Impact of various pressures on fracture resistance and microleakage of amalgam and composite restorations.

BACKGROUND: Pressure changes can influence dental restorations especially among divers. The aim of the current study was to evaluate the fracture resistance and microleakage of mesio-occluso-distal (MOD) amalgam and composite restorations undergoing pressure changes via diving and aviation simulation. METHODS: For the fracture resistance test, 60 sound maxillary premolar teeth were randomly allocated to two groups. Each group was then divided into three subgroups (n = 10) for simulating scuba-diving (pressure cycle to 203 kPa, 2 bar), flight (50.6 kPa, 0.5 bar), and control (atmospheric pressure). The teeth underwent pressure cycles for one month and then the fracture resistance test was conducted on them using the Instron testing machine. Microleakage scores were afterwards recorded by using a 2% methylene blue dye for 24 hours. RESULTS: Composite restorations showed significantly higher fracture resistance values compared to the amalgam group (P < 0.05). The control group had significantly higher fracture resistance values compared to the dive group, whereas there was no significant difference between the control group and the flight group (P = 0.083). No significant difference in the level of microleakage was observed between restoration materials or pressure cycles (P > 0.05). CONCLUSIONS: Composite restorations showed better fracture resistance compared to the amalgam group. However, diving pressure cycles demonstrated adverse effects on the fracture resistance values of both restorative materials.