Rosentritt M, Beuer F, Frankenberger R. Is adhesive
cementation of endodontic posts necessary? J Endod 2008;34:1006–10.
19. Wrbas KT, Altenburger MJ, Schirrmeister JF, Bitter K, Kielbassa AM. Effect of adhe-
sive resin cements and post surface silanization on the bond strengths of adhesively
inserted fiber posts. J Endod 2007;33:840–3.
20. D’Arcangelo C, D’Amario M, De Angelis F, Zazzeroni S, Vadini M, Caputi S. Effect of
application technique of luting agent on the retention of three types of fiber-rein-
forced post systems. J Endod 2007;33:1378–82.
21. Cailleteau JG, Rieger MR, Akin JE. A comparison of intracanal stresses in a post-
restored tooth utilizing the finite element method. J Endod 1992;18:540–4.
22. Meerbeek BV, Landuyt KV, De Munck J, et al. Bonding to enamel and dentin. In:
Summitt JB, Robbins JB, Hilton TJ, Schwartz RS, eds. Fundamentals of operative
dentistry: a contemporary approach. 3rd ed. Chicago: Quintessence, 2006:200–1.
23. Rosentritt M, Sikora M, Behr M, Handel G. In vitro fracture resistance and marginal
adaptation of metallic and tooth-coloured post systems. J Oral Rehabil 2004;31:
675–81.
24. D’Arcangelo C, De Angelis F, Vadini M, Zazzeroni S, Ciampoli C, D’Amario M. In vitro
fracture resistance and deflection of pulpless teeth restored with fiber posts and
prepared for veneers. J Endod 2008;34:838–41.
25. Mannocci F, Bertelli E, Sherriff M, Watson TF, Ford TRP. Three-year clinical
comparison of survival of endodontically treated teeth restored with either full
cast coverage or with direct composite restoration. J Prosthet Dent 2002;88:
297–301.
26. Brunton PA, Cattell P, Burke FJ, Wilson NH. Fracture resistance of teeth restored with
onlays of three contemporary tooth-colored resin-bonded restorative materials.
J Prosthet Dent 1999;82:167–71.
27. Oliveira FC, Denehy GE, Boyer DB. Fracture resistance of endodontically prepared
teeth using various restorative materials. J Am Dent Assoc 1987;115:57–60.
28. Goel VK, Khera SC, Gurusami S, Chen RC. Effect of cavity depth on stresses in
a restored tooth. J Prosthet Dent 1992;67:174–83.
Fracture Resistance of Endodontically Treated Maxillary Premolars 1431
Basic Research—Technology
29. Ausiello P, Apicella A, Davidson CL. Effect of adhesive layer properties on stress
distribution in composite restorations: a 3D finite element analysis. Dent Mater
2002;18:295–303.
30. Newman MP, Yaman P, Dennison J, Rafter M, Billy E. Fracture resistance of endodon-
tically treated teeth restored with composite posts. J Prosthet Dent 2003;89:360–7.
31. Sorrentino R, Salameh Z, Zarone F, Tay FR, Ferrari M. Effect of post-retained
composite restoration of MOD preparations on the fracture resistance of endodon-
tically treated teeth. J Adhes Dent 2007;9:49–56.
32. Salameh Z, Sorrentino R, Ounsi HF, et al. Effect of different all-ceramic crown
system on fracture resistance and failure pattern of endodontically treated maxil-
1432 Mohammadi et al.
lary premolars restored with and without glass fiber posts. J Endod 2007;33:
848–51.
33. Jantarat J, Palamara JE, Messer HH. An investigation of cuspal deformation and
delayed recovery after occlusal loading. J Dent 2001;29:363–70.
34. Molinaro JD, Diefenderfer KE, Strother JM. The influence of a packable resin
composite, conventional resin composite and amalgam on molar cuspal stiffness.
Oper Dent 2002;27:516–24.
35. Hofmann N, Just N, Haller B, Hugo B, Klaiber B. The effect of glass ionomer cement
or composite resin bases on restoration of cuspal stiffness of endodontically-treated
premolars in vitro. Clin Oral Investig 1998;2:77–83.
JOE — Volume 35, Number 10, October 2009