Aim: This study aimed to compare the fracture resistance of endodontically treated premolars restored by alkasite cement (Cention N), composite resin, and glass ionomer cement (GIC). Materials and Methods: Fifty freshly extracted mandibular and maxillary premolars with typical morphology were selected and mounted on acrylic cylinders. Five groups were made with ten teeth in each group as follows: Group A: intact teeth with no restoration (control); Group B: unfilled teeth with prepared mesio-occluso-distal (MOD) cavity; Group C: Teeth with MOD cavity restored with nanohybrid composite; Group D: Teeth with MOD cavity restored with type IX GIC; and Group E: Teeth with MOD cavity restored with Cention N. Root canal treatment was done for groups B, C, D, and E after MOD cavity and before placement of the coronal filling. The specimens were mounted on a universal testing machine, and load was applied until the specimen fractured. The values were tabulated and subjected to statistical analysis. Results: The mean value of fracture resistance was highest in Group A (2015 N) followed by Group C (1504 N) and Group E (1319 N). Groups D and B showed the lowest reading. However, there was no statistical difference between Groups C and E. Conclusions: Within the limitations of the study, it can be concluded that composite is the material of choice for restorations in endodontically treated tooth. Alkasite cement can be used as an alternative to composite resin due to ease of manipulation.
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