Nezir, MerveDinctuerk, Beyza ArslandasSari, CeydaAlp, Cemile KediciAltinisik, Hanife2024-06-122024-06-1220241432-69811436-3771https://doi.org/10.1007/s00784-024-05720-4https://hdl.handle.net/20.500.14551/19406Objective This study aimed to evaluate the fracture strength of teeth restored using fiber-reinforced direct restorative materials after endodontic treatment with a conservative mesio-occlusal access cavity design. Materials and methods A total of 100 extracted intact mandibular first molars were selected and distributed into a positive control group where teeth left intact and the following four test groups comprised of teeth with conservative mesio-occlusal access cavities that had undergone root canal treatment (n = 20/group): access cavity without restoration (negative control), bulk-fill resin composite with horizontal glass fiber post reinforcement, fiber-reinforced composite with bulk-fill resin and bulk-fill resin composite. Following thermocycling (10,000 cycles), fracture resistance was measured using a universal testing machine. Statistical analyses (one-way analysis of variance and the Tamhane test) were performed, and statistical significance was set at p < 0.05. Results Groups with minimally invasive access cavities had lower fracture strength than intact teeth, regardless of the restoration material (p < 0.05). Fiber-reinforced composite groups demonstrated higher fracture strength than bulk-fill resin composite alone (p < 0.05). Fracture types varied among groups, with restorable fractures predominant in the fiber-reinforced composite groups. Conclusion This study suggests that using fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, can effectively enhance the fracture strength of endodontically treated teeth with conservative access cavities. However, using only bulk-fill resin composite is not recommended based on the fracture strength results. Clinical significance When teeth that undergo endodontic treatment are restored using a conservative access cavity design and fiber-reinforced composite materials, especially in combination with bulk-fill resin composites, the fracture strength of the teeth can be effectively increased.en10.1007/s00784-024-05720-4info:eu-repo/semantics/openAccessBulk-FillFiberAccess CavityEndodontic TreatmentResin CompositeLong-Term SurvivalBond StrengthResin CompositeBiomechanical BehaviorMaxillary PremolarsAdhesive SystemsAccess CavitiesGlass-FiberTeethDentinArticle286N/AWOS:00122417820000238750289