Background: This study evaluated the influence of different fiber formulations incorporation in resin composite on cuspal deflection (CD) of endodontically-treated teeth with mesio-occluso-distal (MOD) cavities. Materials and Methods: Thirty-two freshly extracted maxillary premolar teeth received MOD cavity preparation followed by endodontic treatment using single cone obturation technique, and divided into: Group I: direct composite resin only using a centripetal technique, Group II: direct composite resin with short fiber-reinforced composite (everX Flow), Group III: direct composite resin with leno wave ultra-high molecular weight polyethylene (LWUHMWPE) fibers placed on the cavity floor, and Group IV: direct composite resin with LWUHMWPE fibers placed circumferentially around the cavity walls (wallpapering technique). The CD was measured using a novel digital evaluation method, whereby each tooth was scanned by a desktop scanner (Medit T710) at three different time intervals: before and after cavity preparation, and after restoration. The intercuspal distance (ICD) was measured digitally in μm at each interval using Medit compare metrology software, followed by measurement of the CD by subtracting the ICD after cavity preparation; and after restoration from the before preparation one to obtain the “after cavity preparation CD1” and “the after restoration CD2”, respectively. The data were analyzed using one-way ANOVA and Tukey HSD tests at a significance level of 0.05. Results: The highest CD was recorded in Group I with statistically significant differences with all other groups (P<0.05). No statistically significant differences were found between the other groups (Groups II, III, and IV) (P>0.05). Conclusions: There was an inward deflection of the cusps in all groups following cavity preparation and restoration as elicited by the negative CD1 and CD2 values. The incorporation of fibers, regardless of their type or orientation, resulted in a significant reduction in CD of endodontically treated premolar teeth as compared with those restored with resin composite alone.