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Objectives: This retrospective study aimed to investigate the effect of an additional cervical lesion on the rate of survival without fracture in endodontically treated teeth (ETT) with exposed occluso-proximal cavity and restored with direct resin composite, and to identify the predisposing factors of fracture.
Materials and Methods: Clinical and radiographic records of patients who received endodontic treatment and direct resin composite restoration in premolars during 2011-2020 were reviewed. Data regarding premolar ETT with exposed occluso-proximal cavity- with (CII+V) and without (CII) the cervical lesion, were analyzed. Incidences of postoperative fracture were identified and categorized into ‘restorable’ or ‘non-restorable’. Cumulative survival rates of CII and CII+V were compared using Kaplan-Meier survival analysis and log-rank test (p-value = 0.05). Cox proportional hazard model was used to identify any potential risk factors for fracture.
Results: In the 102 premolar ETT analyzed from 89 patients, 53 and 49 teeth were CII and CII+V, respectively. With a recall period of 30.7±16.4 months, no significant difference in the cumulative survival rate without fracture between CII (49/53, 92.5%) and CII+V (44/49, 89.8%). For the fractured ETT, a higher incidence of non-restorable and crown-root fracture was reported in CII+V. No predisposing factor for fracture was identified.
Conclusions: The presence of restored cervical lesion did not affect the rate of survival without fracture in premolar ETT with exposed occluso-proximal cavity and restored with resin composite.
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